Intuitive Surgical creates products and services born of inspiration and intelligence, from robotic-assisted surgical systems to data generation that unlocks the potential to benefit care systems worldwide. Intuitive India, the India arm of Intuitive, is a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery (RAS). Intuitive Surgical works closely and collaboratively with its customers to help achieve better outcomes, care team experiences, and patient experiences, as well as lower care costs.
By providing advanced instruments for robotic surgery, Intuitive Surgical enables faster recovery times and less impact on patients, allowing them to quickly return to the activities that matter most to them. This technology has revolutionized the quality of life for countless patients, significantly improving surgical outcomes and making a profound difference in healthcare.
Today, we are honored to have Gerardo Haro, the Continuous Improvement (CI) Manager at Intuitive Surgical in Mexicali, Baja California, Mexico, with us. Gerardo is an operations excellence expert with extensive experience in continuous improvement and management philosophies like Hoshin Kanri. He has developed the Kaizen Leader Program, preparing over 65 team leaders and managers to execute strategic improvements within their functional areas. Gerardo coaches project leaders from project charter completion to execution and closing/verification of their projects. His role focuses on ensuring that the company has the mechanisms for effective, efficient, and aligned operations to achieve strategic objectives.
Join us for a fireside chat with Gerardo Haro, where we will explore how Intuitive Surgical fosters high-performing teams and drives continuous improvement.
Given your rich experience in continuous improvement, you must have been exposed to other management frameworks. What are the other management frameworks that you are familiar with apart from OKRs?
Gerardo Haro “Yes, indeed. I have been using Hoshin Kanri for eight years. We have also been mixing in other frameworks, like OGSM or OGST, in cases where tactics or measures are used. Additionally, we have used the balanced scorecard as well. Of course, the very well-known MBO, or Managing by Objectives, is where we started. We then moved to something more structured, like Hoshin Kanri for the long term. We have been looking for something that helps us in the short term with execution, and that’s how we connected with OKRs.”
What is the history of OKRs at Intuitive Surgical, and how did you decide to implement them? How long have you been using OKRs?
Gerardo Haro elaborated, “That was a challenge for me in 2022. We started looking around to see what was available for short-term strategy execution and found that most of the software available used OKRs. We were initially using just Hoshin Kanri with action plans and all of that.
It became clear that we would be using something based on OKRs. This necessitated a change management process with the rest of the leadership team. So, I started mixing Hoshin Kanri and OKRs, finding a great way to make it easier internally by naming the X2’s objectives, or site objectives, as objectives in the OKRs and the X3’s as key results. Initially, we used spreadsheets or Smartsheets, naming one column ‘objective’ for the X2s and the other ‘key results’ for the X3s.
We started using the nomenclature for OKRs in 2023, but it wasn’t as solid as it is now until we adopted the Profit.co application. This transition provided valuable resources from Profit.co, including OKR University and website materials that are available to everyone. We could share the link with everyone and educate them about OKRs, strengthening our change management process. Now, everyone is talking about OKRs.”

What exactly did you want to achieve through OKRs? What is the purpose of using OKRs?”
Gerardo Haro replied, “It was about finding an easier way to communicate to my teams internally what an objective and a key result are. The terminology itself ‘objective’ and ‘key result’ is more intuitive. When using X2 and X3, it was difficult to explain what an X3 is and how it fits into the overall strategy.
With OKRs, the objective is strategic, and the key results are measurable efforts that help achieve that objective. This clarity made it easier for teams to understand that if an activity is part of their day-to-day tasks, it should be included as a key result only if it directly impacts the objective. We often ask, ‘Is it a key result or just a task?’ It doesn’t need to be included as a key result if it’s just a task. This approach helps us avoid having too many key results under one objective, keeping the focus on what truly impacts the objective.
Overall, OKRs were effective in improving communication, and they complemented Hoshin Kanri well. Together, they provided a clear and structured framework that helped our teams focus on what matters and drives strategic success.”
How did you decide on Profit.co and what was the selection process like? Did you consider other products as well?
Gerardo Haro: “Yes, we started the process by Googling ‘strategy execution software,’ and a list of software options came up. We began reaching out to the vendors on that list. Profit.co was one of the first to respond to our request for a demonstration.
Your team was really helpful in providing live demonstrations online. Some other vendors shared videos or links to explore, but Profit.co provided live-action demonstrations, which made a big difference for us. After evaluating all the options, we identified our current challenges with our existing method, which was using Smartsheet. Identifying who was involved, aligning objectives, and achieving the desired cascade approach took a lot of work.
During the demonstrations, we listed our opportunities for improvement and asked specific questions. Profit.co’s team showed us how to seamlessly align objectives and initiatives, which addressed our needs. We compared this with other applications and found that Profit.co met our requirements better than the others.
Another significant factor in choosing Profit.co was its user-friendly interface. Once we saw the platform and how information was integrated and displayed. It didn’t require extensive training or explanation, which is really helpful for us as program managers at Intuitive Surgical. The ease of use allowed us to get started quickly and efficiently.”
What else did you particularly like about Profit.co compared to other products?
Gerardo Haro added, “Yes, absolutely. The platform’s user-friendliness was a major plus. It was easy to understand and use immediately, without much training. This made it much easier for us to implement and start seeing the benefits immediately. It was a crucial factor in our decision.”
How many people did you start using the platform with?
Gerardo Haro: “We started with a very small group in the beginning. Initially, we had about 11 people involved in the process, primarily staff managers, along with a couple of people from my team working on the management of the initiatives. We planned to empower them to upload information and manage tasks for the next cycle. As we moved forward, we gradually expanded the number of users, and now we have a broader team working together on the platform.”
What was your experience with the implementation and onboarding process with Profit.co? How did the users feel about starting to use the product?
Gerardo Haro: “The implementation was really challenging because it was the first time we moved from something everyone knew well. When we transitioned from spreadsheets in Excel to Smartsheet, it was simpler because everyone was familiar with it. It was just another Smartsheet document. But with Profit.co, it was a completely different platform.
In the beginning, this small group of users had some ideas and were just barely clicking on the options available. The implementation team from Profit.co was incredibly helpful, even during the Christmas season. They provided training sessions that made our users feel more comfortable exploring the platform and understanding what views and types of information they could upload.
Having an expert from Profit.co available to answer questions was invaluable. They showed us how to use the platform effectively, explaining that we could generate useful reports if we input specific data. This support was crucial. Initially, it was challenging, but once users started using the platform and saw that nothing was highly complicated, they found it easier to navigate. They began exploring more and felt confident in reaching out for help if needed.
The Profit.co team was always ready to assist, helping us realign or correct any issues that arose. The implementation process was ultimately very successful with the proper training, communication, and change management.”

Location:
USA
Industry:
Medical Instrument Manufacturing
Challenge:
Improve Operational Efficiency
Outcome:
Ease of Adoption