The Integration Design Consortium

We’re in an exciting time, one in which a lot of leaders, educators, families, and students are engaged in advocating for a more equitable education system. Even still, young people are falling through the cracks.

It’s not their fault. We often hear about how students are failed by a broken education system, without fully acknowledging that we are the architects of the system. The onus is on us to change because getting to the outcomes we want for young people will mean transforming the way we operate. This isn’t easy and the answers aren’t straightforward. But now is the time for all of us—from educators to philanthropic foundations—to reclaim our imagination and creativity in service of our students.

In an attempt to do things differently, Carnegie Corporation of New York has partnered with the Business Innovation Factory (BIF) to design and run the Integration Design Consortium (IDC). The IDC is an experiment for the Corporation: rather than funding programmatic proof points, the IDC is giving leaders permission to test various integrative approaches to support students throughout their journey in the education system. It consists of five teams2Revolutions, Bellwether, Education First, FSG, and The Teachers Guildworking from the classroom to the statehouse to explore the structures, mindsets, and processes that can create a more equitable education system. Instead of funding these teams in isolation, Carnegie Corporation of New Yorkwith the help of BIFis supporting the IDC as a collaborative learning network, allowing teams to share insights in real time.

Teams working at the Integration Design Consortium convening

WHERE WE’VE BEEN

Since June 2017, BIF has been leading the shared learning agenda for the IDC—collecting learnings and uncovering insights from across the teams to share with the field more broadly. The collaborative structure of the IDC has allowed us to observe both what is happening in the individual projects, as well as how the five teams are engaging with one another.

We’ve used the collective structure to experiment with different ways to engage the teams—including gathering project updates and sharing them with the teams, convening teams in person for collective sensemaking, and managing self-organized, cross-project exploration groups that focus on specific areas of overlap. Testing these various ways of engaging the teams will help us understand how we might spark collaboration, inspire reflection, and encourage pivots based on real-time learnings. Ultimately, these insights can be used to create field-facing learnings and tools that can reduce fragmentation in education.

WHAT WE’VE LEARNED SO FAR

It’s been over a year and a half since we first embarked on this grand experiment, so we wanted to share some emerging questions, reflections, and curiosities we’ve had over the past eighteen months.

Patterns of Fragmentation and Integration

At our second convening that took place in January 2018, we wanted to identify the key levers to integration based on the teams’ project experiences. These real-world examples provided a breakdown of the aspects that are most vital to creating a poor or an excellent state of integration, potentially helping us see how complex systems are changing over time. 

Changing Systems Requires Continuous (Un)learning

Monthly calls with teams have allowed us to peek under the hood of the individual projects and identify common themes that point to potential learnings for the field. One insight that we’ve recognized is that there is some amount of unlearning that needs to happen in order to rethink how the system can work.

These calls have served as a touchpoint for project updates but moreso, they have allowed us to ask other questions, such as: What has surprised teams? What challenges have arisen in their projects? What have they been learning that informs us about the nature of fragmentation? Having this kind of visibility into teams’ internal reflections as they are in the midst of planning and implementing their projects has fueled the collection of insights—like the significance of unlearningin real time.

The Power of Relationships

At our very first convening, Todd Kern from 2Revolutions said that change happens at the speed of trust; and at our latest convening, David Garfunkel from FSG talked about the importance of building relational fieldsor the strength, depth, and quality of how we relate to one anotherto create lasting change for young people. In both cases, it was clear that the connection between people is key when doing system change work.

The IDC is by no means the first to say that relationships are important. However, what has been apparent to us as we’ve been doing this work is that relationships should be the goal, not just a means to an end.

WHAT WE’RE THINKING ABOUT NOW

Going Slow to Go Fast

True systems change takes time; we need to know when to move slow and when to move fast. But we’re incentivized, through both structures (like grant cycles and metrics of evaluation) and culture (such as a bias towards action), to actand measure our impactnow. If we reframe our idea of short-term success to bias more towards learning as opposed to measurable outcomes, we can give ourselves the time we need to create the change we want to see.

Moving slowly might mean taking time to 1) build trust and relationships, 2) understand the underlying social forces at play, 3) develop new skills and practice new ways of thinking, and 4) craft a clear, compelling narrative that motivates people to act.

Taking time to build relationships and understand the underlying social dynamics at play might mean taking a look around to see who is in the room (from leaders, to students, to constituents) and valuing both their roles as well as their lived experiences. Doing this can help create a sense of ownership over the work and help people shift from self-advocacy to collective advocacy. While this increased trust isn’t always necessary for the work, it does usually strengthen it.

INTERESTED IN THE WORK OF THE IDC? LEARN MORE!

To learn more about the IDC and see the latest learnings from the teams, visit the website at www.integration-design-consortium.org.

You can also find more information about integrative approaches and how the learning agenda operates in Carnegie Corporation’s new report: From Fragmentation to Coherence: How more integrative ways of working could accelerate improvement and progress toward equity in education. This resource—meant for practitioners at all levels of the education system, including those in the public, nonprofit, and business sectors offers practical insights into the causes, consequences, and potential remedies of fragmentation.

Read more about the five projects teams in their own words:

  1. Supporting Community-Driven Solutions to Achieve Equity and Improvement in Education | Rachel Lopkin | 2Revolutions
  2. Redefining Professional Development: Educators as Leaders and Learners | Larry Corio | The Teachers Guild
  3. To Improve the Lives of Students, Two Communities Learn to Relate Differently | David Garfunkel, Peter Senge and Jessica Pizarek | FSG, Systems Leadership Institute and PolicyLink
  4. Helping Education Leaders Build Coherence into Reform Strategies to Support Teachers and Student Learning | Jenn Vranek and Cristina Muñoz | Education First
  5. How Greater Continuity Can Help the Millions of Students Rotating Through Social Services | Hailly T.N. Korman | Bellwether Education Partners

 

By: Reid Henkel and Isabelle Yisak


Amazon: The Elephant in the Room

As an innovation junkie, Amazon is the elephant in a whole lot of rooms I find myself in these days. The number and variety of the rooms in which the elephant seems to be hiding in plain sight are remarkable.

Amazon either already impacts or is poised to disrupt many traditional retail industry segments ranging from books to food to consumer tech to prescription drugs. No retail segment is immune. And now Amazon has announced it will aggressively extend its platform more broadly into healthcare sending shudders through the entire industry. Amazon also weighs heavily in public sector economic development discussions with the announcement of two new locations in the DC beltway and NYC for its burgeoning headquarters functions and the devastating local impact of so many lost entry-level jobs as many bricks and mortar retailers either go out of business or downsize due to the growth of online commerce.

It’s beyond me how so many public and private sector leaders have ignored the elephant in the room for so long but one thing is clear, no one can ignore Amazon any longer. The question of what to do about it looms large for every leader. One thing for sure, it’s a good time to be an innovation junkie.

It’s been a retailers dream start to the holiday season this year according to Internet Retailer with total retail sales estimates between Thanksgiving and Cyber Monday of $143.8 billion. On-line sales commanded 15% of total retail sales or $21.6 billion. Amazon is estimated to have sold 29% of the online total for a whopping $6.25 billion. Not bad for five days of work!

Both the online percentage of retail sales and Amazon’s share continue to grow showing no signs of slowing down. Just because in-store retail sales also grew over the Thanksgiving holiday don’t be fooled into thinking traditional retailers are safe. We’re at the top of a long cycle of economic growth and when the next inevitable downturn starts retail is always one of the first industries to take a hit and it always gets hit hard. The transformation of the retail industry to online and mobile is still in its early days and the impact on communities and the retail workforce will accelerate over the next five years.

Amazon isn’t just the elephant in a lot of work-related rooms, the pachyderm has also found its way into my home, literally. Never mind the growing number of packages I trip over on the porch when I get home after work but the other night on the local news I watched a segment of a weekly series called Tuesday’s Child featuring a heartwarming story about a local child available for adoption named Alexa. Every time Alexa’s name was mentioned throughout the segment another less human Alexa in the room piped up making her presence known and reminding me that Amazon really is in the room!

Perhaps the best evidence that the elephant is on the move and can’t be ignored is today’s Amazon healthcare announcement. The healthcare industry has been on emergency Amazon watch for the last several years. Every Amazon announcement has been parsed to handicap the odds that Amazon would try to work its disruptive magic on the heavily regulated healthcare industry. Every comment from Jeff Bezos about Amazon’s healthcare intentions sends industry stocks reeling. To say healthcare institution leaders are nervous is an understatement.

There was no ambiguity in today’s announcement from Amazon about their healthcare industry intentions. Amazon announced the launch of a new healthcare service platform called Comprehend Medical. It’s a predictable platform play by Amazon to stampede aggressively into healthcare.

Comprehend Medical is touted as a healthcare service platform which will aggregate patient EMR data, apply machine learning and artificial intelligence, and then provide institutional health care players and professionals with the information and tools necessary to make better more economic healthcare decisions. And oh yeah, it will also integrate the world’s largest product commerce engine. Incumbent healthcare institutions and companies have good reason to shudder at the sound of the elephant’s footsteps approaching.

