Actors? Story line? How did a copy of one of your entertainment magazines get mixed in with your professional journals? Wait a minute—this is your professional journal! But before you flip to the next article or begin a letter to the editor complaining about this healthcare heresy, consider this: Good acting has nothing to do with pretending or with reciting a script. It is not in the realm of the fake or the phony. If that were the case, any actor could play any part and all casting directors would be out of work.

Instead actors must be able to touch something real inside themselves, so that they can authentically be the person called for in a particular circumstance. Understanding that person's motivation on an emotional level, not just a cognitive one, is much more important to actors than memorizing their lines or hitting their marks. And since their experiences are staged, success in the Experience Economy will require companies in all industries, including healthcare, to use theatrical disciplines to create vibrantly distinct cultures.

We need actors (nurse, doctor, manager, housekeeper) who can perform their standard roles in a unique, cohesive, and memorable way. Space design will be required to go way beyond containing products, equipment, and people in a functionally efficient manner. Architects and interior designers will be asked to build new cultures, not just new containers. And as in almost any field of human endeavor, stories will go a long way toward creating understanding and support.

Before Geeks Were Famous

If you want to study how themed design and culture can turn the mundane into the memorable, consider the Geek Squad, a home computer repair business begun in Minneapolis. Robert Stephens, Geek Squad founder, wanted to make the computer repair experience so engaging that people couldn't wait until their machines broke down! He started by designing the “precincts” (think NYPD Blue) from which the Geeks would be dispatched, as well as their distinctive Volkswagen Beetle “Squad Cars.” He then designed their geeky looking uniforms: white shirts, thin black clip-on ties, too-short trousers exposing white socks, and Geek Squad badges that are flashed during the opening dialogue: “Hello, ma'am, I'm from the Geek Squad—please step slowly away from your computer.”

But Stephens didn't stop there. He auditioned and cast his employees as Geeks, so that right from the start prospective employees would know that something well beyond technical competence was needed to work here. In the early days of the Geek Squad, applicants would be given a to-the-minute time and an out-of-the-way location for their job interview. At the appointed moment two squad cars would pull up and dramatically clear the area for the arrival of the Geek Squad limo (think Secret Service). The candidate would be escorted into the limo, where an audition, not just an interview, would take place. And who would it be driving the limo, listening in to hear if the candidate had the personal characteristics necessary to be cast as a Geek? Robert Stephens, of course.

With this strong, intentional culture reinforced by compelling environmental design, the Geek Squad offered a computer repair experience so unique that the company was bought by Best Buy and expanded nationally. This acquisition will change forever the after-sale experience expectations of Big Box customers. It will be interesting to see if Best Buy learns the design and culture lessons from their new subsidiary and applies them throughout the store, thus reinventing its entire brand through a new customer experience.

ROI on Architecture

The Geek Squad shows that moving from mundane delivery of services to staging a memorable experience is a transformation, not an incremental change. And when is the right time to attempt something as daunting as cultural transformation? When you're already spending tens of millions, sometimes hundreds of millions, to build something new, that's when. That sort of investment should have a much greater return than simply shiny, new facilities that are quickly diminished by housing dull, old behaviors. One essential point should not be missed when you're making an investment of this magnitude in the healing environments of tomorrow: You need to place as much emphasis on changing the actors as changing the stage. You can do that with a proper story line.

A Tale of Two Stories

More and more companies are using storytelling as a way to convey transformational strategy in an emotionally memorable way. It's also a way to “rehearse” their employees for a new kind of performance. Stories can provide the “why” (the motivation, in theatrical terms) that is so often overlooked in any company's race to implement something new.

In the early 1990s, for example, Pepsi was faced with an industry-altering change. For years, success had been measured purely in terms of sales of its brand of carbonated soft drinks in comparison with those of its archenemy, Coca-Cola. Take a market-share point from Coke—a good year. Lose a point—bad year. But then people started doing something quite amazing—they started drinking things other than carbonated soft drinks. Iced teas, juices, even bottled water. (Remember your first thought about that idea? Yeah, me too.) Even the cola companies' retail “partners” started making private-label soft drinks and were becoming more significant competitors.

So, faced with all this change, what did Pepsi do? It created a themed strategy story called “The Revolution on Beverage Street.” The story, told to employees all over the world, depicted a street with storefronts, vehicles, pavement—and numerous displayed facts on industry trends, competitors, and Pepsi's new strategy. The spread of this story among Pepsi employees around the world is widely credited with enabling Pepsi to make the product, distribution, and marketing changes it needed to succeed in its new marketplace.

