The Five Ds of Brand Positioning

By Candace A. Quinn
Brand=Experience

The following pages are intended to describe for you the major elements in determining a brand
position for an organization.
Many factors can contribute to the time required, and within the discussion of each phase, those
factors are detailed.

Discovery 8-16
weeks

Design 12-24
weeks

Developmen
t 8-12 weeks

Deployment
48-70 weeks

Display 28-52
weeks

BRAND STRATEGY: DISCOVERY PHASE

All healthcare organizations have a brandthat set of deliverable expectations that are linked with
the organization, commonly, consistently observed, and deliveredbut that does not make it a
strategy. Many brands simply exist; delivering changing brand promises, confusing messages, and
falling generally in the category of indistinct, without significant value, irrelevant, or out of sync with
the organizational aspirations. The first step in forming a winning brand strategy is to discover what
can be known about the brand as it is today, and the potential for the brand going forward in your
target market.
During the discovery phase of the brand position, the organization must look at all measures of the
brands performance in the market, understand the aspirations for the brand by the leadership
(board, administrative, and clinical), and discover the brands potential in the minds of the consumer
as it competes in its unique target markets. This phase is intended to bring to light the following:
1) Those areas of strength and weakness regarding the current performance of the brand. We
learn this by:
a) Consumer awareness, attitudes, and utilization surveys (AAUsquantitative research)
b) Market share reports (by service line)
c) In-Depth Interviews with leadership (board, administrative, and clinical)
d) Patient , Employee and Physician satisfaction/loyalty surveys, by service line
e) Qualitative research among current/recent patients
2) Those aspiration for the brand that support the long-term organizational goals
a) Strategic plan review for brand contribution (growth, people, quality, community, service)
b) Interviews with leadership (1.c)
3) Those brand attributes that add value to the brands position among its target market

The Five Ds of Brand Positioning

a) Quantitative research of target market(s)
b) Qualitative research among current/recent patients
c) Comprehensive review of competitors performance and position (Physician Interviews,
market intel, etc.)
4) An understanding of the brand positions currently held by the competition in the target markets
a) Comprehensive review of competitors performance and position
b) Quantitative research of target market
c) AAU studies
The drivers for the timeline include the process steps needed internally to conduct the n-depth
interviews of leadership. Typically, this can take as long as 24-40 hours of interview time alone, 1-2
weeks of scheduling, and another week or more to consolidate the input. The review of the existing
secondary data is not usually an encumbrance to the time element, but where data does not exist,
and primary research is required, the time line for this phase can grow quickly.
Patient focus groups can take 1-2 weeks to schedule, and typically 2-3 can be conducted per day by
a trained facilitator. Typically, hospitals offer participants free parking or transportation assistance, a
meal, cash or equivalent gift cars of $50-100, and a hospital item, like a mug, tote bag, first aid kit,
etc. The patients should be grouped with some degree of commonality, such as similar points of
service (OP, IP, ED) and/or same unit or service line (ortho, cardiac, neuro, etc.). This shared
experience frequently allows the conversation to get to specific attributes that reflect relevant areas
of focus.
Physician and employee focus groups, similarly, require 1-2 weeks of planning and scheduling and
take a similar amount of time to conduct. Again, hospitals thank these participants with a meal,
cash or gift equivalent (if employed, there is a value that does not require withholdingyour HR
department can be helpful here), hospital logo items, and the opportunity to participate during paid
work time. With volunteer physicians, you may reward them for work under Stark as long as the
reward for the work is reasonablea $50-100 gift for one and hours is typical.
The Quantitative survey (including the AAU) can take 4-12 weeks to conduct, depending upon the
following parameters:
1. Survey design 1-3 weeks, dependent upon the level of organizational process required at your
hospital
2. Survey implementation 2-10 weeks
i) Target market size (local, regional, national)
ii) Sample size
iii) Methodology
(1) Mailnot recommended typically
(2) Telephone
(3) Online
3. Findings tabulation and report generation 2-4 weeks

The Five Ds of Brand Positioning

At the completion of this phase, you should know the following:
The current brand and its consistency in the hearts and minds of your multiple audiences
What is desired, valued, and compelling to the target audience
What is doable, motivational, and aligned with your organization, your employees, and your
physicians
What brand position is held by the competition, and how effective those positions are in the
target market