Disrupting healthcare won’t be as easy as disrupting bookstores or big-box retailers for Amazon. There are many institutional interests and regulatory moats making it more challenging. As Amazon sees it, our current healthcare system is vulnerable and ripe for disruption. It leaves too many individuals and families behind and delivers a fragmented, confusing, overspecialized, unaffordable, and painful experience for far too many consumers. Healthcare institutions and professionals are too slow to disrupt themselves and to take advantage of new emerging technologies to transform customer experience. Our healthcare system as currently comprised is also unsustainable financially. The elephant likes what it sees with lots of room to forage for value creating opportunities that leverage Amazon’s superpowers.

I am curious to watch how Amazon architects its Comprehend Medical platform and service offerings. I’m concerned about privacy issues, control and use of individual healthcare data and believe that the long-term winning play is more like Apple (focus on consumers) than Microsoft (focus on the institutional market). It will also be interesting to see how Amazon handles the growing public backlash to its market size and influence including the risk of increased regulation or antitrust actions to slow the behemoth down.

It’s always best to recognize the elephant in any room. Ignoring elephants is an unwise strategy in an era where cycles of disruption are shorter placing a premium on reinvention, new business models, experimenting with emerging technologies and transforming customer experience. Everyone loves innovation until it affects them. Today, innovation affects all of us. If we try to ignore it, wait it out, or lean against it we leave ourselves increasingly vulnerable to disruption. The only winning strategy to avoid disruption is to innovate from a position of strength while we still can and not from a position of weakness when it is too late.

We also have to be clear-eyed about the impact of innovation on real people and communities. That doesn’t mean we should block innovation and the promise of leveraging exciting emerging technologies for good, it means that we need to recognize the impact on real people, institutions and communities and enable them to leverage emerging technologies to get better faster and to reinvent themselves in order to stay relevant in a rapidly changing world.


Reimagining the Disability Services System in RI

BIF kicked off a new project with The Sherlock Center on Disabilities and five service providing agencies in RI to reimagine the services offered to adults with intellectual and developmental disabilities in the state.

Driven by a deep sense of commitment to better serve individuals with disabilities, they seek to transform the current provider-driven service model into one that puts personal agency and self-determination at its core.

“Our highest hopes are to re-design the system of supports for people with intellectual and developmental disabilities, “said Mary Madden, Conversion Institute Facilitator at the Sherlock Center,” and to impact the quality of their lives in very real terms. The BIF Summit has set the stage for a powerful shared learning experience, moving us out of our silo and into the realm of possibility.”

Speaking to her personal motivation for participating in the work, Maya Colantuono, Technical Assistance Specialist at Sherlock, shared the following: “My 10-year-old gets around in a power wheelchair and uses an app on her iPad to communicate. These differences have not gotten in the way of her having the same childhood experiences as our other children. As she moves toward the adult service system, it is our imperative to ensure that she continues to be a fully engaged and valued member of our community.”

Leaders from participating agencies acknowledge that current service offerings are not sufficiently providing the individuals they serve with the supports needed to have and build a great life. They are committed to a more inclusive and person-centered transformation of the system of services for people with disabilities in RI. As one participant put it during the project kickoff meeting, the shared aim is to “get past our agencies to create more agency” for individuals with disabilities to lead and take charge of their own lives.

Participating agencies are Perspectives Corporation, Whitmarsh, West Bay RI, Looking Upwards, and The Cove Center / The Groden Network. Funds from RI’s Department of Labor and Training are being used to finance the work.


Personalized Medicine by Design

Business Innovation Factory (BIF), in collaboration with The School of the Possible founded by Dave Gray, Hatch founded by Yarrow Kraner, and Overlap founded by Michael Dila, is launching a project to explore the opportunity for a transformational personalized medicine business model.

Leveraging a network of networks we will start with a four-month exploratory phase of work to establish a deep customer experience foundation upon which we plan to design, prototype and commercialize a new model that empowers individuals and families to improve their own health and wellbeing. Our intention is to start-out-loud and to work iteratively and collaboratively to inform the development of a repeatable and scalable model. Our intention is to catalyze a personalized medicine movement.

Our U.S. healthcare system is leaving too many individuals and families behind. It delivers a fragmented, confusing, over-specialized, unaffordable and painful experience for far too many of us. Healthcare institutions are slow to disrupt themselves by leveraging new emerging technologies to transform the customer experience, and the healthcare system as currently comprised is unsustainable financially.

Healthcare is ripe for disruption. It is up to all of us to make sure that we disrupt it on behalf of those being left behind by today’s system. It is up to us to imagine a new healthcare system that puts individuals and families first. We need a new system in which families have access to the information, tools, and resources necessary to improve their own health and wellbeing. We need a new healthcare system that puts us at its core.

In the exploratory phase of our Personalized Medicine By Design project, we will establish a strong foundation of understanding of today’s healthcare customer experience. Any transformational personalized medicine business model must start with an understanding of the job-to-be-done from the customer’s point of view, not primarily from the perspective of today’s healthcare institutions and system. We will not be admiring the problems of today’s healthcare system, they are well known. We are seeking to understand how individuals and families experience the current healthcare system and their pain points as a jumping off point for imagining how we might transform, not tweak, it. A rigorous human-centered exploration phase will inform the design and prototyping of a transformational personalized medicine business model with healthcare consumers and families at the core.

We won’t start with the question, “how can we improve today’s healthcare system.” Building on a deep understanding of healthcare customer experience as an actionable foundation for design we will start with the question, “Can we imagine a new healthcare system that is in service of helping families better manage their own health and wellbeing?” We won’t get bogged down worrying about scalability and how to change the current system until we have demonstrated at a small scale that there is a better way that is financially viable. Let’s figure out what we want to change to before we obsess over how to change the way it works today. It’s time to create the conditions to imagine, design, prototype, and commercialize a transformative new patient and family-centered business model unconstrained by how healthcare works today.

I have been waiting for the stars to align for personalized medicine and to lead this BIF project for a long time. Over my career, I have engaged in and have every black and blue mark imaginable from working in and trying to change every aspect of how today’s healthcare system and business models work. Our passion at BIF is making transformation safer and easier to manage. As a leader in the healthcare industry, a strategy consultant, a government bureaucrat, and as the founder and Chief Catalyst of BIF I have led teams working on the mindsets, muscles, and tools to enable business model transformation and healthcare has always been my home industry.

I worked at Eli Lilly and Company in the 1980’s and will never forget the opportunity to witness first-hand how genomics might transform healthcare when I got to attend the opening of the world’s first commercial-scale recombinant DNA manufacturing facility. I was wowed by Lilly’s fete of tricking e-coli into producing human insulin at scale. Fast forward to today when the cost of mapping our own personal genome is rapidly approaching $100 and companies are already being launched that will offer us the opportunity to map and store our genome for free if we allow them to monetize our most valuable data set, our double helix. What if we made sure that we controlled our own healthcare information and who and how others can access it?

As a road-warrior strategy consultant, I worked with the visionary Mark Levin, founder of Millennium, who was early with a personalized medicine vision to transform the pharmaceutical and biotechnology industry in the 1990’s. Mark’s idea was brilliant but the technology hadn’t advanced enough for a transformational business model to take hold. I never forgot the boldness of his vision and have always believed that it would ultimately come to pass. I believe that personalized medicine is now a viable business model with the potential to transform healthcare. We can already see its transformational potential in the diagnosis and treatment of many forms of cancer. The changes we can now see in personalizing cancer care and treatment will expand to other diseases and care paths. The promise of personalized medicine is within reach and hugely disruptive to every aspect of today’s healthcare system. What if we made sure that personalized medicine business models were designed with individuals and families at their core?

As a geek wannabe, I’ve always lived in the space between emerging technologies and new business models. Emerging technologies including genomics, big data, artificial intelligence, Internet of things, blockchain and all things digital are at a stage where they can actually be deployed in service of new human-centered business models. They are all capabilities in our sandbox ready to be combined and recombined to enable a personalized medicine vision. I was troubled when in 2011 the National Research Council declared that personalized medicine was an antiquated term and should be replaced by the more technology friendly label of precision medicine. I’m certain new technologies will continue to fill our business model sandbox enabling us to more precisely diagnose and treat disease. Today, these new technologies are out ahead of the business models to deliver their value at scale, and their development is predominantly shaped through the lens of today’s healthcare institutions and not customer experience. We need to transform from a sick care to a wellness model. To transform healthcare we will have to put the personalized back into precision medicine.

Our collaborative exploration of personalized medicine opportunities will put individuals and families at the center of our design process. It will bridge the exciting space between enabling agency at the consumer level and leveraging emerging technologies to transform customer experience and outcomes. Join us. We’ve created a Personalized Medicine by Design Facebook group to welcome other purposeful networks like School of the Possible, Overlap and Hatch, companies and institutions that want to play and any individuals interested in project updates or engaging in our exploration process. Let’s transform healthcare together.

