In 1987, the three companies that would later form IDEO worked together with Microsoft to create the world’s first ergonomically designed mouse. IDEO’s human factors research suggested a small but significant change: Moving the location of the mouse ball forward, from under the palm to under the fingertips, enabled more precise control and resulted in measurable performance differences compared with earlier models.

The industrial design effort examined and tested dozens of shapes in comfort and aesthetic studies that led to the famous “Dove Bar” form, a significant advance over the boxy mouses prevalent at the time. The resulting clean appearance, enhanced control, and improved reliability created enormous consumer appeal that replaced all earlier versions, and Microsoft sold more than 2 million units in its first two years.

With approximately 55,000 Americans waiting to receive kidneys and a list that could double in the next 10 years, there is an acute and urgent need for new technology to increase the quality and number of organs available for transplant. Using the conventional method of organ storage and transportation—a cooler filled with ice—doctors and nurses needed to accompany the organ to ensure proper handling.

IDEO and Organ Recovery Systems created the LifePort Kidney Transporter to provide a new high-tech alternative. The LifePort gently perfuses, or pumps, the kidney with a cold liquid solution to improve its condition before transplantation, which can nearly double storage time and may increase the number of usable kidneys and improve patient outcomes. The device also provides critical data to monitor and evaluate kidneys during transport.

Organ Recovery Systems believes that perfusion has the potential to remove tens of thousands of patients from the waiting list and dialysis, and save the healthcare system more than $1 billion annually. In 2006, the LifePort Kidney Transporter was used to transport 350 kidneys per month in 12 countries, and was included in the permanent architecture and design collection at the Museum of Modern Art in New York City.

Pediatric healthcare system Nemours provides primary, hospital, and clinic-based specialty care, prevention and health information services, and medical education programs in Delaware, Florida, New Jersey, and Pennsylvania. When Nemours wanted to strengthen its brand, it faced two challenges: Empowered patients had more access to information and choice than ever before, and new players—alternative-care centers, retail-based care clinics, and urgent-care centers—were entering the marketplace, diverting market share.

Nemours approached IDEO for help in creating an innovative, differentiated, and patient-centric experience for a new hospital in Orlando, with the goal of establishing Nemours as a destination care provider and industry leader. Together, they identified and clarified both family needs and key experience touchpoints in the patient journey, resulting in the state-of-the-art-designed, 60-acre, $400 million Nemours Children’s Hospital in Lake Nona Medical City, Florida. “The design team’s approach to defining key moments in the patient journey was highly instructive,” said Dr. David Milov, chief of clinical informatics at Nemours. “They captured insights otherwise unavailable to us.”

Concepts that were realized in the hospital’s final design include:

• Care Team Room ID: Patients and families are introduced to each member of their care team to ensure continuity of care.
• Floor Greeters: Concierge-like greeters welcome and orient families and answer questions.
• Family Lounges: Private dining rooms have kitchenettes, so families can cook and eat together.
• Emergency Department: Patients are greeted, sorted by medical condition, and immediately checked into rooms.
• Patient Information Screens: Doctors and nurses can access patient information prior to entering an exam room to enable informed conversations and build trust.
• Smart Bracelets: Personalized RFID-enabled bracelets keep track of the care team.
• Smart Rooms: Triggered by the Smart Bracelet, Smart Rooms “welcome” the patient upon entry.

To arrive at these designs, IDEO sought inspiration via analogous kid-friendly environments, such as museums, schools, toy stores, and zoos. Designers also conducted in-context interviews with patients, parents, families, doctors, nurses, support staff, and outside physicians. One key insight that led to the final design: Patients and families came to Nemours with varied levels of experience—first-timers, occasional visitors, and those who were chronically ill—but the hospital treated them all the same.

To address these needs, the team created an experience blueprint focused on welcoming, guiding, and supporting patients and families through unique environments, integrated service moments, and market-differentiating spaces and tools. To test the look, feel, and value of the designs, designers built full-scale foam core prototypes of welcome stations, waiting lounges, and exam rooms.

The results appeal to patients, families, and caregivers. According to Dr. Lane Donnelly, Nemours chief medical officer, “all the amenities at Nemours focus not only on the child but their parents and families as well.”

The hospital won two awards at the International Interior Design Association’s 2013 Best of the Best Gala (Georgia Chapter), one for the Healthcare Design category and one for best overall out of all 11 categories. Parenting.com writer Shawn Bean noted, “Set amidst a wooded expanse of central Florida, with theme park roller coasters peppering the horizon, Nemours Children’s Hospital is arguably the new high water mark for pediatric care in the United States.”

