Zebra’s proven approach to cost structure improvement therefore focuses on flexibility. An enterprise with a flexible cost structure is better positioned to take advantages of market opportunities as they arise. Conversely, flexibility allows an enterprise to retrench rapidly if an important stream of revenue or profit becomes impaired.

Cost structure improvement may take multiple forms. For example, three common types are:

1. Variabilisation of fixed cost, e.g. through creation of a contingent labour pool, outsourcing of activities or deployment of Software as a Service;
2. Peak shaving through demand management;
3. Raising utilisation of the asset base, e.g. economies of scope, economies of scale or simply through extended working hours.

Although every situation is different, there are usually four main steps in a cost structure improvement program:

1. Diagnosis: establishing the potential for improvement;
2. Options: deciding on feasible courses of action, some of which may be overlapping or complementary;
3. Action planning: determining who will do what when, and what prerequisites exist
4. Execution and evaluation: carrying out the plan and driving benefit realization.

1. Developing and summarizes the strategy using a One Page wall chart that is logical and easy to understand. It recognises that there is often a complex relationship between enablers and results, defines measurable steps in both areas and strikes a balance between overview and detail.
2. Stimulating development of stretching but achievable plans; it uses a logical series of work stages and milestone decisions, ‘reasons back’ from stretch targets for results towards ways to achieve these, and creates flexibility by treating results and enablers as linked but separate.
3. Using a participative approach that encourages creativity and ownership; it is driven by the leadership team rather than a select group, draws out good ideas from within the business and fits these into a strategic context, but also emphasises ownership of delivery of enablers as well as business results.

The resulting plan is summarised on a ‘one page’ wall chart that shows how all elements of the plan link to one another. Because goals, enablers and projects are linked but shown separately, it is relatively easy to assess the impact of changes. This makes the chart and associated documentation a powerful program management tool.

• Sales staff hade difficulty with presentation of the value propositions, thus running the risk of being squeezed on price;
• Some volume product lines were unprofitable;
• One niche product line with clear clinical advantages was performing poorly in the market and achieving almost no volume.

The client was considering whether to reprice the latter product line to stimulate demand, but was concerned about possible cannibalisation of other product lines. Zebra reviewed the overall portfolio, including available clinical evidence, value propositions, pricing and cost structure. The review found that the niche product could be repositioned as a mainstream product and would vastly improve the company’s value proposition and profitability. Key to this was a value proposition based on minimising the risk of specific types of post-operative complication; this required a more strategic approach to selling this product portfolio.

• Improved surgical procedures, such as the use of Mohs techniques in the treatment of skin cancer and the further deployment of minimally invasive approaches;
• Informed choices as to whether to offer specialist procedures or refer these to others;
• Consideration of the effect of medical, operational and financial risks;
• Use of alternative care paths that are cheaper than alternatives, without compromising on outcomes;
• Seeking economies through upscaling or outsourcing supporting disciplines and facilities. Examples include laboratories, hospital pharmacies, sterilisation facilities and interpretation of radiographic images.

Each of these topics requires some form of analysis of cost structure and/or integral cost. In many cases it is also necessary to consider the reimbursement regime.

Zebra conducts analyses of cost structures, including process analyses and activity based costing where appropriate. The results are used to identify leverage points that can be used to restructure costs. Common themes include:

• Lower unit costs through logistic improvements, for instance in drug distribution or laboratory analyses;
• Variabilisation of cost, enabling cost to be better matched to demand, for instance through outsourcing or the use of alternative technologies;
• Trade-offs between increased procedure cost (e.g. through more expensive materials) and reduction of the risk of complications or readmission.

“Arguing for Action” is a technique that structures communication to engage and persuade the audience to take a course of action.

It is ideal for anyone preparing a document or presentation intended to influence their audience to take a decision, form a well-founded opinion or initiate a specific course of action. The course is particularly appropriate for:

• Senior and middle management and staff in complex organizations
• Project and change managers
• Civil servants and others involved in policy formulation
• Providers of professional advice, including consultants, lawyers and bankers

who need to deliver concise messages with impeccable argumentation to decision-makers with severe time constraints.

Participants will be able to clarify the message of any communication, identify the information that is essential to the message and structure the document to support the message, by:

• Presorting or ‘pyramiding’ the ideas and facts used,
• Using faultless logic to structure the argument,
• Structuring an introduction to engage the audience and develop the key question to be answered,
• Employing appropriate visual devices to signpost the structure,
• Closing with the immediate actions or decisions required.

As a result, participants will be able to (a) cut down the time they need to produce a first draft, (b) increase its clarity, and (c) decrease its length.  The result is ideas that ‘jump off the page’ into the reader’s mind with minimum effort on the reader’s part.

A course specification can be downloaded here: Arguing for Action (English) or here: Arguing for Action (Dutch).

• find a common purpose
• overcome hard problems
• take difficult decisions
• grow

My ambition is to provide a level of service and expertise normally associated with major international consultancies, but at substantially lower cost and with greater flexibility. I aim to provide this service and expertise world-wide using cloud technologies that allow a maximum of interaction while minimizing the time loss and cost associated with project travel.