Design the Intangible

Mark VanderKlipp
4 min readAug 20, 2018


Systems Thinking and Patient Experience

“We know we have a problem, we just don’t know what it looks like.”

We’ve mentioned in our manifesto that, in the world of healthcare, the least tangible elements are often the most critical to business success. That it’s important to design experiences, rather than have them happen by default. That the answers to many patient experience challenges already exist, and that they need to be unlocked from within a given culture.

Research speaks to the truth of these statements: in the Beryl Institute’s recent publication Consumer Perspectives on Patient Experience 2018, we read that communication is seen as the key to success for patients and family members.

95% of survey respondents report as “Very or Extremely Important” that:

  • caregivers listen to them,
  • that they communicate in ways that are easy to understand, and
  • that they are treated with courtesy and respect.

But what does a system designed to support these priorities look like?

Using Systems Thinking to guide our practice has the potential to deepen our impact. You may have reviewed some of the system maps that we’ve created for our clients to help define and visualize the systems within which they work. These are helpful in a variety of ways, most importantly that they allow the viewer to step back, see the system as its defined, and assess how a system functions.

The value of these maps is in the conversations that they elicit. We challenged ourselves to create a system map that describes the intangible aspects of patient experience from the standpoint of staff, who deliver the experience, and patient/family members who receive it.

The key to translating culture into experience is communication. And communication is the single element of this map that can be designed.

We know that an organization’s culture is deeply held by each individual. That their beliefs about the organization give rise to the values to which they aspire as they do their work. These, in turn, fuel the attitudes that caregivers bring to work each day.

This translates directly into the experience as it’s delivered. A person’s attitude impacts their behavior, which creates positive or negative perceptions of the individual and the institution alike. Those perceptions fuel the stories that are told, both within the organization and outside of it.

The arrows on the outside demonstrate what happens when communication is not at the core of this system: negative stories about an institution can influence the beliefs that both staff and potential patients carry (see the last statistic below), and thus their decisions. Without proactive communication, attitudes will directly impact behaviors, which could degrade patient experiences.

This system map can be virtuous or vicious depending on how communication is employed to fuel both culture and experience. Done well, the system is strengthened and nutured; neglected, it suffers.

Proactive communication is at the heart of other patient priorities as well. Again, from the Beryl Institute study, these percentages report as “Very or Extremely Important”:

  • 93%: Provide a clear plan of care and tell me why it’s happening
  • 92%: Ask questions to understand my needs and preferences
  • 92%: A discharge/check out process where my treatment plan and next steps in care are clearly defined.
  • 72%: the recommendations of family and friends as important in their decisions about healthcare.

This final statistic speaks to the critical nature of stories generated from the perceptions in the map above: It’s the stories that are told that feed beliefs about your institution among those who might recommend you — and those stories directly impact your bottom line. This is why we build “Better Stories by Design.”

“To provide the best in experience, healthcare organizations need to be focused on effective communication, sharing of information and processes that support that in happening. These needs do not require extensive resource investment, but they do call for unwavering commitment and focus. These priorities also provide a clear call to action and a path to experience success for organizations willing to focus on and address them.”
- Jason Wolf, PhD, CPXP — President of the Beryl Institute

What are your thoughts? Have we captured the system as you understand it? As we mention above, the value of a system map is in the conversation it elicits. Please comment below and let’s begin a conversation.

Originally published by Yvette Fevurly at on August 15, 2018.



Mark VanderKlipp

Partner at Connect_CX, The Adjacency; speaker, facilitator, systems thinker, healthcare experience designer: