What Matters

In 2001 I landed a job as a design engineer at Alaris Medical Systems (now part f BD). It was there I learned design controls and the Waterfall Design Process that calls out User Needs. It was my good friend, co-founder of Gilero, and then colleague at Alaris, Ted Mosler, who gave me a first lesson in User Needs. My takeaways were this:

1. User Needs and Voice of Customer (VOC)
Who exactly are “users” and “customers” of any product, especially medical devices? Are they Doctors? Nurses? Therapists? Patients? What other needs should be considered? Hospital Administrators?  There are many stakeholders to consult. I started substituting “Stakeholder” for “User” and “Customer” … they are the Stakeholder Needs and Voice of Stakeholders.

2. Solution Independence
Ted would say that the user needs should be clear, concise, verifiable, and free of solutions. More on that to come…

In 2006, I started teaching Biomedical Engineering Design at NC State.  Taking these two lessons, I implemented a process where students interviewed and shadowed stakeholders and developed a single statement. At the time, I called it The Problem Definition.  This was a single sentence (to be clear and concise), needed to include a metric for success (to be verifiable), and was to be free of solutions.

None of this was a secret, but rather well known industry best practices being implemented in a classroom.  And I wasn’t alone.  In fact, Stanford had recently started a fellowship called Biodesign that was built on a foundation of having diverse teams immersed in clinical settings to identify stakeholder needs and develop innovative solutions.  The Stanford Biodesign lexicon became the standard in Biomedical Engineering Education when they published their book by the same name in 2010.

Biodesign highlights a process they coined, Need Statement Development, to compose a single statement that is solution independent.  This is the cornerstone of the Biodesign process, and the mantra they’ve coined is, “A well-charactarized need is the DNA of a great invention.

So from 2006 to 2010 I called this solution free statement, The Problem Definition… and from 2011 to 2016… the Need Statement.

While the results of this methodology are undoubtedly successful, it is not straightforward as an educator to teach what this solution free need statement is.

Over the years I got more specific with the instructions for how to craft a well written need statement. They should be:

  • Free of solution
  • Free of bias
  • Concise
  • No assumptions, inferences, or judgement
  • Incorporates a metric of success or indicator of change
  • Be pleasant to the ear and clearly understood

In 2017 while serving as a coach for the NIH C3i Program, there was this combination of coaching a nurse from Arizona while being married to a nurse in North Carolina.

My wife and I were sitting at a bar in downtown Raleigh at Trophy Tap & Table where I was describing the challenge I was having teaching Need Statement Development to the Nurse in Arizona.

Abby said, “Can you give me an example?” and when I did…, she followed that up by saying, “Isn’t that an outcome?”


This sparked an email chain to two gurus in the area that are the best in the world at Need Statement Development: Ty Hagler of Trig Innovation and Scott Burleson of The AIM Institute.

It was meeting with Ty and Scott that triggered what matters.

What Stanford Biodesign calls Need Statement Development is, in my opinion, what Clayton Christensen calls Jobs to be Done…, and what Tony Ulwick calls Outcome-Driven Innovation.  Indeed, it was the word “outcome” from Abby that triggered this…  Indeed, it was early 20th century economist and Harvard Business School professor, Theodore Levitt, that said, “People don’t want to buy a quarter-inch drill, they want a quarter-inch hole.”

Whether it’s a need statement, job to be done, or outcome… it’s the “WHAT” that matters… not how it’s done.  And not only is it the “what” that matters, the “what” has to matter.  After all, if the need, job, or outcome has no value, it doesn’t matter, and therefore, it’s not worth doing.

So what I used to call The Problem Definition, and then the Need Statement, is today referred to as the What that Matters (WTM).

More thoughts on what matters in future blog posts…  in the meantime, would love to hear your thoughts.

Health & Happiness for All

The Mansion at Glen Cove

For those that have had me in class, you’ll know my teaching style is rooted in story telling, metaphors, and analogies. For this post, I thought it might be fun to start a tradition to blog the story that I’m currently telling students. For the alums, maybe these will ring a bell.

This week, it’s the story of The Mansion at Glen Cove.

From left to right, Andrew DiMeo, James Gandolfini, and Joseph Badalucco Jr. on the set of The Sopranos

Seems like ancient history, but, way back when, I had the fortune of being born into the NYC Motion Picture Industry and worked as a set dresser and prop. The most noteworthy show I worked on was The Sopranos and had the pleasure of getting to personally know James Gandolfini (rest his soul).

