Parallels between “Lean Startups” and “Adaptive Design”


I've been a fan of the “Lean Startups” work of Eric Ries since last year, so I'm happy to be producing a free LEI webinar called “Lessons from Lean Startups,” to be presented live on April 28 at 2 PM EDT.

I have also just started reading the book Designed to Adapt: Leading Healthcare in Challenging Times, written about the use of Lean in healthcare to create what Dr. Charles Kenagy calls “ideal care” based on the “rules in use” from Steven J. Spear, Ph.D.

I found some interesting parallels between the methodologies, which surprised me.

In his talks about Lean Startups, Eric compares the approach to traditional “waterfall” software development and the “agile” methodology. As illustrated in this short slide show, the differences are about whether the problem and/or the solution are known.

  • Waterfall = Problem KNOWN, solution KNOWN
  • Agile = Problem KNOWN, solution UNKNOWN
  • Lean Startups = Problem UNKNOWN, solution UNKNOWN

In the Kenagy book, he talks about cases where his “adaptive design” approach to Lean and problem solving is appropriate (or not) – from page 154:

  • Problem CLEAR, solution CLEAR = don't use adaptive design
  • Problem CLEAR, solution “Difficult to define, complex, interdependent = maybe use adaptive design
  • Problem “Unclear, many potential causes, chaotic, variable inputs and/or outputs”, solution “ill-defined, cause and effect unpredictable, complex, variable, chaotic” = do use adaptive design

I thought it was interested that there's a similar structure there.

You might also be interested in Eric's recent post “Four myths about the Lean Startup,” which includes the myth that this approach is only about web-based software products. That's why we think his webinar will have lessons that apply to innovation in any industry, even if you're not a traditional startup.


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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

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