Personalized Medicine by Design Facebook Group


Experimenting for Education Equity

Year after year, we see new big hairy audacious goals emerging for our education system. For example, by 2025, we want to see 60% of Americans attaining a higher education degree. Currently, the national average is 46.9%, up from only 9 basis points in 2008, calling the question:

What is it going to take for us to move 13 percentage points in 7 years, given our track record?

The same question emerges when you look at school readiness, 3rd-grade reading levels, and high school graduation rates versus goals. Unfortunately, we have to get our heads around the inconvenient truth:

Unless we do something dramatically different, we can’t get there from here.

So what is that different way?

In BIF’s Student Experience Lab, we understand that the problem exists on two fronts:

  1. The education gaps in attainment (from readiness to degree attainment) are largely the output of inequity.
  2. Transformational activities to close these education gaps are few and far between, and those that do emerge are local and fragmented throughout our education system.

The result is that even our efforts to close the equity gap is inequitable. This is why in the fall of 2017, BIF teamed up with the Carnegie Corporation of New York to explore this very design challenge:

How might more integrated approaches to education transform outcomes, specifically for the children who are being left beyond today? How might we reduce fragmentation in our innovation efforts to spread and scale breakthrough solutions? How might we accelerate collaborative innovation to reduce education gaps across the country?

Obviously, this is a project that is near and dear to me personally, and all of us at BIF. It is structured in a unique way, enabling us to both mirror the problem, create a petri dish for experimentation, and collaborate with some our favorite innovative designers in education. This is how it works:

Five organizations — FSG in partnership with PolicyLink, EducationFirst, Bellwether, 2Revolutions, and IDEO’S Teachers Guild — received grants to run two-year projects, each one geared at reducing fragmentation in education and accelerating integrated approaches to equity in education. These five organizations form the Integration Design Consortium. BIF serves as the connective tissue of the IDC — connecting, convening, and collecting learnings towards our combined learning agenda. We also serve as the Chief Instigator, running small experiments to understand how we might spark collaboration, inspire reflection, and insight pivots based on real-time learnings. The objective is to create field facing learnings and tools that can enable greater integration in education.

Being 6 months into our grant, we are in a position to begin to share some of our emerging curiosities.

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Fragmentation by Design

One the challenging aspects of our public education system, as with our government, is that it is fragmented by design. We grant local autonomy to states on many issues, and even further down the pecking order to districts. On the one hand, this enables creativity in responding to context (and much of the challenges in education are about context). Even in the classroom, teachers are often given the autonomy to respond to immediate learning needs in new and different ways. This enables “depth” as it relates to impact on individual students, but it prevents “breadth” in the scale of that impact. It is almost like we’re missing a “hyperloop” in our systems that enable us to quickly move learnings up, down, and out of the system hierarchy. Further, it is indeed a hierarchy which prevents the outward bound mobility of learnings and innovation. When we imagine systems that are well integrated (e.g. platforms), they tend to be flatter with basic protocols (e.g. common languages) that enable users to plug and play, adopt and adapt. This dynamic has us curious:

How might we enable horizontal information flows across a system that is fragmented by design?

Reducing the Hunt

It is rumored that by the time Sir Isaac Newton was 12 he had read every book on mathematics. This is less a statement about his intellectual prowess (albeit undeniable) and more a statement about the availability of information. Today, we are overwhelmed by the abundance of information. This is as true for us as individual players in our education system (teachers, superintendents), as it is for us as organizations exploring and testing innovative approaches in education. We know that innovative methods are out there, but we don’t know where to find them. Further, we are handicapped by our evidence-centric society, that frowns upon “experimentation” in education (i.e. experimenting with our children’s futures), and before innovations can spread or scale, they are put through the “evidence-based” time-consuming process of collecting proof, such that they can be deemed a “best practice.” This slows and curtails the ability for organizations and the system as a whole to get better faster. We’re not the first to ask this, but it remains a question that needs to be addressed:

How might we reduce the hunt for individuals and organizations seeking innovative methods for reducing inequity, thereby accelerating the integrated spread of innovations across the education system?

Catalyzing Learning Organizations

This leads us to a related curiosity:

How might we create the conditions that encourage organizations to learn and adapt in real time to emerging learnings and insights?

Peter Senge framed the notion of a learning organization in The 5th Discipline. It is a framework for understanding how organizations can unleash productivity and success by creating the conditions for adaptive and continual learning. Unfortunately, this is not the norm in a society that is still very much governed by industrial era models — which use business models as the organizational straight jacket in service of organizational efficiency and specifically constrain versus nurture expansive thinking by employees and business units. As a result, we have education institutions which create 5-year strategic plans with lofty success metrics (note the before mentioned degree attainment goal), measuring progress yearly, but not adapting in real time to what is working and what isn’t working.

There are three challenges here:

The first is that we lack the signaling systems and metrics to act in dynamic ways. The second is that learning is a generative act and requires a vulnerability which is often considered a high-risk proposition for organizations. For nonprofit organizations, this dynamic is exasperated by funding models. We are funded to achieve certain outcomes through a specific approach. The conditions are not good for real-time pivots; we perceive, right or wrong, that this demonstrates a weakness, a lack of expertise. Finally, learning networks don’t exist in the wild. Learning networks enable organizations to learn together and from each other, getting better faster. But they are most often catalyzed by an outside force, like a funding partner, and they are exclusive. This exasperates the conditions where some organizations learn and others don’t, and where the benefits of such a network are limited by the funding timeframe to sustain it.

Networking Business Models

Finally, if we can learn and adapt, our growth response is limited by our own organizational capabilities. Collaboration is still understood as coming together and learning together, rather than coming together to network our capabilities to deliver value in entirely different ways. The latter is hard, hard work, and requires a few key ingredients. It requires leadership who is willing and able to experiment with new approaches, and lend the organizational brand and reputation to outcomes that can not be attributed back to a single player. It requires the ability to dedicate a few capabilities, on a small scale, to a new delivery model without disrupting the efficiency of the existing delivery model. And, it requires a new revenue model which will work across organizations.

However hard, it is also essential for integration of a system. If a business model is a network of capabilities woven together into a sustainable financial model, a system is a network of business models that have learned to collaborate. Until organizations learn how to do this, integration in our education system won’t work, and innovations that fundamentally transform outcomes will remain localized and dispersed. Leading us to wonder:

How might we create the conditions (incentives, resources, leadership, and know-how) to build organizational collaboration and integration?

Above, I framed this all as emerging curiosities, because that is what they are. They aren’t necessarily new insights about the education system or guidelines for closing the equity gap. In the spirit of working out loud, they are the thoughts and wonders that come to us as we explore the intersection of equity, integration, and education.

We do not do this exploration blindly; we are standing on the shoulders of giants who have explored it before us. Many frameworks have been developed that answer and address some of what we are finding. As such, we intentionally look at the work through the lens of these frameworks — from Adaptive Leadership and Coherence Frameworks to Learning Organization Theory and the PELP Framework. Our goal is to suss out what can be bundled into these existing frameworks, and what can’t be answered — helping us define new insights and opportunity spaces to accelerate an integrated approach to equity in education.

In the coming weeks and months, we’ll be sharing many outputs from this work — from podcasts and interviews with the other IDC grantees to videos capturing our learnings and curiosities. We invite you to help us get better faster —engaging with us along the learning journey. Help us identify more blind spots that might be an important puzzle piece; go a bit further and help us put some of these learnings into action, sharing what happens along the way.

It is, as our partners at the Carnegie Corporation of New York often say, a grand experiment.

And. Experimentation in service of education and equity might be the best alliteration, and purpose, ever.

Thanks to Jessica Brown.

 

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Finding our Equity Why

Twice recently I’ve been asked to reflect on “my why.” The first time, at a student-led professional development on unconscious bias from Diversity Talks and the second, at a meet-up of EduLeaders of Color RI. I am grateful for these two gatherings because I’ve been putting a lot of pressure on myself to find words to describe my investment in equity and justice in education (and broadly). Additionally, I’ve been trying to think of ways to bring others on that journey — both friends and opponents.

In short, I’ve been searching for a point of view to ground me and provide direction as I imagine the future of education. As the conversation around diversity, equity, and inclusion (DEI) picks up steam, I have felt even more pressure. It is one thing to talk about these topics with folks that “get it”, are increasing their consciousness, and are actively building equity into their practice. It is another to be in conversations and settings where equity is just a casual topic or bolt-on.

My why: I am angry that students and educators (especially those who are Black and brown, LGBTQ, lower-income, English language learners etc.) are flattened by a system that doesn’t allow them to be their full selves. I love my communities and want to be in the business of co-designing and building an education system where they can thrive—one where equity is at the core.

Most of the conversations and actions in the education sector are not structured with the same ‘why’ in mind. Equity is often a bolt-on added to existing conversations, practices, or programs. This has produced inconsistent, narrow-focused point solutions or top-down mandates across schools, organizations, and policy.