I used to work with and for family members that each had different personalities. Two of interest to this story are my cousins Jerry and Chris.  Jerry was usually a boss and ball buster. When working for Jerry, I just remember being wise to keep my mouth shut, opinions to myself, and head down, focused on the orders given to complete the job.  When working with Chris, I just remember it being fun.

I think it was the summer of ’94.  I was working on the movie Sabrina starring Harrison Ford, Julia Ormond, and Greg Kinnear.  We were filming all summer at this mansion in Glen Cove, Long Island.  I remember it being the first time for me that Jerry wasn’t the boss. He had taken a job with another movie, and Chris was now the lead man.  Oh, it was going to be a great summer.  Most days, I was commuting in with my brother, working for Chris…  it couldn’t be better.

I was a selfish kid then, early 20-something.  With the money made from working the movie, I ordered a new Harley Davidson motorcycle, coming from the factory to Darryl’s Harley Davidson in Congers, NY.  For what it’s worth, Glen Cove is a solid 90 minute drive to Congers on a quiet weekend in New York.

Nearing the end of the summer as the movie was wrapping up, I got word that the motorcycle was going to be delivered, prepped, and ready to pick up on a Saturday.  Darryl’s closed at 2PM on Saturdays and was closed on Sundays.  The Saturday pickup was key, because the hours we worked at the Mansion, there was no way I could get it on a week day.

Friday night, the day before the bike was ready, I got a call from Chris. The production company wanted the mansion cleared out Saturday.  He had a crew of 6 coming in (not including my brother), to show up at 7AM.  We’d have 8 hours of pay to get it cleared out.

I was bummed.  The work day was going to delay picking up the bike by a week.

Saturday morning, 7AM, the crew is sitting in a kitchen at the mansion, drinking coffee, eating eggs on rolls, and Chris wasn’t around.  The attitude of the crew was… 6 guys… 8 hours… this was going to be a breeze of a day.  But by 7:15, when no one was moving from the kitchen…, all I could think about was if we moved fast, I could get out of here by Noon and get that bike.

I just got to work. Pretty fit back then, I was carrying couches down stairs on my back (OK, maybe a stretch)…, but literally, busting ass, solo, getting that truck loaded.  From my perspective, the rest of the team was standing still, drinking coffee, and just watching as I loaded that truck (biased eyes maybe?).

At Noon, the job was done. The truck loaded…, and Chris showed up to check on the progress.

I walked up to him and said, “Job’s done, can I go? I want to get to Congers before Darryl’s closes at 2.”

Chris said, “If I hired you for 8 hours, you work 8 hours. After lunch, go out and get started on the yard, we have a lot to do out there that we can get a jump on.”

I was pissed. I didn’t eat lunch, I just went directly to the yard and started clearing the grounds.

Twenty minutes later, Chris came out to me and said, “It’s good. Just go. You can leave and get your motorcycle.”

I screamed out of there on 4 wheels…, made it to Congers just in time, left the 4 wheels in the lot, and road off into the afternoon sun along the Palisades on my new Harley Davidson.

-The End

Morals of the Story

  • Authority changes things: Maybe Chris and Jerry were both awesome guys. As I grew up, I learned this to be true. Jerry was a boss and Chris was a colleague…, until Chris became a boss. Our perceptions of people can be heavily influenced by the authority they may or may not have over us. When a friend becomes a boss, the relationship can change.
  • Leaders are not omniscient:  When Chris rolled up that day, he had no idea what went on that morning.
  • Communication is key: Why did Chris let me go? Did one of the team members let him know how hard I worked that morning?
  • Alignment of mission and motivation are important: Was I a hard worker, or did I just have a selfish motivation? These other 5 crew members expected an 8 hour day of working inside during the summer, unloading a mansion. What they got was an afternoon in the hot sun, working in the yard as I left them behind.

I think that high performing teams are those that communicate with each other and with management. They discuss their personal likes, dislikes, strengths, weaknesses, passions and mission. They work together to get on the same page for the team’s mission. High performing teams have members that are all motivated to build each other up, rather than internalize selfish interests.

Thoughts? What do you think are aspects of high performing teams? Looking forward to hearing from you in the comments section below.

Health & Happiness for All

Learning to WordPress

It’s still dark outside and I’ve got a nice view of the Christmas Tree.  I imagine before long, Gus will be stirring and the house will start to come alive.

So, here it is, the holiday season. As a college professor, it’s a break from the hustle and bustle of the academic year. With this break, wanted to do some creative things…, so, toying around with starting an etsy shop, oeMiD, reflections of life…  Poetry to start with, but, we shall see.  Maybe it’ll evolve into something more.

And, while at it, why not try to learn how to build a web site with WordPress.  So, that’s what I’m really up to this morning.

Health & Happiness for All