When the five-person team from an exotic West Coast design firm called IDEO descended on Memorial Hospital in South Bend, Ind., hospital administrators--as one later put it--"had no idea what we were getting into." IDEO is the nation's largest industrial-design firm, the outfit that created Apple's first mouse, the sleek
Palm V handheld computer, Nike's wraparound sunglasses and Crest's stand-up toothpaste tube. Its 350 designers, in eight cities around the world, take on some 500 projects a year. But the IDEO team had more on its mind than spiffing up the medical widgetry and moving the furniture around. In two weeks they turned the hospital upside down: not just taking over the boardroom to build models of nurses' stations and cubicles out of foam board and duct tape, but invading rooms to take notes and photographs, analyzing and rethinking how staff interacted with patients and visitors. Didn't these people have any boundaries?
Well, they hope not. IDEO is at the forefront of a radical shift in the very concept of design, moving from inventing objects to analyzing and reshaping the way environments and customs mold our experiences. The Palo Alto, Calif.-based firm now applies the open-eyed, open-ended process it uses for coming up with new products to rethink the placement of signs in a store, the positioning of seats in an airplane, even the way a company treats customers and suppliers; it's obliterating traditional distinctions among designers, architects and business-strategy consultants. "IDEO's advantage is they have their fingers in so many different industries," says Stanford engineering professor Bob Sutton, who has studied the firm. "They're not experts in applying industrial design to any one discipline, but they're really good at bringing them together, remembering and recombining them to do new stuff."
IDEO's innovation engine was conceived in 1978 by David Kelley, then a Stanford engineering grad student, who believed that a design firm should incorporate not just mechanical engineering but social science, computer science and marketing. "I fell in love with the idea of design as a discipline that puts things together and innovates in any subject," says Kelley, who now directs Stanford's product-design program and is IDEO's chairman. The team that worked on Memorial Hospital, for example, included both a high-tech engineer and a widely respected photographer. At IDEO, designers engage in both the usual brainstorming and seat-of-the-pants proto-typing--one device used for sinus surgery was mocked up from a marker pen, a film canister and a clothespin--and the sort of field observation Jane Goodall did among the primates of Africa. As CEO Tim Brown puts it, "We think you get nothing from sitting at a computer all day."
This shift from products to process--or, in IDEO-speak, "verbs, not nouns"--comes partly from sheer necessity. With traditional manufacturing migrating overseas and Silicon Valley in a slump, the gizmo market has shrunk, so a product IDEO now sells is its prized method for unleashing creativity, applying it both to physical spaces and to human behavior. It offers "innovation services" to such companies as Amtrak, which hired the firm to design the interior of its new high-speed Acela Express train. Focusing on the experience of riding a train, and not the train itself, IDEO and partners surveyed 24,000 travelers and Amtrak employees. Out of this came such recommendations as swiveling oversize seats so passengers can face each other, conference tables in each car for onboard meetings--no more treks to an overcrowded dining car--and every traveler's favorite amenity, spacious bathrooms.
At Memorial Hospital, IDEO's method of observation and innovation yielded more dramatic results. The design team noted that the nurses' stations looked too much like information desks; nurses were interrupted dozens of times a day, usually just by visitors who were lost in the subterranean hallways and needed directions. Designers modeled new workstations with more privacy and simplified signs to help disoriented visitors. In the drab waiting rooms they found nervous, loitering families, sometimes bivouacked on the floor, sometimes sitting side by side as if they were waiting for a bus. So IDEO asked hospital staffers to bring in photos of how their own families interacted; most brought pictures of the dinner table. In the new wing, opening in 2005, the waiting room will have tables, private family rooms, a large bistro and designated family space in the larger and more accommodating patient rooms. And, borrowing an idea from the world of retail, IDEO recommended transparent entrance doors to departments, to create welcoming "storefronts" that give visitors permission to enter, instead of making them feel trapped in a confusing, alienating maze.
Getting IDEO-ized doesn't always work out so happily. Boston's Brigham and Women's Hospital hired the firm last year. IDEO came up with clearer wall signs and better traffic flow, but the hospital couldn't afford to replace its outmoded call-light system in patient rooms, and the employee union understandably went ballistic when IDEO suggested new language for the hospital's "philosophy of care" statement: that its mission was to "surprise and delight" patients and families. As CEO Brown puts it, "The notion that you can make changes happen quickly is not true." Still, IDEO's vision of more intelligent and humane engineering of everyday life persists after its design teams depart--often leaving behind IDEO-style in-house committees to carry on the process of observation, brainstorming, prototyping and reinvention. They're learning that good design isn't easy; IDEO only makes it look that way.