The Five Ds of Brand Positioning

BRAND STRATEGY: DESIGN PHASE
Enlightened by the findings in the discovery phase, the design phase work involves designing a
meaningful brand position (s) to test within the organization to validate fit with the same. Successful
brands are relevant, valued, believable, recognizable, and compelling to not only the target market, but
also to the organization, staff and physicians.
Key elements in this phase involve equally considering what to include as well as what to exclude. This
may seem simple enough, yet there are many potholes to avoidspecifically:
1) Lets add the kitchen sink this is the tendency to take every position possible and combine it into
a single position. The problem that resultsno position. You have really done nothing to create a
situation that truly distinguishes you in the market.
2) Just pick oneany one---no process. Successful brand development needs to be an integrated,
facilitated, and inclusive process, requiring participation by patients, target market, employees, and
your medical staff. Agree to a process in advance, and stick to it.
Many organizations hold the focus group session detailed in the discovery phase during this phase,
incorporating non-=patient groups representing the targeted future market to better understand the
expectations that come with the brand positions articulated as valued/compelling in the Quantitative
study.
Also, during this phase, if you did not start the process with one, it is recommended that you form and
convene a Brand Team to work through the internal brand build. Typically, organizations include the
following types (roles) on the team:
1) The marketing team as staff, with the department leadership as full member/chair
2) A brand strategy consultant as guide and facilitator
3) Senior leadership, both administrative and clinical (CEO, COO, CMO, CNO, HR, Key service line
leadership, other key medical staff leaders)
4) 1-2 Board representatives if this is appropriate in your organization
5) The Account representative/manager from your ad agency if you have one
The Brand Team can be convened up front or upon the commencement of this phase. In either case, a
kick-off meeting with education in mind is highly recommended. The brand strategy consultant in
partnership with the Chief Marketing leader co-present an educational session intended to define terms,
explain what brand strategy is and is not, and clearly articulate the process and products that are
intended through your process. Critical to this is clearly articulating the role of this brand team in your
process.
It is important to share with the Brand team all of the findings of the discovery phase to gain consensus
on those brand positions that have possibilities for the organization. Taking these 3-4 positions into
testing will really be the focus of this design phase.

The Five Ds of Brand Positioning

Throughout the design phase, the brand teams role is to digest the focus group findings and ultimately
select he optimal position.
Another key aspect of the design phase is to assess the GAP between the brand positions tested and
the organizations reality. A sweet spot happens when the brand position is deemed very strong and the
GAP is small or non-existent. Typically, however, there is an experience GAP. Critical to moving on to
the development phase is identifying and gaining leaderships support for not only the marketing
elements of the GAP (i.e., what can be fixed by Marketing/Communications alone) but also the
operational elements of the GAP (i.e., service, quality, performance issues, etc.). This is where the
Brand Teams ownership is crucial.
Factors affecting the time element in this phase include-focus groups (see discovery phase for details),
Brand Team consensus building, and detailing the GAP analysis (3-6 weeks).
You will have at the conclusion of this phase the desired organizational brand position, the GAP
analysis for both the marketing elements of the brand strategy as well as the operational experience
elements that will be required as a part of the brand strategy. You will also have identified if you brand
architecture issues (what you call elements of the brand, how you portray them visually, etc.).

The Five Ds of Brand Positioning

BRAND STRATEGY: DEVELOPMENT PHASE
Armed with a Brand position that you have found to be valued, desirable, and compelling to the target
markets, as well as deemed doable, aspirational, and appropriate for your organization to deliver, you
are in a position to develop your Activation plan. Activation plans must include not only the Marketing
communications plans (for both internal and external audiences) but also the experience design plan.
For the latter, this may mean changing the way things are done, or hard wiring the things you are
doinggetting to that brand promise delivery consistency that successful brands do well. Many
organizations today are turning to experts to assist them with this work. Organizations like The Studer
Group, Disney Institute, Starizon, Baptist Hospital and others offer organizations prescriptions and
processes to deliberately create and deliver consistent experiences that support a strong brand position.
It other cases, the experience piece may only mean tweaking a service/unit/department to fix or close
the GAP, with our without the help of an outside expert. Clearly the nature and scope of the
organizational experience GAP will drive the complexity, expense, and time needed for this phase.
For the former, here is where the inclusion of both a Brand Strategy consultant and your ad agency
representative on the Brand Team is helpful. Working with HR and the Marketing communications team,
this group can create the internal communication plan (a critical first step.no successful brand exists
that cannot be articulated by those delivering it!). This plan must incorporate the background work in
understandable terms as the backdrop for the employee/physician appreciation and ultimate ownership
of the position, as well as visual and narrative around the position itself, including an understanding of
the words selected, their behavioral implications, and other key strategies and operational implications.
For example, if your brand position includes being the market leader in technology and innovation, how
will that be realized? What will the organization do and not do to make that happen?
Depending upon the GAP, the internal plan may have multiple phases---those in support of
establishing the GAP, those in support of closing the GAP, and those in support of the external plan
launch.
The external plan, similarly, is driven by the size and nature of the GAP. If the GAP is less about
operations and more about image or awareness, then the phases of the external plan may include first
building a foundation then articulating the promise. If the GAP is significantly operational, the external
plan should include a strategic response to positioning short term (during the deployment phase) and
long term (the marketing communication brand display phase).
This development phase is driven largely by the GAPs size and nature. During this phase, the selection
of an experience design partner and/or agency partner (if one did not exist) will add 8-12 weeks to the
8-12 week work processin essence doubling the time needed.
Outcomes of this phase include the activation plans detailed above, development of the Brand Story to
share with internal audiences, definition of behavioral elements related to the Brand, and incorporation
of the same into job descriptions and performance evaluations, resolution of any brand architecture
issues (naming, graphics, etc.) and a broad engagement of the management level of the organization in
the activation work.

