99% Invisible


I just started listening to 99% invisible, a tiny radio show about design, with Roman Mars. The stories are short, fascinating, and an inspiration for my work as a visual designer. One episode in particular, The Blue Yarn, really hit home for me. It tells the story of Virginia Mason Medical Center in Seattle, and their drive to implement a patient-centered management system.

This entire, multiyear overhaul started with a ball of blue yarn. The staff met with a Toyota Production System sensei and he took out the ball of blue yarn and a map of the hospital and told the staff to trace the path a cancer patient would take on a typical visit for chemotherapy treatment. When they were finished, it was an immensely powerful visual experience for everyone in the room… The blue yarn told the story of what Virginia Mason was doing wrong. “We couldn’t conceive of it intellectually until we saw it visually.”

At this point, I hit rewind and listened to that phrase again: We couldn’t conceive of it intellectually until we saw it visually. Cancer patients, already weak from chemo treatments, were spending a great deal of time and energy walking a circuitous route through the hospital. This was happening every day right in front of their eyes, but not one doctor saw enough of the problem to fully understand it. The Toyota sensei helped staff reach a common understanding of the key problem facing the hospital. With this in mind, most doctors agreed to forge ahead with the challenging first steps towards redesigning the hospital.

The blue yarn is a poignant example of something we strive for in all Fat Pencil Studio projects: helping stakeholders reach a common understanding of complex issues. It’s a beautiful thing to watch unfold, and one reason that I love my job.


Joshua Cohen is a Principal at Fat Pencil Studio