These efforts do not:

  • Combat the root causes of inequity and oppression that are stitched into the fabric of the education system (and our society)
  • Raise the achievement of all students, while narrowing the gaps between the highest and lowest performing students or eliminate the racial predictability and disproportionality of which student groups occupy the highest and lowest achievement categories [Glenn Singleton, 2015]
  • Transform experiences for students, educators, and families

To do that, we need something more. We all need personal and institutional ‘whys’ around equity. And our why has to be stronger than our why not.

Luckily over the past year, the Student Experience Lab has had a project that has helped me imagine what an education system with equity at the core might look like. Throughout the Teachers For Equity project, we developed and tested a model that used a system-focused, teacher-driven approach to advancing racial equity. I have previously written about the conditions that make this model powerful: educators were close to their communities, focused on equity, and were designing with NOT for other educators and students.

Our prototype’s why: We want to transform the values, norms, and practice of the classroom and activate teachers to change not only what is taught, but how it is taught, how teachers and students engage, and how school communities learn and grow together.

Download Our DEI Toolkits

Transforming values, norms, and practices that are rooted in systemic racism is not work that happens easily. It is work that put equity at the core and required every educator to have a strong personal ‘why’. They needed something that rooted them in the work when facing pushback from colleagues or when they did not immediately see results in student achievement.  

As they uncovered, explored, and modified their whys we were able to move from a lens where equity was merely a bolt-on. We were then able to surface other key conditions of an equity-centered education system:

A commitment to building racial consciousness. There is no such thing as achieving complete cultural competence, this work requires being actively adaptive and responsive. In Teachers For Equity that required two things: content and reflection. The content was the “easy” part. There are plentiful resources to get educated on racial dynamics and histories—what’s harder to uncover is what is stopping us from engaging with these histories or conversations about race. Deep reflection on our own racial identity and experience is essential for understanding structures and mental models that perpetuate racial disparities. By creating opportunities for courageous conversations, our racial consciousness grew from a deeply personal place—and I believe our lives and work will be impacted forever because of it.

A transformational point of view. Transformation often feels intimidating. When we are challenged, it is more natural to go to what is comfortable, technical, or measurable. However, just like getting to the core of our personal racial narratives changes the work, so does getting to the core of the system. Combining a strong ‘why’ with a systems focused lens made educators more confident providing leadership to address root issues of educational equity.

An acceptance of losing competence. All of us like to be (or to be seen as) smart, capable, and competent. Throughout this process we had to work through losing competence— discovering all that we didn’t know about race, having vulnerable conversations, and redesigning a system founded on oppression. When facing uncertainty, we had to avoid disengaging or pivoting the work so that we can speak and act with more authority. Spoiler alert: we were not always successful.

A human-centered culture. Teachers are the closest to students and their needs, yet they are often the last to be considered when designing new, equity-centered models. The goal to advance equity must be supported at every level, but most importantly, teachers must be supported in building equitable practices in order for significant impact to take place. This requires institutions to build in time, space, and a culture of design that allows teachers to create and reflect on equitable values, norms, curriculums, and practice. It can also be aided by intentionally pushing the boundaries of professional-personal divides that hinder vulnerable, courageous conversations. Vulnerable sharing doesn’t mean sharing every detail of your life, but wanting and giving permission to bring in your authentic personal experiences to the table as we work to solve some of the toughest issues facing classrooms and education.


Throughout this project, we saw powerful glimpses of these conditions in action. They enabled us to go beyond surface level solutions to think more holistically about how school and communities could better learn and grow together.

Transformation is comprised of actions taken to change the core of how things are done. The conditions above may seem small/intuitive, but because they target the core of the challenges we face around racial equity (mindsets, feelings, and actions), we saw them enable powerful actions. On a large scale, actions like these can make significant changes in student outcomes. They can help us fulfill our “why” and transform how we deliver more value. For me that looks like using these conditions to create more opportunities for students, educators and leaders to be their authentic selves. It is a commitment to have an explicit focus on equity in my work in education.

At BIF, this experience provides guidance as we continue to design with equity at the core. This prototype imagines the future of education. One that is more equitable. One that our students and educators deserve. One that we hope to collectively work towards.

Tell us your equity why! How does it impact how you create and deliver value? And if you don’t have one, how are you going to find it?


Part 1: The Diversity, Equity, Inclusion Imperative

Part 3: The Equity Opportunity in Healthcare

 

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The Diversity, Equity, and Inclusion Imperative

A few years ago, while working on a project for Cincinnati Children’s Hospital, I faced one of the more challenging experiences in my professional work — and, even now, reflecting on it gives me goosebumps.

Here’s the context:

BIF had been asked by Cincinnati Children’s to help them explore and design next practices that would reduce infant mortality in the surrounding community — Avondale. Avondale, at the time, was ranked highest in the country for infant mortality, largely stemming from (a) preterm births and (b) a majority population that was at high-risk for preterm births. Sadly, the reason why stems from race — black women experience more preterm births and infant deaths than any other population. I will come back to the role that race (or racism more specifically) plays in preterm births later.

Our team had spent months immersed in so many powerful, wonderful, and often sad stories. We interviewed pregnant teenagers (and non-pregnant teenagers). We interviewed formerly incarcerated women. We interviewed moms and pregnant women, whose abusive husbands had landed them in shelters. We interviewed pregnant moms and their pregnant daughters. We interviewed non-pregnant women. And we interviewed dads.

We synthesized all of the findings from these interviews, landing on a handful of opportunity spaces and brought diverse community stakeholders together into a participatory design studio. And that’s when it happened.

I had just wrapped up a presentation of our findings, including a podcast of women talking about their experiences (note: listening without visual cues is so core to empathizing without judgment), and had opened up the room to observations and questions. One community stakeholder raised her hand and said:

“You’re white. I’m sure it goes without saying. But if you had knocked on my door, my family and I wouldn’t have told you sh*t.”

There are many things that flew through my mind in the nanosecond I had before I needed to respond.

  • She just questioned the credibility of our findings, at a moment when I need buy-in in order to move forward
  • She’s not wrong; I’m sure there are definitely things we didn’t hear
  • What if we didn’t just not hear things, but what if, given our white privilege (and the biases that come with it) we weren’t able to truly witness their experiences?
  • Holy crap, are we about to talk about race, for real, in public?

I remember my voice shaking in my response, and (having played this scene over and over again in my head), I know I said something along the lines of:

“Yes, I am white, and as such, I can never fully understand what it means to be a black woman. We’re trained to listen, and we do our best to listen with open hearts. And I’d like to honor these women and their time by considering what they did tell us.”

The conversation continued, but I never forgot that interchange.

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Here’s why it matters.

I’ve been working in innovation long enough to see trends cycle through the social sector. Diversity, equity, and inclusion (DEI) has been and might continue to be, one of those trends. It has been on everyone’s radar at one time or another in every decade since, well, before I started working. For example, in 1992, I did my field training in Kenya and required reading was Moving the Centre, a book that invited researchers to consider moving their own race and class privileges out the center of their mental models, in order to explore new ways of working that would leverage diversity. Why do I feel that the invitation didn’t get much traction?

I believe the answer lies in the traditional approach. In BIF speak, institutions approach DEI as a “bolt-on.” This is what we know how to do. We take our existing culture and bolt-on a DEI committee. We take our existing marketing strategy and bolt-on specific activities to reach “underserved communities.” We take our existing products or services and we tweak them to serve “new” audiences.

I think there are perils with this approach:

  1. People are truly hurt, and injustices are created, when we don’t truly shift our lens, mental models, or our behaviors to address DEI systemically.
  2. We miss huge opportunities to serve everyone better.
  3. Bolt-ons aren’t sustainable and will continue to perpetuate trends.

I think the real invitation is to consider how our institutions move from bolt-ons to next practices and new business models. Here’s how.

Shifting our Lens

At the beginning of the Cincinnati research, one phrase kept getting me hung up: Baby Daddy. Women had baby daddies and not husbands. Women had multiple baby daddies. As a white girl from Connecticut, it was hard to say baby daddy comfortably. But here’s the thing that I was comfortable doing:

Asking myself why.

And what surfaces is a bias. Aren’t we supposed to grow up, get married, and have one father for our children? Isn’t nuclear family the right kind of family? The irony, of course, is that I am divorced with two kids. I will never have a nuclear family, and I have learned it takes a village. I host Sunday Dinner — supper with my family, my partner’s family, random teenagers, lonely neighbors, good friends. Why? Because I understand that we don’t get by on a nuclear family. But nuclear family is stuck in my mind — it is part of the whiteness culture that is prevalent in this country – as the universally accepted right way.

Cincinnati Children’s Hospital won a Mayo Transform Award for Neighborhood Feasts, a concept that forged communal relationships between physicians and community women.

Once I acknowledged and moved beyond the notion that there is a right or wrong way, I grew a sense of wonder. Communal families are more expansive; there are more people to play so many roles — regardless of age, gender, or relationship. They are inclusive and accepting. They are more adaptive and responsive; less fragile. There are so many implications for this and how these strengths could be used; it inspired my thinking about how we can re-image support systems; and also, it inspired a key opportunity area:

How might inclusive relationships and communal events change the power structure between patients and doctors (a power structure that often dissuades women from engaging in their care)?

