Here's a great tool that I'll bet you'll use over and over...once you get to know it.

This one is commonly used to help create new companies and understand the ones in which we work. 

This tool was introduced in 2008 by Alexander Osterwalder.  It allows you to visualize, in one page, what your business or service line does and how it provides value to patients.  It also describes how it makes money. 

You can make one for your service at, and there are lots of other templates out there too.

The canvas is extraordinarily useful.  It helps you understand how your system works right now and is flexible enough to change easily over time to demonstrate changes or predict what’s next.  I first learned about it in an online course from Stanford about how to start a business.

Business plans are great, but the problem is that they’re complex and, frequently, times change.  There’s a famous quotation about starting new businesses and modifying existing ones that’s attributed to Mike Tyson.  (Some people say it was Tyson’s trainer.)

"Everyone has a plan until they're punched in the face."  

--Mike Tyson

The business model canvas, updated over time, is more fluid and adaptable than a business plan.  

When the trauma service gets “punched in the mouth” by the unexpected, the canvas works better as times change.  And oh, by the way, in healthcare those times are changing greatly with even more changes soon to come!

How do you use the canvas?  Usually, you start in middle with the section for the value proposition for the service.  What, exactly, does Trauma (and Acute Care Surgery if that’s how your program is structured) bring to your hospital?  It may be more than you think at first.  Make sure you and the team are complete and succinct with what you describe.

This value proposition focuses on the core of what the service does. 

In Trauma and Acute Care surgery a lot of this may seem straightforward.  We often take patients who are injured or have an acute surgical condition and work to get them the best functional outcome they can maintain for the longest period of time in accordance with their wishes. 

…but don’t we support other services too?  Do you help your OB / GYN colleagues when they call?  Do you admit patients for other services, like Interventional Radiology patients who need to be watched overnight?  Again, take a moment to think of all your service really does to support the care provided at your center.

Next, take a moment to remember all of the people and groups who are necessary to achieve what trauma achieves. 

List those under Key Partners or Key Resources where appropriate.  Be inclusive.

 If you do decide to make a canvas right now, here are some important tips to help you be sure you set it up correctly...

The excerpt above is from The Trauma Program Operator's Manual by David Kashmer. Click here for more information on the newly released book.

Dr. David Kashmer is a quality improvement expert & trauma and acute-care surgeon. He has previously served as a Section chief and Chief of Surgery for healthcare organizations. He currently serves on the Board of Examiners for the Malcolm Baldrige National Quality Award.