Designer turned educator Kiran Bir Sethi wanted to blur the boundaries between school and life to help young students become aware, enabled, and empowered to effect change in the world. In aiming to spread her message to millions of children across India , Sethi tapped IDEO and the d.school at Stanford to help create a design contest for youth that would show them that they could make a difference in their community.

Together with the d.school, IDEO designed a competition for middle school students called the Design for Change Contest. Adapting the human-centered design approach into a simple process that 10- to 13-year-old kids could follow on their own, the contest included rules, tools, and platforms that would be accessible to children and teachers throughout India regardless of their previous exposure to design.

The team shaped the rules so that students could learn core design-thinking skills such as empathy, brainstorming, collaboration, and reflection through the process of participating in the contest. And together, the group developed a toolkit to walk students through the simple four-step process.

The biggest challenges to the contest were overcoming the lack of infrastructure, language barriers, and a discrepancy in school resources. There was no national database of schools for easy outreach, so Riverside built relationships with NGOs across India to distribute the contest toolkit to more than 30,000 schools.

The contest receives about 2,000 entries from groups of youth in India each year. They have been addressing challenges such as illiteracy, pollution, traffic safety, care for the elderly, alcoholism, and the environment.

As of 2015, the Design for Change Contest has scaled far beyond India, and is being run in 30-plus countries, with millions of children participating. Each contest entry shows that kids really can make a big difference in the world.

We know this is easier said than done, especially for large teams spread across multiple locations. Over the years, IDEO has helped organizations around the globe develop the capacity to innovate, and that work has allowed us to gather data on the behaviors that have the greatest impact on a team’s ability to develop a successful solution.

Here are four insights into the ways today’s businesses innovate—and what you can learn from what they’ve learned.

1. Quick and dirty prototyping isn’t just for software

Though many executives dismiss MVP-style prototyping as a software-only approach, we've found it's actually more effective in other industries.

In fact, rough, low-fidelity prototyping is significantly more impactful when used in industries where it's currently least applied—particularly for companies with long development cycles and long product lifecycles.

When we looked at data from our research, we found that organizations with long development cycles and long product lifecycles saw their chance of successful launches increase by 109% compared to their more nimble counterparts.

Why? And how? Let’s consider a car company: For those teams, the cost and risk of investing in poorly thought-out ideas is much, much higher. Building a high-fidelity vehicle prototype can cost millions of dollars using traditional methods. Instead, low fidelity mock-ups (in this case, using foam core and tape to create a simulated car dashboard) can uncover critical flaws that can save millions of dollars and years of effort.

2. Don’t let your team become blinded by purpose

Purpose statements are incredibly valuable. We’ve seen that organizations without a sense of purpose find it difficult to innovate: They struggle to choose which opportunities to pursue, and they have a more difficult time getting employees excited about developing those ideas. Our data shows that organizations with a strong purpose are 12% more likely to launch new solutions successfully.

But purpose can have a downside. Our research has shown that it lowers the ability to listen objectively to the results of customer experimentation.

What does that mean? A benefit of a strong purpose is that it simplifies decision-making. However, at its extreme, this approach can lead to less flexible thinking, leaving organizations a little less likely to truly hear what a stakeholder or customer is telling them.

Does this mean you should crumple up your purpose statement and toss it in the trash? No, not at all. Purpose is fundamental to innovation: It energizes employees, speeds up decision-making, and leads to more productive collaboration. But beware the line where purpose turns into dogma and diminishes your team’s ability to truly listen to customers and interpret data.

3. Move fast—but not too fast

With the rise of lean startups, companies are feeling the pressure to get moving. But getting started without a plan and a clear idea of your objectives can end up being a drain on resources.

What’s the cost? First, skipping the steps of getting to know your customer and market causes teams to fail 180% more often. Also, organizations that evaluate multiple ways to solve a problem are much more likely to succeed—more than 42% more likely—and, on average, get to market faster.

We’ve seen two significant reasons for this: First, testing multiple ideas in parallel keeps the team’s mind flexible; and second, customers involved in research and testing during development provide more useful feedback when they are presented with multiple ideas.

If your guess is right from the start, great—you've saved a lot of time. But many startup or venture teams don’t have the right idea at the start. Teams that spend the time getting to know their customer early, then testing multiple ideas can take months off of the overall duration of their initiative.

4. Don’t underestimate the power of culture

When you're working to solve complicated problems, it’s natural to rely on process. Process feels tangible, comfortable. Nail that "innovation formula," and success will come.

But process isn’t—and can’t be—everything. Sure, certain methods are helpful for testing assumptions and getting to the right ideas, but it’s people—their spirit, their judgment, and their energy—that ultimately lead to the development of great ideas.

Organizations whose employees consistently state that they understand how to drive ideas forward and feel that they're making significant strides toward their organization’s goals are 16% more likely to have a successful launch.