Designing for Diversity, Equity, and Inclusion

The second opportunity is to not just seek inspiration from – but to also design business models for –  diversity, equity, and inclusion. In a forthcoming blog, you’ll hear about our friends at Trinity Rep who came to BIF because they were facing an inflection point in their very identity. As a community repertory theatre, it is charged with reflecting the challenges and issues that exist in the community around it. But a racially charged scene on the stage catalyzed a racially charged response from the community; causing them to question what it would mean to not just have a DEI initiative or do DEI programming, but to transform their business model and put DEI at the core? They asked themselves if this could transform their community.

It’s a compelling question and one that is important for all institutions. If public service put DEI at its core, how would communities look different? How would public services look different? For example, the immigrant debate rages so loudly in this country, through a mindset of who stays and who goes; it is a conversation about exclusion. Through this lens, we are failing to recognize the opportunities found through inclusion. This could mean many things, but my mind goes immediately to the power of entrepreneurship. As entrepreneurs, immigrants ground and fuel our small businesses, and through it, our economy. When we design for inclusion and equity, we’re creating institutions that unleash, rather than limit, people’s potential.

The opportunities in education are also enormous. If higher education designed for diversity, it would have a system that was more flexible and affordable. In short, we would have higher education models that are better for everyone. If K-12 education designed for diversity, we would have classrooms that taught us how to collaborate with “unusual suspects” for critical problem solving (hello – major skill requirement of the 21st century), higher graduation rates, and more people actually engaged in developing the skills, competencies, and capabilities that can move this country forward. In our next post in this series, we’ll share findings from our SXL Teachers for Equity project, which points to the fact that racially conscious classrooms forced teachers and students alike to be more authentic and open — the very conditions for learning and evolving.

In healthcare, I have seen first hand (and designed) opportunities for putting DEI at the core of what we do. DEI forced us to question the 9–5 schedule of primary care. It forced us to consider the importance of “connected knowledge,” given how many people are part of raising a child. It forced us to consider the power and importance of first-generation changemakers, for creating and spreading new habits and values related to good health. It forced us to consider how we move from sick care to family well being. And new business models emerged as a result that could better serve everyone.

In short, when we design for DEI, we create more opportunities to be true and worthy market makers.

Sustaining the DEI Shift

The Cincinnati project was one of BIF’s first forays into the use of a community critique. Early on in our research and synthesis, we invited a handful of “experts” in infant/maternal health and community health to hear our findings. I discussed the role that race was playing in women’s experience. One of our critiquers, a white male physician from Brown University, asked me point blank:

“It sounds like you want to address racism.”

The way I heard it, it sounded less like a question, and more like an observation of the preposterous.

“I think we need to,” I said.

I felt small, then. But I’m not feeling small anymore.

Since then, studies have proven conclusively that infant mortality is a direct result of racism in this country. When I say that people are hurt regularly by racism, this is what I mean. We lose babies. And we don’t just lose them as babies, we lose them as children, young adults, adults. We lose the potential they can offer the world. Can you imagine how our communities, cities, country might be different if that creative potential was unleashed and tapped rather than lost? Can you imagine how your institution might be different? More creative? More innovative?

If we fail to create a sustaining shift, if we continue to treat DEI as a bolt-on, we’ll fail to prevent that hurt and injustice. We’ll fail to seize opportunities to make things better. For everyone. We’ll miss opportunities for innovation, and market making.

This is why BIF has taken on a series of DEI efforts — both in the projects that we take on and how we embrace it internally.

This is the first in a series of blog posts focused on how our real-world experience labs are using diversity, equity, and inclusion to design innovative new business models. Coming up next, you’ll see how we’re transforming classrooms and learning by activating teacher leaders in order to design more equitable and diverse experiences. From our Patient Experience Lab, we’ll share how “witnessing our patients,” establishes trust, and fundamentally improves health and well-being. Our Citizen Experience Lab will share how communities become stronger and more resilient through inclusion. Finally, we’ll share the courageous conversations we’re tackling internally, to ensure that our own culture and values are a reflection of sustaining the shift to DEI, knowing that what we design will be better the more diverse our designers are and our culture is.

We invite you to join these conversations, and to explore how putting DEI at the core of your business model exploration can surface opportunities for transformation.


Part 2: Finding Our Equity Why

Part 3: The Equity Opportunity in Healthcare

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Bringing “Hip-Hope” To Underserved Communities

Roberto Rivera’s personal story is about the expansion of true consciousness in one young person, who was tagged early on as learning-disabled, then shunted from one alternative school to another. He got into trouble, and almost slid into an abyss of statistics that presumed his ultimate disconnection from family and community — from the “good life.”

Now, he says he is learning about love.  How to love other people, how to love himself.

A turning point for Rivera was the death of his grandfather, who saw young Roberto in his wholeness, simmering and on the brink of something. “He didn’t just see the talent and passion in me,” Rivera says of his grandfather, “He saw my pain.”

Rivera is the president and lead change agent of The Good Life Organization (GLO), a social enterprise that catches young people who slip through the cracks of our educational and social systems.  He catches them with hip-hop, storytelling, videography, and personal connection. He does it because he stepped out of the cracks himself in a journey that took him from “dope dealer to hope dealer.”

That’s how Rivera sees students in GLO’s afterschool Fulfill the Dream workshops, a series of encounters that draw out the genius of young people who are considered “at-risk”, but who have the impulse to give and create. Seeing the beauty beneath a rough exterior is what Rivera calls “Michelangelo vision” —the ability to look beyond like his grandfather could.

“He was my Michelangelo,” Rivera says. His grandfather was the son of immigrants. He went to college against the odds, sent money home to his siblings, and led an altruistic life grounded in the community. His death took Rivera off the “track to distraction,” the path that seeks a pleasure-centered life, filled with fleeting feel-good moments that leave an emptiness in their wake.

Ten years ago, Rivera started GLO as a service born out of love, he says. He works in underserved communities, mostly with young people of color who struggle as he did. “All that work is bursting out of the heart of a big brother who is trying to love these kids,” he says. “I want them to be great, to be walking in their dreams.”

As he pursues a Ph.D. in educational psychology at the University of Wisconsin-Madison, Rivera applies empirical evidence to what he already knows through experience: “Education can have the most profound impact on people’s lives.” But he is careful not to fall for clichéd strategies aimed at pulling kids from one side of the achievement gap to the other.

He notes that standard educational goals can produce high-achievers who go to Ivy League schools, earn their MBAs, join blue-chip corporations, and devise brilliant financial schemes that build immense wealth for the few on Wall Street, and chaos for everyone else.

It’s not enough to be smart, self-satisfied, and successful, Rivera says. “We want all kids on both sides of the gap to have a moral compass, to think critically, and to make the institutions that they’re a part of and the communities that they serve to be more just and more humane.”

At GLO, he reminds young people of their heritage in hip-hop, the most innovative cultural movement of this age. He tells them about the Jamaican-born, Bronx-raised DJ Kool Herc, who transformed the turntable into an instrument, got everyone break-dancing, and brought hip-hop into being. Kool Herc opened a space for joy and expression and thus transformed a culture. And he started out just like them.

“This is their history, and it’s important that they know it and claim it, and build off that foundation,” Rivera says. “If our kids today can recapture that narrative, realize their link in the chain of tradition, it’s not so farfetched that they might have the idea for the new Facebook.”

Rivera helps young people find their “inner GPS” and turn it up so that the reality of love dominates all others. “There’s a real clash of realities happening right now,” he says. “The one that will win is the one that people embody and live.”


TD4Ed Overview: A Look Back

What do you get when you put 5 classroom teachers, 6 teaching artists, 3 youth development staff members, 3 graduate students, 1 coach, and 1 parent in BIF’s office space for a 2-day intensive “design jam”?  What if they all come with a problem they’re currently facing and want to tackle? During the last weekend in March, we found out.

Fueled by caffeine, collaboration, and adrenaline, these 19 dedicated educators worked in teams of 2-6 to tackle their chosen challenges, using our Teachers Design for Education (TD4Ed) curriculum. In the week leading up to the event, the teams conducted qualitative research to explore their issues and develop a deeper understanding of what they meant to various stakeholders. At the design jam, they reflected on what they had learned, generated and evaluated 60-70 new ideas to solve their challenge, built 3D prototypes of a new solution, tested out their concepts with a partner team, and plotted next steps to implement what they had created…all in just over 8 hours.

Sound intense? It was. But all five teams walked away with a tangible solution they were excited to test out and implement on their own turf, and it was an inspiring way to wrap up the work we’ve been doing on the TD4Ed project over the past six months.

As our current phase of work on TD4Ed draws to an end, we wanted to share some of the things we’ve done, how our thinking has evolved, and where we see TD4Ed going next. Beyond just what we’ve learned specifically about TD4Ed, we think the larger lessons we’ve learned about the fields of blended learning, professional development, and education innovation have broader applicability, especially for those who are playing in these spaces.

