At the 2015 Healthcare Design Expo & Conference (Nov. 14-17, Washington, D.C.), Deborah Adler, the founder of Adler Design in New York City, will present the closing keynote presentation, “Go to the Gemba!” on Tuesday, Nov. 17.

In this conference preview, Healthcare Design talks with Adler about her career and how working in the gemba has inspired new ideas for the healthcare industry.

Healthcare Design: After starting your career, you went back to school earn a Master of Fine Arts in design from School of Visual Arts in New York. It was while working on your senior thesis that you got your first experience in healthcare design. Tell us what happened.

Deborah Adler: I was going to develop my thesis on curly hair and create this mecca with products for different ethnicities and curl types because back then, there really wasn’t much out there for curly hair. Then 9/11 happened and suddenly my idea didn’t seem that important to me and I felt like I needed to do something that would really make a difference. Around that same time, I had this incident where my grandmother had taken my grandfather’s medication. They both had the same first initial “H,” for Helen and Herman Adler, and she mixed up the labels. I wanted to try to change that so I came up with this new idea to develop a whole system to package prescription medication. Prior to launching my firm, I partnered with Target to develop the ClearRx prescription packaging system. What I learned through that project, and many others since then, is this idea that if you really want to try to make a difference in the world, you have to go to the gemba.

What’s the Gemba?

Gemba is a Japanese term that translates to “the real place” or “the place where the work is done.” It’s mostly used in Lean manufacturing. In this case, gemba would have been my grandmother’s medicine cabinet; it’s where we can see what really happens and what needs changing.

How has this approach helped you on a recent project?

I was asked to redesign a wound care kit. We did a study where 68 nurses were given a state-of-the-art dressing and asked to apply it onto a wound on a model. All of the kits came with instructions, but not one nurse applied the dressing correctly. We went into the gemba to learn how to improve the kit by redesigning it to how people actually use the product. For example, we put a big picture of the contents on the outside of the package so nurses could see what was inside before opening the foil wrap, which would reduce the chance of wasting it or it becoming unsterile. We gave nurses step-by-step instructions that were easy to understand; some quick illustrations; and a sticker where you could put the time, date, and your initials on the actual dressing, so that the next nurse knew how long the dressing had been on and when it should be changed. When we gave them the redesigned version, there was an 88 percent increase in compliance.

What’s a takeaway that you want our audience to go home with from your presentation at the Healthcare Design Expo & Conference?

The personal is really the universal, and we should all be paying attention to the little things and to experiences that we’re observing. The best place to be right now is in healthcare. Designers have a huge say in what’s going on. It’s a very ripe moment. The collaborations between designers and architects and physicians and patients and nurses, everyone seems more open now than ever before to sharing information and innovating in this space. Now that hospitals are no longer single facilities but systems, there’s a lot more need for continuity of patient experience throughout all of the different touch points on the continuum of care. Design needs to get involved on that most basic level of trying to make sure it’s a seamless experience for patients.

Anne DiNardo is senior editor of Healthcare Design. She can be reached at