One of the qualities we’ve measured is whether an organization’s team members describe their culture positively. Do they see their interactions with those in other organizational functions as productive and supportive? The teams who score each other in the top 5% are 30% less likely to fail than those under the 50th percentile.

Methodology and approach matter, but lean too hard on just those elements while neglecting culture and people will quickly lose their passion and energy, and resort to a paint-by-numbers approach that yields unspectacular results.

Countless more insights like these have yet to be uncovered, but one thing is already clear: Innovation leaders can’t fall back into old, stagnant patterns, but instead must continually find new edges for their teams to push.

Illustrations by Beena Mistry

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Creative solutions don’t happen by accident. They aren’t enacted by lone geniuses—they come from diverse teams that work well together and optimize the right methods and behaviors.

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I’m grateful for Chicago’s trains—even amid the crush of people jammed into the morning’s rush hour commute and the thought-clouding clatter and clank that pervades every metal car. It’s a marvel that these hulking workhorses of public transport coordinate at all, and are generally safe, on time, and comfortable. And yet I often notice fellow train-goers challenged, like myself, by something basic: What do we do with our stuff? In my time as a commuter, I’ve seen myriad workarounds. Legs became walls propping up clothes and bags; thighs became resting ports for big headphones. And then there was the man who transformed his suitcase handle into a coat rack. Human ingenuity: It’s one more thing I’m grateful for during my commute.

Human-centered design requires us to observe human behavior with beginner's eyes, so that we can spot the innate ways people interact with the world around them. We call these intuitive and unconscious reactions Thoughtless Acts, and IDEO designers collect photos of them to inspire their work.

Tim Brown, CEO of IDEO, shows how the techniques and strategies of design belong at every level of business.

The myth of innovation is that brilliant ideas leap fully formed from the minds of geniuses. The reality is that most innovations come from a process of rigorous examination through which great ideas are identified and developed before being realized as new offerings and capabilities.

In this revised and updated edition of Change By Design, Tim Brown reintroduces design thinking, the collaborative process by which the designer’s sensibilities and methods are employed to match people’s needs with what is technically feasible and a viable business strategy. In short, design thinking converts need into demand. It’s a human-centered approach to problem-solving that helps people and organizations become more innovative and creative.

Change by Design is not a book by designers for designers; it is a book for creative leaders seeking to infuse design thinking into every level of an organization, product, or service to drive new alternatives for business and society.

Purchase

Know someone who might love this book? Purchase Change By Design here.

Our checklist made all the difference when the Wellcome Trust tasked us with designing a way to cut down on unnecessary antibiotics use in middle-income countries. The world’s antibiotic misuse has staggering implications: By 2050, antimicrobial resistance is expected to kill 10 million people every year. That’s more people than we lose annually to cancer.

What became known as Project Marvelous took us to Kenya and India, where we encountered patients who self-diagnose and prescribe for themselves and their friends, community health workers with very little training, and pharmacies that dole out antibiotics without a prescription in order to make a sale.

As far as complex systems challenges go, it was an extreme one, but after testing several rounds of concepts rooted in behavior change, we found an intervention with real potential. Smart Prescriptions, as we called it, was an endpoint that varied drastically from where we began. The original hypothesis was that the intervention should be designed for pharmacists. But after following the checklist, we found we had to start with doctors.

Here are the five steps we followed to address this complex systems challenge:

1. Define your ecosystem

We can’t claim to have reached an understanding of the whole ecosystem by a longshot—the sheer number of stakeholders involved is what makes it such a complex problem. So at the outset, we defined our ecosystem, drawing a line at pharmaceutical companies, which seemed beyond the scope of the design challenge Wellcome had set. We then set out to interview antibiotic users, doctors, and pharmacists. In doing so, we realized there was a category we had overlooked: India’s tens of thousands of registered medical practitioners (RMPs). They typically aren’t licensed to prescribe antibiotics but have studied Ayurvedic medicine. Being willing to pivot and expand (or contract) the ecosystem is key: We began interviewing RMPs after realizing the huge impact their population has on antibiotics consumption.

2. Adopt a beginner’s mindset

In interviews, we positioned ourselves as people who didn’t know much about the topic. We were there to learn about them as people—their motivations, their struggles, their day-to-day. We listened. We made sure our questions were free of judgement and left our assumptions at the door. What we came to understand is that a primary motivator for doctors is to succeed as a business. They depend on patients coming back.

This insight made it through to the final design. Smart Prescriptions is, at its core, a tool to improve the doctor-patient relationship. Features like automated advice for patients and medication reminders increase the personal interactions doctors have with patients. The antibiotics recommendation is a Trojan horse, tucked inside the features doctors were really clamoring for.

