The challenge

Our client was a top three global manufacturer of continence supplies seeking to formulate a North American market and sales strategy for the institutional segment of its business - primarily nursing homes and long-term care facilities.

The challenge was not a product problem. The client's products were competitive. The challenge was a sales and positioning problem. The company was approaching a deeply heterogeneous market - nursing home managers, purchasing directors, and care staff, each with fundamentally different priorities, pressures, and decision-making frameworks - with a single, undifferentiated commercial message focused on product cost.

That message was systematically failing to land. Not because the products were wrong but because the message was pitched at the wrong dimension of the decision. The people buying continence supplies were not primarily making cost decisions. They were making total cost of use decisions - and the relationship between product choice and the downstream costs of continence care, staff time, skin integrity management, and resident wellbeing was the dimension that actually drove purchasing behaviour. It was also the dimension that the client's sales approach was entirely missing.

The insight that reframes the market

The number that unlocked the entire project was this: continence products typically account for around 1% of total nursing home costs. But continence care as a whole — the staff time, the skin care, the management of complications, the impact on resident dignity and wellbeing - can account for up to 15% of total costs.

That ratio changes everything about how to sell in this market. A supplier that can demonstrate how its products reduce total continence care costs - not just product unit costs - has a fundamentally different and more compelling commercial proposition than one competing on price alone. But making that argument requires understanding how different nursing homes think about and manage continence care, what drives their purchasing decisions, and where the greatest leverage points are in the relationship between product choice and care outcomes.

That understanding did not exist. And without it, no differentiated commercial strategy was possible.

What we did

Umio conducted a detailed assessment of the North American nursing home continence market - focused not on product performance or competitive pricing but on the goals, priorities, contexts, and decision-making processes of the people actually purchasing and using continence supplies.

We interviewed nursing home managers, purchasing directors, and care staff across a range of facility types and sizes to surface the precise dimensions of their decision-making - what they were trying to achieve, what was constraining them, what they valued in a supplier relationship, and why current sales messaging was failing to resonate with the majority of them.

From that research we produced a rigorous segmentation of the purchaser landscape - not demographic or facility-size based, but grounded in the distinct priorities, outlooks, and purchasing goals that differentiated how different buyers actually made decisions. Each segment represented a different commercial opportunity requiring a different value proposition and a different sales approach.

We then facilitated persona creation workshops with North American sales teams, translating the segments into vivid, practical portraits of the buyers they were actually talking to - and the specific arguments, evidence, and approaches that would work for each. This built the internal capability to execute a differentiated strategy rather than simply handing over a report.

What we found

The research revealed several consistent patterns that the existing sales approach had made invisible.

The most significant was the gap between how the client framed value - product cost, clinical performance specifications, compliance with care standards - and how the most commercially attractive purchaser segments actually made decisions. For a substantial portion of the market, the relevant question was not which continence product was cheapest or even which performed best clinically. It was which supplier and product approach would reduce the total burden of continence care on staff, reduce skin integrity complications, and support the dignity and quality of life of residents in ways that mattered to the facility's reputation and its own sense of its purpose.

Those buyers were being talked to about price. They were ready to be talked to about something entirely different - and were actively looking for a supplier who understood their situation well enough to have that conversation.

The second finding was that a significant segment of the market was genuinely not accessible through standard sales approaches - not because they were unreachable but because the sales message was pitched at priorities they did not hold. Understanding that segment's actual decision framework was as valuable for deciding where not to invest sales effort as it was for developing new approaches.

The outcome

The client went from a single undifferentiated market message to a segmented sales strategy grounded in a precise understanding of how different purchasers actually made decisions. Sales teams who had been applying the same approach to everyone - and getting the same inconsistent results - had a coherent framework for matching their conversation to their customer.

In the full year following the project, the client experienced steady sales growth in the North American institutional segment. More significantly, the sales organisation had developed a durable capability - an understanding of the market that could be built on rather than a one-time insight that faded when the project ended.

The nursing home continence project is a clear example of what happens when a commercial challenge is approached from the perspective of how people actually make decisions - rather than from the perspective of what the product does or what the supplier wants to say about it. The insight that unlocked the strategy was not about the product at all. It was about the gap between a 1% cost line and a 15% care burden - and everything that gap implied about what a genuinely differentiated commercial proposition needed to address.