Want all the insights and details? Use the links at the bottom of this post as an index to jump to more in-depth information. Interested in just the highlights? Well, here’s the quick version:

Where We Started

In round one of work on TD4Ed (November 2013-June 2014), BIF’s Student Experience Lab (SXL) designed, tested, and launched a free, collaborative platform that teaches educators design thinking skills and empowers them to create, test, and implement solutions to challenges they face in their classrooms, schools, districts, and communities. Through a series of pilot programs in Rhode Island, Chicago, and Philadelphia, the SXL co-created this platform with teachers and with support from the Bill & Melinda Gates Foundation (BMGF).

Round two of our work, which we started in October 2014 and are now wrapping up, gave us a chance to strategize around how to partner with other organizations to get TD4Ed into the hands of more teachers, make it even more valuable to them, and create a sustainable model for TD4Ed going forward.

At the start of this second phase, we had in mind a variety of partnership types that could increase the impact of TD4Ed in different ways: integrating TD4Ed with a high profile crowdfunding site to attract new users and offer them funding for their solutions; offering blended in-person professional development trainings; rolling TD4Ed out across an entire school, network, or district; working with other organizations to create sponsored design challenges around specific problems; embedding TD4Ed into existing tech platforms that educators are already using; and/or offering micro credentials to teachers that complete the TD4Ed curriculum. Our goal was to figure out which combination of partnerships would be the right mix for TD4Ed, and make those partnerships happen.

What We’ve Been Doing & What We’ve Learned

We started by identifying who the major players were in each category and looking into the unique elements they brought to the table that could deliver value to our users. After getting an overview and deeper understanding of the potential strategic value of each partnership type, we began having conversations with representatives from the organizations that seemed most promising and experimented with what form these partnerships could take.

Through this process, our biggest and most generalizable learnings have included:

Learning #1: Experiences must be personalized.

Educators need choices, and it’s wise to accommodate a variety of levels of desired time investment and learning outcomes. With TD4Ed, we found that the full 6-8 week curriculum works great in a blended, facilitated model. But not all teachers have 6-8 weeks to commit to learning a new process. To give such teachers a chance to use aspects of design thinking in their practice, we played with a spectrum of engagement options. These ranged from bite-sized individual downloadable guides and activities to concentrated one-off workshops and the above-mentioned weekend-long design jam, and finally to more extensive blended professional development training.

        Learning #2: Engage teachers early in their career.

Working with individuals while they are training to become teachers is a particularly powerful time to make in a difference in their practice and mindsets, and ultimately in their students’ learning. Teachers-in-training are looking to add new skills to their teaching arsenal, and are more likely to have the time to try out resources. From the ways we’ve seen education students engage with design thinking and the TD4Ed platform, we recommend that others working in the education space think about how they might bring their tools to teachers-to-be.

Learning #3: Teacher-designed solutions — and the teachers behind them — are powerful.

This comes as no surprise, and we’ve seen it time and time again both in the initial round of work on TD4Ed and in everything we do in the SXL. But it bears repeating. In this phase of work we’ve seen over and over how educators take the solutions they’ve developed — and the design thinking process itself — and run with them.

We had been tossing around the idea of involving TD4Ed teacher “alumni” in our blended professional offerings for a while but got serious about it after an illuminating conversation with    Wendy Sauer, our Program Officer at BMGF. She thought incorporating teachers into our PD facilitation could be a great model for TD4Ed, and so we decided to experiment with what that could look like. At our design jam, we invited one of our pilot teams, a group of teachers from Warwick, Rhode Island, to join us to offer tips, share about their TD4Ed experience, and describe how their solution has grown and evolved over the past year. It was a powerful moment in which the new participants saw just how significant the effects of their solutions could be.

Learning #4: Professional development training and edtech platforms must deliver learning experiences that are relevant, interactive, and ongoing.

The BMGF recently put out a report on teachers’ views on professional development, describing how teachers believe that PD is effective when it involves “learning that is relevant, hands-on, and sustained over time.” This finding resonates deeply with what we’ve seen from TD4Ed. Whether learning is delivered via online or in-person methods, it must align with educators’ existing skills and capabilities, as well as the challenges they are currently facing, and provide ways for them to collaborate and learn actively. Much of the power of TD4Ed lies in how it enables teachers to take on challenges of their own choosing through an ongoing, hands-on process.

Learning #5: There’s a productive tension between integrating into what teachers are already doing, and offering them a completely unexpected experience.

There’s great value in incorporating learning opportunities for teachers into the things they’re already doing and the online and in-person spaces they already inhabit. Meeting educators (or any users, for that matter) where they are is critical to making new experiences valuable to them. At the same time, creating new and unexpected experiences can inspire creativity and open novel pathways for collaboration. In our design jam and workshops, we’ve taken teachers out of their everyday contexts, and as a result, have seen them develop new and enriching ideas and connections. Creating unexpected experiences is something that can be done in online spaces, too.

Where We’re Going Next

In the end (or at least for the time being…iteration is never complete!), most of our energy is going toward offering blended professional development training on TD4Ed. We’re also pursuing a few other complementary avenues, including delivering TD4Ed via existing edtech platforms (look for us on BloomBoard!), offering TD4Ed to teacher credentialing programs, using TD4Ed as a way to engage networks of teachers around larger challenges, and continuing to offer micro credentials to recognize educators who complete the curriculum. Crowdfunding and rolling TD4Ed out across a model school, network, or district fell out of the running for us as pathways to pursue for TD4Ed right now, but looking into these areas taught us useful lessons.

We still believe that storytelling can spread the impact of TD4Ed beyond individual teams, schools, and districts. As educators continue to use TD4Ed to tackle the challenges they face, we hope it becomes a free marketplace of ideas, where teachers, administrators, policymakers, and others can learn what effective, teacher-designed solutions look like.

Looking for all of the blog posts in this series? Use the links below:

Hot Off the Presses: Healthcare Narrative Playbook!

“After nourishment, shelter, and companionship, stories are the thing we need most in the world.” – Phillip Pullman

BIF PXL is so excited and proud to announce that our Healthcare Narrative Playbook is finally complete!

Check out the video story to learn more:

Special thanks to Rob Ranney for his beautiful video storytelling. 

The narrative playbook is a practical guide for patients, providers, and caregivers – it provides strategies for using narrative methods in healthcare, in ways that have real impact. The methods included have been vetted by our thought leaders, are backed by research, and can be used cost-effectively and time-efficiently.

Click through below to view the Playbook:

Sincere and heartfelt thanks to our participants and supporters, from all of us on the BIF PXL team! As is true of all great stories, the story of the Healthcare Narrative Playbook was a co-created one: informed by your knowledge of our healthcare system and inspired by your passion for the potential impact of narrative on health and outcomes.


The Power of the Narrative

What happens when you bring together 30+ doctors, nurses, patient advocates, researchers, professors, artists, performers, entrepreneurs, hospital administrators, consultants, and more who believe the power of story can improve care, healing, and health outcomes?

Random Collisions of Unusual Suspects (or for those who know BIF, #RCUS).

Our mission over two days — February 5th and 6th  was to bring these thought leaders together to help define and co-create a narrative “playbook” that will demonstrate the value of narrative methods in the context of healthcare, codify best practices, and engage people in its adoption & implementation. As an Experience Designer, it was important to me to provide the right mix of inspiration, collaboration, and productivity that would allow for people to design their emerging experiences (both online with the #hcnarrative hashtag and offline during the workshop). That’s when beautiful things happen.

Here are some of the big questions we tackled and started to unpack. Over the next few weeks, we will continue to synthesize the ideas, insights, and content that came out of the participatory design studio in order to publicly share the Narrative Healthcare Playbook in March.

 

How do we define “narrative” (and is that even the right term)?

In planning this event, we expected that defining “narrative” would be an easy task. But the power of nuance and language brought in some messiness to the process  doesn’t it always? We did land on some common elements of the definition, such as the continual and iterative process it takes to build and form, the sense- and meaning-making it provides, and different roles it creates space for. But it also highlighted some differences of opinion (Is it really about empathy for understanding? Or improving care?) including using the term, “narrative”.

What is a narrative “playbook”?

We use the metaphor of a playbook to explain how we envision people using the output. In football, a playbook is a notebook with techniques and strategies relating to game plays. Different situations require different strategies, which take the context (the team formation, skills of the players, how far the goal line is, etc.) into account. This is how we want the playbook to be structured and used  we are building it to provide strategic guidance about how different users can use narrative methods during specific scenarios.

Who are the users and what value does it provide?

As for the users of the playbook, we had originally named three user groups  patients, providers, caregivers, and the fourth group of general “others” (hospital admins/policymakers/payors/etc.). We included the last bucket to see if there were, in fact, other potential users for which narrative could have value. To further develop the user groups and the use case scenarios in which they could use narrative methods, we assigned teams to each group. Starting with a brainstorm about their general needs, teams developed common scenarios (As a patient, “I’ve been diagnosed with a chronic condition”), the challenges within the scenario (“I don’t know how to tell my family”, “I want a second opinion”), and the potential impact the playbook could have (“Linking experience/emotions to language, fostering hope, creating connection”).

