Becoming Unique Together: The Living Ecosystem of Cosanum

Maria Lorenzo
Written by Maria Lorenzo September 01, 2025

In 1980, Cosanum AG was born as a traditional, family-owned distribution company in Schlieren, Switzerland. Itsmission was straightforward: to provide Swiss hospitals, clinics, and care homes with high-quality, single-use medical supplies. But over the past 15 years, that mission has quietly expanded into something far more ambitious. Today,Cosanum stands not only as a supplier of essential healthcare products, but as a pioneering example of long-term, human-centered organizational transformation. Guided by a deep sense of continuity, responsibility, and a willingness to evolve, the company is reimagining how people work together.

This blog post is part of 80+ case studies of progressive organizations we created for the ZeroDX awards 2025. These organizations embody the principles of RenDanHeYi in their work structures:

  • Zero Distance to customer: Decision what to build is based on insights from the marketplace

  • Autonomy: Small teams with full decision-making autonomy enable speed in execution

  • Shared Rewards: Everyone in the micro-enterprise participates in its financial success.

The business is still owned and governed by the Schefer family. It employs 135 people and operates in a highly competitive sector with low product differentiation. As Thomas Schefer, a family member and current Head Coach at Cosanum AG, explained during an interview, the company recognised early on that its product portfolio alone wouldnot distinguish it in the long run. This realisation prompted a deeper shift: Cosanum would set itself apart through how it worked, not just what it sold.

That decision did not result in a sweeping reorganization. Instead, what unfolded was a long-term, generational shift in both mindset and practice a process still underway. When Bruno Schefer took over the leadership of the company from his brother about 15 years ago, he introduced a new direction: branding changes, amore customer-focused identity, and a push to become a more attractive workplace. But the foundational shift began when Thomas joined the company nine years ago with a clear intention: to leave behind the traditional pyramid andgrow something different.

Although Cosanum has not formally adopted Haier’s RenDanHeYi (RDHY) model, many of its structural and cultural changes resonate strongly with RDHY’s foundational principles: decentralization, dynamic adaptation, ecosystemdesign, and zero-distance to users. Thomas described the model not as a rigid framework, but as a living organism, aterm that would later become central to the company’s language.

The first structural step came six years ago, when Cosanum dismantled its executive leadership team. Roles like marketing director or head of supply chain were abolished. Some leaders left the company. Others remained, taking on new responsibilities as coaches, now positioned alongside teams rather than above them.

“That was a turning point,” Thomas recalled. “It was a clear signal that we were serious about doing things differently.”

What followed was a deliberate choice to nurture change at a pace that respected each team’s starting point andstrengths. Three of Cosanum’s eleven teams are now fully self-organized. The IT department was the first. After successfully completing a major ERP migration, team members distributed their coach's former responsibilities among themselves. Budgeting, hiring, and decision-making now happen within the team.

Irina Nessensohn, who leads IT projects and coaches other teams, supported the transition. The team had alreadybeen working independently, but it still took time to define how decisions would be made, feedback given, and conflicts addressed.

The second team to transform was Customer Support. When the long-serving manager retired, Cosanum chose not toreplace her. Instead, Irina worked with the team over six months to build internal capacity for self-organization. Despite initial doubts, they quickly demonstrated their readiness. "Twelve months later, we hadn’t received a single complaint from customers," Thomas said. "Some of the team members were only 20 years old. It showed us that responsibility has nothing to do with age."

Rather than enforce uniformity, Cosanum encouraged coexistence of different ways of working, trusting teams to move forward when they felt ready. Some teams remain in more traditional formats, supported by coaches rather than managers. Others are slowly shifting toward more autonomous models. This approach reflects RDHY's principle of dynamic optimization, where different units evolve based on readiness and context, rather than uniform mandates.

Another key pillar in Cosanum’s transformation has been its investment in cross-functional Impact Teams. These are voluntary, self-organized groups focused on themes such as sustainability, lean logistics, and data-driven business models. Staff from different departments participate based on interest, not hierarchy. Over the last four years, theseteams have launched dozens of small projects, many of which have had measurable operational impact.

The Impact Teams launched with a simple mindset: act first, organize as needed. Their momentum has since shaped how many initiatives now get started at Cosanum.

This distributed, voluntary innovation approach closely reflects RDHY’s concept of micro-enterprise partnerships. Though Cosanum teams do not hold formal P&L responsibility, the logic of self-driven,user-oriented value creation is strongly present. It also reflects the idea of "dynamic contract mechanisms" betweenteams, where people organize themselves around shared challenges and opportunities rather than fixed reporting lines.

Cosanum’s culture is held together by a few non-negotiable values. New employees attend a cultural onboarding session facilitated by Thomas and his father. Respect is central. So is authenticity "Come as you are" along withinnovation and long-term thinking. These values act as the outer boundaries of the organizational ecosystem,shaping behavior without prescribing exact roles or methods.

Practices such as meeting cadences, feedback formats, and decision protocols are not standardized. Teams definetheir own, supported by Irina Nessensohn and other internal facilitators. "We introduce frameworks as options," she explained, "but it's up to each team to choose what works."

Standardization exists only where it supports business continuity: in logistics, sales operations, and other coreprocesses that must comply with ISO certification. This dual system fluid people structures and stable process infrastructure has helped Cosanum remain adaptive without losing control.

Crucially, the transformation has not been driven by external pressure or financial crisis. It has been a proactive,values-led evolution. The company’s family shareholders, including Thomas’s uncle and cousins, have supported the changes. They prioritize long-term sustainability and social contribution over short-term profit maximization. Thomas noted that the family shareholders consistently prioritize long-term viability over short-term profit.

The financial impact has affirmed the transformation’s value. Profitability has steadily improved over the last five years, a trend Thomas attributes not to any single initiative, but to a cultural shift that encourages shared responsibility. Employees now take greater ownership of their work, and that engagement is reflected in outcomes. Rather than being the primary goal, increased profitability has emerged as a byproduct of a more participatory and purpose-driven way of working.

Looking ahead, Cosanum sees growing pressure in its industry: tighter budgets, regulatory complexity, andincreasing demands for sustainability. Much of the company’s product line consists of single-use items, and leadership is aware that the business model will have to evolve.

Rather than wait for external pressure, Cosanum is actively engaging suppliers, partners, and internal teams to rethink the future of its offering. This orientation reflects RDHY’s zero-distance principle: embedding users into the process ofinnovation rather than keeping them at the end of it.

Cosanum’s transformation continues to unfold. While only three teams are fully self-organized so far, the company sees this as an intentional and sustainable rhythm of growth. But the direction is clear, and the underlying conditions trust, openness, shared purpose are firmly in place.

The transformation, according to the team, has unfolded like a living system, adapting gradually, responding to its context, and gaining strength through diversity rather than control.

Written by Maria Lorenzo
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