Closer to home for HEALTHCARE DESIGN readers, Steve Altmiller, CEO of San Juan Regional Medical Center in Farmington, New Mexico, reviewed the challenges of the hospital's largest-ever expansion and renovation project and thought, “The understanding and motivation necessary for us to be successful in a venture this big is not going to come from a bullet-point plan or a PowerPoint presentation. What we need is a ‘what's the point?’ experience.” Altmiller liked the Pepsi story approach, so he commissioned the development of San Juan Regional's own story called “Raiders of the Lost Art,” the point being to create employee understanding and support for the upcoming project and the changes it would bring (see “Raiders of the Lost Art,” p. 18, for the amazing details).

If he had stopped there, Altmiller would have proven the power of storytelling for large campaigns and significant events like new construction. But he didn't stop there because he realized that the building was the “easy” part. Instead, as soon as “Raiders” was complete, he began work on a second story entitled “Riddle of the Sphinx.” San Juan Regional rented a closed middle school and turned it into an ancient Egyptian environment for the Riddle of the Sphinx adventure map story (figure 1).

The story picked up where “Raiders” left off—under the crossed palm trees (figure 2). The school library was turned into a Disney-esque preshow area, where employees watched a video story that set the stage for the challenges to come (figure 3). The gymnasium was transformed into the inside of an ancient Egyptian pyramid, where small “crews” of employees learned about issues facing the hospital. Through riddles, anagrams, adventure, and plenty of Socratic method (the power of these stories is that they are both told and asked), “Riddle” captured the imagination of employees and made them feel the story. At each stop along the way, the story hit them with the effects of five specific healthcare “confusions” (expressed in hieroglyphics) created by: patient expectations, complex communications, complicated technology, arcane regulations and finance requirements, and ever-changing staffing challenges. Interior design and propping created an immersive environment that magnified the lessons learned from confronting these confusions.

As they made each fact-based stop (some 20 in all, as per the map), employees discussed questions such as: Does this fact surprise you? What do you think about San Juan Regional's plans? What else might be done (figure 4)? Once employees had solved the riddle associated with each of the five “confusions,” they had the individual letters necessary to unlock the cryptic anagram at one of the story's last stops (figure 5). And finally, they discovered the identity of the pharaoh buried in the sarcophagus—the “source of light” for all of San Juan's future (figure 6): a cleverly conceived ceremony revealing the source to be each and every employee of San Juan Regional, listed by name.

First managers, then current employees, and finally new employees were immersed in this story. In fact, San Juan has themed the new employee-orientation center as “the Sphinx.” Altmiller summarizes the impact of “Raiders” and “Sphinx” this way: “When I first came here and talked about doing things in a dramatically different way, I was told time and time again, ‘You can't do that in Farmington.’ Now we're doing all those things and more. And we couldn't have done it without the stories.”

What's Your Story?

How can you use culture and design to transform your experience, even if you don't have a big construction project on the drawing board right now? Start by walking down to your Human Resources Department and then to your employee education space. What do they say about your culture or your distinctive approach to the healthcare experience? What story does the physical space tell?

That's what I thought. So why not start putting them to use? Good luck in mixing traditional theater, design, culture, and storytelling to transform your entire operation.

Or, more to the point, break a leg. HD

Gary Adamson is Chief Experience Officer at Starizon, an Experience Design center in Keystone, Colorado.


Key Principles of Lesson 4: Give the Actors a Story Line

  1. Use architecture and design to intentionally change culture, not just to change space.

  2. Develop a context story that gives meaning and motivation to your strategy. Make sure that the story addresses the “why,” not just the “how” and the “when” contained in most strategic plans.

  3. Make sure the story captures each employee's imagination and makes him or her feel. This is always important, but especially so when you're involved in a major construction project that you want to result in a new experience, not just the old experience in new surroundings.

  4. Start right now. Build a themed immersive environment encompassing your Human Resources Department and your educational spaces. Pretend that each time you open the door to these areas you are saying, “Once upon a times.” What visual depiction of your vibrantly distinct culture is waiting on the other side? What audition or rehearsal (as opposed to interview or education) should be taking place. Make the design communicate your story.

—Gary Adamson