What are the barriers to adoption?

We know there are a lot of barriers  emotional, cognitive, cultural, ethical, and systemic  that stand in the way of exploring, adopting, and implementing narrative methods. By writing them all down, it felt overwhelming but also a challenge that we, as a collective group, can undertake.

While we have much work ahead of us  synthesizing scenarios, codifying methods, developing language and tone, and building the deliverable itself  we hope to continue to bring people into the process to co-create the narrative of the power of narrative in healthcare. Check back in to learn about our process and opportunities to participate!


Patients and Families and Doctors, Oh My!

Wow.  ‘Hair on Fire Moments’ and all, the Patient Experience Lab was smokin’ this week (actually, literally, because my hair caught on fire last night from a poorly placed dinner candle, giving me the tapered look I was searching for at my last haircut but didn’t get, making it the perfect metaphorical ending to a crazy but productive week).

The more context, depth, empathy, and honesty that the story has, the better chance we have at using those stories to inspire new relationships, design more relevant experience — and transform social systems.   

The BIF studio was all abuzz this week with brilliant minds from the across the US and UK, collaborating on strategies to catalyze the inculcation of more systematic use of ‘the narrative’ in our healthcare systems.  And our “Family Well-Being” team was down in Dallas exploring the concept of what it means to be “well” with families from all socioeconomic classes, experiencing the role that Texas pride takes on for the born and bred, the incredible resilience found in some of Dallas’ poorest neighborhoods, and the hopes and fears of the first generation change-makers trying to forge a different path than the ones their parents and grandparents took.

The theme: stories, stories, and more stories.  From patients who told us of the day they decided to speak out about failed, intractable systems, to physicians who saved patients from life-altering treatments by avoiding a contextual error discovered through conversation, not data. And of course, families who spoke of the importance of trusted relationships — not only in your inner circle but in your community support system  as a key element of well-being.

I was saddened, inspired, touched, motivated, and challenged by the many stories I heard this week from patients, families, doctors, educators, researchers, and business leaders. It reaffirms my belief that storytelling is one of the most powerful tools for transformation…and the more context, depth, empathy, and honesty that the story has, the better chance we have at using those stories to inspire new relationships, design more relevant experience — and transform social systems.   


Innovation Lessons From Taylor Swift

I’m not a fan of pop music but I am an innovation junkie. My daughter Alyssa, a self- professed Swiftie, has been pestering me to pay attention, if not to Taylor Swift’s music at least to her business model. She wore me down. Turns out, there’s a lot we innovation junkies can learn from Taylor Swift.

Whether her music is your thing or not (I have to admit its growing on me!), you can’t help but be impressed with Taylor Swift’s business savvy during a time when the music industry is being disrupted to smithereens. I’m most impressed with her social media presence to catalyze a growing army of Swifties and her aggressive stand against Spotify as the business model war between mp3 sales and streaming services rages on.

The most successful businesses today are movements more than companies. Movements don’t market. Movements inspire and engage. They create an emotional connection through storytelling. Not stories to be enjoyed passively but stories we see ourselves in, stories we can actively participate in. What Taylor Swift realizes, that most businesses haven’t figured out, is that “social” isn’t an extension to an existing business model, it is an entirely new business model. Social isn’t a bolt on, its central to how movements start and grow.

Over the last two years, the bottom has fallen out of the U.S. album market with sales plummeting 20%. Taylor Swift’s new album 1989 defies gravity with amazing launch week sales of 1.28 million copies exceeding all expectations according to Nielsen SoundScan. Swifties everywhere mobilized to make it so. My daughter, the fangirl, drove this innovation lesson home for me. Alyssa maintains a Tumblr site dedicated to all things Taylor Swift. I didn’t pay attention until the day she called home proclaiming that the pop star had followed her and had actually responded to her question about all important lipstick choices. My daughter was so excited you would think it was a national holiday! That’s what I call fan engagement.

As if that wasn’t enough to lock in a fan for life, my daughter’s next post was a video of her 3-year-old twin nieces (our granddaughters) dancing to “Shake It Off.” Cute, aren’t they? When Taylor Swift tweeted out the video to her 46 million followers, our granddaughters went viral. Now everyone in our family is a Swiftie!

Multiply the ripple effect from this example of personal engagement thousands and thousands of times and you begin to see how social isn’t about pushing a message out to potential customers, its about pulling people into a movement. Talk about force multipliers. Social business is redundant. All business is social.

There is also an important innovation lesson in the way Taylor Swift has staked out her position in the music industry business model wars. Album sales are declining rapidly because consumers are flocking to free streaming services like Spotify with over 40 million active users. Only about 25% of those active users pay for a premium service without ads, the rest stream for free. 40 million streamers can put a serious dent in album sales. Spotify pays per stream royalties of between $0.006 and $0.0084 which is significantly less than an artist can make through mp3 sales.

Not many artists have Taylor Swift’s market clout but when she announced she was pulling her music off of Spotify it sent a clear message to the market. Content matters and should be paid for. In a Wall Street Journal op-ed and in a Yahoo interview she makes her point of view clear.

“Music is art, and art is important and rare. Important, rare things are valuable. Valuable things should be paid for”.

“I’m not willing to contribute my life’s work to an experiment that I don’t feel fairly compensates the writers, producers, artists, and creators of this music”.

In a world where content can be digitized and the marginal cost of global distribution is virtually zero consumers have been conditioned to get content for free. It’s a business model free for all. Content producers have been squeezed mercilessly. Journalists, authors, and musicians are being decimated. Newspaper and magazine journalists have been let go in droves left to scramble to make ends meet as free agents. Authors bear the brunt of collateral damage from the battle between Hachette and Amazon. Fewer and fewer musicians can make a living pursuing their passion.

A dangerous narrative has emerged in which content creators are supposed to just accept that their content will be free. Authors are expected to write articles and books for free so they can make money giving speeches and doing consulting work. Musicians are expected to release music for peanuts so they can make money on the road doing concerts.

I have personally fallen into this trap as a steady content producer including tweets, blogs, articles, and even a book. How many of us keep pumping out content for free or very little money in the hopes that it will translate into value in other ways? Taylor Swift is taking an impressive stand. Yes, it is in her best interest to do so but it is also in the interest of content creators everywhere.

Many new business models will emerge in the digital era. It will be messy while the market sorts out and balances consumer, platform, and content creator interests. Business models that don’t recognize the power of customer engagement and fully value the contribution of content creators are unsustainable. This new Swiftie is rooting for Taylor Swift’s continued success.

Originally published on Medium.


#BIF10 Storytellers Featured in TIME.com Series

This summer we’ve been honored with the opportunity to publish a series of articles in the Business section of TIME.com. For the series, BIF’s Chief Catalyst Saul Kaplan and our wonderful Brown University intern Nicha Ratana have created a series of interviews with BIF10 storytellers that explore their approaches to innovation and the importance of the BIF Collaborative Innovation Summit.

Here’s the series so far:


How to Have your Audience at Hello (Sam Horn)

The bloggers have spoken–the BIF summit rocks! Last week Amanda Fenton eloquently discussed her excitement in anticipation for BIF-7, now please turn your attention to Sam Horns’ take on the power of storytelling! -Katherine Hypolite   

One of the best conferences I’ve ever attended was BIF-6, held in Providence, RI and hosted by Saul Kaplan of the Business Innovation Factory.

Saul and his team collect an eclectic mix of pioneering thought leaders ranging from Tony Hsieh of Zappos to Alan Webber, co-founder of Fast Company, Jason Fried of Rework and Keith Yamashita, who believes many of us “fritter away our greatness.”

Each presented a TED-like 18-minute presentation introducing their latest invention or insight.

I was on the edge of my seat for the entire two days.

There was a recurring, underlying theme to each presentation. These visionaries had either:

A) seen something wrong and thought, “Someone should DO something about this. After being bothered about it for a while, they finally concluded, “I’m as much a someone as anyone. I’LL do something about this.”

B) witnessed something that wasn’t what it could be. They thought, “It doesn’t have to be that way. There’s got to be a better way. An easier, greener, more satisfying, profitable way. And I’m going to come up with that way.”

I’ll be featuring some of their intriguing stories in upcoming blogs.

For now, I want to share the opening of the individual who did the best job at winning buy-in the first 60 seconds.

Are you wondering, “Was this someone who’s given hundreds of presentations, who’s done lots of media?”

Nope. The person who had us at hello was a surprise.

She walked to the center of the stage, centered herself (literally and figuratively) and stood tall and confident until everyone in the room gave her their undivided attention.

Then, flashing a playful grin, she said, “I know what you’re thinking.”

Long pause.

“What can a 7th grader possibly teach me about innovation?!”

Big smile.

“Well, we 7th graders know a thing or two. Like,” and here she spoofed herself, “how to flip our hair.” At this point, she tossed her long hair over her shoulder.