3. Lead with empathy

Continually put yourself in your user’s shoes and make sure you’re seeing the situation from their perspective. We quickly came to understand, for instance, that many people working in pharmacies aren’t actually pharmacists, and that their financial motivations eclipse any duty of care. They dole out antibiotics without a prescription because refraining from doing so means sacrificing a sale and possibly losing a customer to a rival. Rather than slapping a “bad” behavior label on this, we accepted it as their reality and used it as a design constraint.

4. Consider your language

Systems challenges are often as sensitive as they are complex (consider homelessness or mental illness). As designers we are outsiders, so in designing Smart Prescriptions, we needed to make sure doctors were upheld as the experts. We weren’t creating a diagnostic tool, but rather an intervention that offers a recommendation based on their diagnosis. The tool doesn’t actually change the way they prescribe, it just offers guidance. It’s tough to remember every antibiotics guideline, especially as they update. The language that was used was consciously designed to be light and supportive of their expertise.

5. Generate unlimited ideas, then co-create

Don’t fall in love with your first good idea. Every assumption we made was challenged in our first trip, which ended up being more exploratory than we expected. We made a point to talk to every stakeholder and actor about our sacrificial concepts—early ideas we put in front of people to spark reactions. We gauged whether they had a positive or negative response, then iterated accordingly. After the discovery phase, we came up with seven concepts to test with participants and gauged their reactions. Smart Prescriptions was the clear standout, generating the most interest and excitement. We refined the concept back home, then returned to India and Kenya to gather more feedback. This allowed us to design something that spoke to doctors’ primary motivation, and to add features that the doctors felt would make it even more useful.

Unlike pilots, we don’t have the benefit of a known destination. Our checklist doesn’t just guarantee a smoother ride, it plays a major role in mapping the route itself. When the ecosystem is unfamiliar and the complexity is vast, it is a must.

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Every time we board an airplane, we assume our pilots aren’t going on instinct alone. They’ve worked their way through a checklist—fuel levels reviewed, the flap setting confirmed—to ensure the plane is ready for takeoff. They may be pros, but they’re human, and the complexity of the job makes it easy to forget a step.

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I help organizations cut through complexity by shaping how they show up, through brand strategy, identity, and storytelling.

Working at the intersection of brand and business, I bring an editorial eye and a bias toward making—turning ideas into tangible experiences that people can understand, trust, and believe in.

My work spans government, healthcare, financial services, media, and consumer goods, from launching Gen Z-focused ventures to building innovation labs and reimagining legacy brands. I relish moments of ambiguity and enjoy translating across teams, perspectives, and priorities to move ideas forward.

I started my career in editorial and digital design, shaping cross-platform experiences and identity systems in publishing and agency environments. That foundation still shapes how I work today: I’m detail-oriented, collaborative, and overreliant on the Oxford comma. I hold a BFA in Visual Communication from the School of the Art Institute of Chicago.

For 25 years, I've asked the same question: Who does this design exclude—and what are we going to do about it?

My work spans human-centered strategy, inclusive design, and qualitative research, with clients ranging from Microsoft, Google, and Verizon to the National Science Foundation, and San Francisco Unified School District.

Before IDEO, I taught elementary school in East Palo Alto and spent a decade doing design work with social service organizations—where I learned firsthand what it costs people when systems are built without them in mind.

I am currently writing User Error, a nonfiction book about digital access and the design decisions behind it. I live in Oakland, California.

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My expertise spans brand, communication, and product design across tech, education, the arts, and social impact.

I believe great work demands both high-level vision and obsessive attention to detail, and only happens through collaboration.

I bring an inclusive, hands-on approach and a deep understanding of business, which enables me to consistently deliver excellence while always asking why.

Before joining IDEO, I worked at the brand firms Pentagram and VSA Partners. I began my career as a designer, leading teams at the School of the Art Institute of Chicago and the Milwaukee Art Museum. I hold an MFA in graphic design from Maryland Institute College of Art and a BFA in communication design from the Milwaukee Institute of Art & Design, and have taught at some of the best design schools in the US.

I am responsible for IDEO’s long-term success in China and working with clients to use design as a tool to enable growth. Specifically, I have helped Chinese companies design holistic brand solutions through the development of their products, communication, services, and innovation teams, and I have helped multinationals expand their presence and influence in China.

I advise global leaders on developing China-led innovation and capabilities.

In over 15 years in IDEO Shanghai, I have worked on projects that use design to elevate the quality of the experience of healthcare products and services, streamline processes that increase productivity, create spaces and programs that promote and enable inclusive communities, and build next generation mobility solutions that are planet-positive.

Before joining IDEO, I worked at Philips Electronics and the Electrolux Group in Italy, the Netherlands, and Singapore on a number of breakthrough commercial products. I am a member of the Young President Organization in Shanghai.