The Five Ds of Brand Positioning

BRAND STRATEGY: DEPLOYMENT PHASE
Armed with the Brand Activation plan, it is time to take action. The emphasis here is on the design and
implementation of those action steps required to close the GAP. If your brand requires minimal or no
operational or experience changes, the deployment phase is minimal, and largely driven by the
Mar/Com team. Work begins insidewhile the agency may be working on the promotional elements
that will display your brand to the world (or at least to your immediate market place), the Mar/Com
team and internal communications experts need to be launching the brand promise, telling the brand
story, and generally allowing the employees and physicians to hear about it and see it first.
The Brand story simply tells the history of the discovery, design and development phase of the brand
strategy exercise. It shares the meaning behind the words, the expectations as articulated by the future
customers and the value the promise represents in establishing a strong, relevant, compelling brand
position. The timing of this internal launch should allow for assurance that each employee has had the
chance to understand the purpose, understand his or her role in realizing the brand, and garner
enthusiasm for the opportunity the Brand Strategy represents. Many organizations hold events,
screenings, Brand Fairs and generally allow employees and physicians to see it first. If job descriptions
have changed, or performance expectations have been altered, it is during this phase that those reviews
happen with managers with the Brand strategy as the backdrop.
The wider the Brand experience GAP, the longer the deployment takes. If an experience
consultant/partner is engaged, deployment includes the time needed to substantially adjust the delivery
experience to reflect the brand promise. Some organizations attack this incrementally (by unit,
department, or service line) and others dive in across the organization. If approached organizationally,
the deployment may take as long as 24 months.
As mentioned above, typically, organizations have pockets or areas that have the brand position
operationalized and are in part why this particular brand position resonated with the leadership. While
the rest of the organization hard wires these brand behaviors, the deployment of a service line specific
launch of the brand can lead the external piece to begin impacting awareness and image. However, it is
critical that you do this if the service is profitable, important to advancing the long-term strategy of the
organization, and if the internal communications has clearly articulated the why behind the launch.
At the end of this phase, the organization should be in a position to begin the final phase, Display.

The Five Ds of Brand Positioning

BRAND STRATEGY: DISPLAY PHASE
Some of you reading this article will say, But this is where my Board member wants me to startget
that ad agency working on the brand campaign! The display phase is the culmination of months of
deliberate work to identify and deliver a Brand Strategy that will be compelling to the target market,
motivational to employees, and relevant in a world where access to care is wide-spread and consumers
face choices for their care. At this stage in the campaign, it is critical that you work with your agency to
clearly articulate the Brand Strategy, the lessons learned throughout its development, and hold the
agency creative on task to deliver the messages consistently and on point with that thoughtful brand
position.
Graphics, tag lines, copy points, and imagery are designed, tested, and deployed during this phase.
Design and testing can commence during the deployment phase as rarely changes in direction occur
from that point forward. Testing the execution among groups of potential patients is key to assuring
yourself and your Brand team that the messages and imagery have captured the brand strategy
effectively.
In conclusion, be sure to continuously test your external efforts against the brand strategy, and measure
the performance of your organization against the brand standards. Annual targets for patient, employee
and physician loyalty; annual market share targets; annual AAU targets for awareness, attitudes, and
utilization should be set and measured; and as you look across the profitable service lines critical to the
success of your organization, be sure you periodically speak with those at the front line delivering on the
brand promise.
In an era of Health reform, where access, choice, and coverage are expanded significantly, a strong
brand position will place you in a position of market leadership and open doors to market expansion,
vertically and horizontally.