The crowd laughed, (with her, not at her). Everyone was instantly engaged and impressed with this young woman’s moxie and presence.

“We also know we have the power to make things better if we put our minds to it. For example . . . ” and she was off and running.

12-year-old Cassandra Lin had us at hello.

The Cliff Notes version of her story is that she and her class discovered the clogged sewer pipes in their city were the verge of causing a disaster because so many restaurants and industrial companies were pouring their F.O.G (Fat, Oil, Grease) down the closest drain.

After doing some research, she and her classmates started T.G.I.F – Turn Grease into Fuel – an award-winning recycling effort that generates money for needy families.

Read the entire article at Sam Horn’s blog


Stories Can Change The World

“Facts are facts, but stories are who we are, how we learn, and what it all means.”  My friend Alan Webber, Co-founder of Fast Company and author of Rules of Thumb, has it exactly right.

Storytelling is the most important tool for any innovator.  It is the best way to create emotional connections to your ideas and innovations.  Sharing stories is the way to create a network of passionate supporters that can help spread ideas and make them a reality.  We remember stories.  We relate to stories and they compel us to action.

Storytelling is a core value at the Business Innovation Factory (BIF).  We believe that advancing our mission to enable system change in health care, education, and government is critically dependant on our ability to create, package, and share stories from our work.  Everything we do is about storytelling and our Innovation Story Studio is one of BIF’s most important capabilities.  By openly sharing stories about the process and output of BIF’s work we are strengthening our community of innovators and becoming more purposeful with every new story.

It is no surprise that BIF’s annual Collaborative Innovation Summit is all about storytelling.  I will never forget meeting with my friend and mentor Richard Saul Wurman (RSW) to get his advice prior to our first summit five years ago.  As an innovation junkie, it doesn’t get any better than having RSW as a mentor. He founded TED for heaven’s sake.  I went to the meeting prepared with an approach that I had worked on for weeks.  As an MBA, of course, I had a matrix, with speakers organized by theme.  RSW heard me out and could only shake his head saying, Saul, you have a lot to learn about how to create an emotional connection with an audience.  He patiently told me to throw away the matrix.  He said it was as simple as inviting people to a dinner party.  Ask speakers that you want to have dinner with to share a personal story that you are selfishly interested in and invite others to listen in.  RSW has been a storyteller at every summit we have hosted.

I love RSW for that advice.  That is exactly what we do.  No PowerPoint presentations, no matrix, just stories.  One glorious story after another in no particular order, from storytellers (not speakers) sharing personal and raw insights about what innovation means to them.  After about four to five stories back to back with no boring Q&A to break the rhythm we take a long break where all of the storytellers and participants can interact, connect, and share their own innovation stories and experiences.  No breakouts, flip charts, or prescriptive assignments.  It is up to the 300 participants to decide what is compelling and which connections are most interesting and valuable. The most interesting collaborations every year come from connecting unusual suspects that find value in the gray area between their interests and disciplines.

Every year one of my favorite things to do is connect with each of the storytellers to discuss the upcoming summit and their stories.  I am almost through these calls for our upcoming summit, BIF-5, on October 7-8.  Talk about a kid in a candy store.  To talk with each of these innovators is inspiring and a great joy.  Check out the BIF-5 storytellers and you will see what I mean.  These innovators are asked to give speeches all of the time.  Many of them have written books and do speaking tours.  They all have PowerPoint presentations in the drawer and a stock speech they can give in their sleep, which they are not allowed to use at a BIF summit.  I always find our storyteller’s reactions interesting when they discuss preparations for sharing a story versus giving a speech.  They all say that it is far more interesting and challenging to tell a story than to give a speech.  Regardless of their fame on the speaking circuit, there is always trepidation in their voices when we discuss their stories.  Every storyteller over five years has said that they are excited to hear the stories from the other storytellers and will be glad when they are done sharing their own. That is why they take the gig.  It is a refreshing break from the grind of the speaking circuit.  Storytelling is harder but more personally rewarding.

I can’t wait to hear the stories at BIF-5.  All of the stories will be posted in the BIF Innovation Story Studio along with the videos from BIF-1 – BIF-4 so everyone can access them.

BIF-1 storyteller and storytelling expert Steve Denning says, “People think in stories, communicate in stories, even dream in stories. If you want to get anything done in an organization, you need to know how to use the story to move people.”  I agree with Steve, stories can change the world and storytelling is the way to make it happen.


The MinuteClinic Disruption

The Boston Herald ran a story over the weekend about Rhode Island-based CVS’s plans to locate low-cost health care clinics in retail stores in Boston. I’m sure CVS knew they were in for a fight considering the lengths many Rhode Island primary-care physicians have taken to block their efforts to do the same here in our state.

From the article Competition won’t ail you:

“Boston Mayor Thomas Menino is concerned about CVS’s plans to locate low-cost health care clinics in retail stores in his city. Limited service medical clinics run by merchants in for-profit corporations will seriously compromise quality of care and hygiene, he has said.”

The idea of the MinuteClinic is as much a mindset problem as it is a financial threat. The model runs counter to everything a physician has been trained for. Another problem – most physicians don’t want to be businesspeople and this is a real business conundrum. Following a disruptive strategy involves fear, risk and potential cannibalization—the mindset being that current customers (or patients as the case may be) are the lifeblood of the company (physician practices) and they must be protected at all costs. Of course in the end, these fears usually become self-fulfilling prophecies.

Clay Christensen is one of our research advisors here at the Business Innovation Factory. He would emphatically say don’t bother fighting the disruption. But he’ll also tell you that if you answer the disruptive threat, you shouldn’t invest your dollars in trying to advance your existing business model to please your existing customers in your existing value network. In so doing, you force the disruptive technology to compete on a sustaining basis, and will nearly always fail.

Clay suggests shifting responsibility for answering the disruptive threat to an autonomous organization that can then frame it as an opportunity. A new organization can pursue alternative channels, utilize different suppliers, and employ different services. Most importantly, they can do this without hindering their current, and most likely profitable value network while also giving their new growth ventures a solid foundation for success.

What does that mean for a primary-care physician’s practice? Here’s what Innosight (the consulting firm founded by Clay Christensen) has to say:

“In reality, these clinic’s present a good growth opportunity, but it will require significant change in one that requires a significant change in business practices vs. operating the sort of doctor’s office to which they are accustomed. Predictably, rather than seeing local doctors seize the opportunity, we are witnessing new specialists such as CHD Meridian and Whole Health Management ride the disruptive wave.”

Without a doubt, this story will be one for the record books. It’ll be fascinating to watch it play out. (Even though we all know the ending.)


Twenty-Nine Words or Fewer

On Wednesday, April 12, 2006, I had the great fortune to participate in Steve Denning’s workshop: Storytelling and Innovation at the Hasbro Corporate Headquarters in Pawtucket.

I did not know what to expect from the day, but I have an MFA in fiction writing (which has not, incidentally, translated into high career potential), so I was curious to hear about how storytelling and narrative could be used to tackle challenging topics in ways that would be compelling to a business audience.

Denning appeared to be a rather unassuming man, standing half-behind the podium as the introductory remarks were being made. As soon as he took center stage, however, he sprung to action and the workshop participants were drawn in by his candor, his enthusiasm, and his dynamic presentation style. He began by sharing a personal anecdote about his own experience at World Bank in the late 1990s. It was his relating of a 29-word story that not only changed the course of his own career, but the path that the World Bank was to embark on from that point forward.

Through a series of clear, straightforward, and thoughtful prompts, and several small group activities, the power of storytelling to persuade, cajole, and inspire was demonstrated. To be sure, Denning was not talking about spinning yarns or fairy tales (although he did warn us that our stories should have “happy endings”), but about concise, well-wrought narratives that were true, positive in tone, and minimalist. This story – a “springboard story” was the key to an effective presentation, which would accomplish three essential tasks: 1. Get the attention of the audience; 2. Stimulate their emotions; and 3. Reinforce emotions with reasons.

We spent the morning working on developing our own “springboard stories” and in the afternoon, Denning took some time to talk more broadly about the role of storytelling in organizational change. Because innovation by definition is a difficult thing for an organization to accomplish, finding the formula to lasting change can be fraught with pitfalls. In order to allow potential naysayers to find their own ways into a new or complex idea, a change agent can use springboard stories and other narrative techniques to encourage envisioning a shared future. “Just imagine…” “What if…” and “Just think…” are key phrases that can link these stories to potential change.

By the end of the afternoon, we had worked out a framework for an effective presentation for organizational change. A few of the braver among us made their own presentations through which we were able to see Denning’s principles at work. These presentations were lively, engaging, inspiring and sound. We were leaving this room with real tools, and real power for change.

I personally left Steve Denning’s workshop invigorated, inspired, and with a deeper understanding of the power of effective communication. And with a renewed faith that my MFA will be valuable in ways I could not have anticipated.

Thank you, Steve Denning, and thank you, Business Innovation Factory!