At least a few times a year I am asked by a senior healthcare leader, “How can I systematize innovation?”. And while I’ve been privileged to lead and execute innovation at Kaiser Permanente, Hopelab, and the Innovation Learning Network, never I have been able to articulate as thoroughly as the WISH 2018 Design in Health Care Report.
In early 2018, I joined a group of esteemed design leaders of healthcare to develop a WISH point-of-view on the human-centered health system. We pooled our collective experience to generate nine recommendations in three categories. And while it was developed for policymakers in government, as I reread the report with fresh eyes this week in Doha, it’s also an excellent starter set for healthcare leaders who are serious about transformation.
Whether your organization is just getting started or needs a transformation tune-up, these nine principles will leapfrog your organization into the future.
Make a visible commitment to human-centeredness
Teach design thinking principles to every staff member
Invest in targeted design expertise
Special thank you to Aaron Sklar who led and organized the committee and the production of this report.
Last week (Sept 26) I was part of a Denver StartUp Week panel featuring the collaboration of Hopelab and Grit Digital Health. Expecting 50 attendees, the afternoon sizzled with over five times that. Many questions illuminated a fascination that a startup and a foundation would find common ground to partner. Below is a quasi-recap and additional pondering on this fascination:
Innovation often has a focus on tools, techniques and approaches. And while these are important building blocks, there are more nuanced ones that accelerate the path to impact. One of these is the innovation mindset. While we all have a “natural” mindset that is ours and ours alone, while it may be perfect for some parts of the innovation cycle, it can be detrimental to others.
For example, let’s assume your natural mindset is “operational” – one that is all about rapidly solving problems, optimizing your system, and putting out fires. Your team is in the earliest phases of an innovation project – trying to more deeply understand the challenge. An operational mindset will reduce the divergent and intentional wandering that the team must do in this phase. You, the leader, would be in unintentional conflict because of your natural mindset.
What to do? With focus and energy, we can temporarily change mindsets to match the phase of work. This is not natural and requires intention. But the leader only needs to hold the unnatural mindset for short periods of time – just long enough to be in sync with the team. One technique I’ve been using is an innovation meditation. It is designed to be used with a sponsor group, board or other advising body, and can be easily applied at the personal level as well.
It could feel risky to conduct a group meditation to the start of a leadership meeting. However, what is the risk of having a super-smart group of advisors who are unintentionally advising with the wrong state of mind?
And so, below is the meditation. As always, I would love to hear your thoughts, comments, or even better, how it went adding in to your leadership practice.
The Innovation Leader’s Mindset Meditation
by Chris McCarthy
Take one deep breath and get comfortable in your meditative pose. Eyes open or shut, whatever you are most comfortable with. (pause 10 seconds)
Take two more deep, cleansing breaths. (pause 10 seconds)
Breathe naturally, except for the cleansing breaths when indicated…or whenever you feel like.
The Four Leadership Mindsets for Innovation are the strategic, the explorative, the generative and the operational. Each mindset powerful in its own way.
The Strategic – the blue sky, the big picture, seeing beyond the horizon. Take a breath and ponder the sophisticated Strategic mindset. (pause 15 seconds)
The Explorative – the curious, the deepening, the pushing past boundaries, wandering and wondering. Take another breath and ponder the ever inquisitive Explorative mindset. (pause 15 seconds)
The Generative – the crayons, the paper, the scissors and glue. It’s the “what if”s and the “Aha!”s. The desire for alternatives. Take another breath and ponder the playful Generative mindset. (pause 15 seconds)
Ahhh… And finally, the Operational – perhaps the most common and most maligned of the mindsets. The Devil’s Advocate, the realist, the analyst, the value-maker. Take another breath and ponder the brass-tack Operational Mindset. (pause 15 seconds)
The four mindsets: equal in need, equal in value, but rarely equal in expression.
Consider for a moment what is your natural mindset? (pause 5 seconds)
What mindset do you bring to this moment? (pause 5 seconds)
What mindset should you move to for today’s work? (pause 5 seconds)
Two more deep breaths. (pause 5 seconds)
We will each check-in with: “My mindset today is <fill in the blank>. And I am here and present.”
Open your eyes.
Who wants to go first?
It really wasn’t that bad. Not nearly as rough as I predicted. And THAT is a damn good reminder about the nature of change. Planning for it, thinking about it, and worrying about it are the painful parts. Going though it is almost mechanical. And reflecting on it in the past tense is almost always a non-event [yawn].
One year ago, I left behind a 20-year journey through the twisty, beautiful and strange halls of Kaiser Permanente. It was where I found my calling, nurtured my passions, and made a difference in the world. Towards the end, I was on a plateau of doing/making really cool shit. Those last few years were executed with a tried and true algorithm of cracking tough challenges into high-value solutions.
The truth is, I thought about a change as I approached the plateau, that place where you’re just leaving the curve of acceleration for THE peak – but why screw around with THAT success? Eventually the itch to see more – experience more –
got the best of me, and so I accepted a challenge at the amazing Hopelab. Those last few months at KP were hard. Was I making the right choice? Could I repeat or recreate “cracking tough challenges”? Who would I be if not a Kaiser Permanente design leader?
The first few months at Hopelab were strange. It felt like I was on assignment from my old world – trecking to a new city, working with a client, and at some point down the road I’d be going home. And every day my identity shifted a little here, a little there. A great week, followed by a tough day, then an amazing retreat, and an interpersonal bump, then a beautiful series of strolling meetings, a mini-set back, and a great leap forward.
One year later, I am riding the curve again. I don’t really know when it happened – 4 months, 8 months, 9 months? – but there was that gentle acceleration of thinking, contributing and making that feels like you’re catching a wave.
Yep, riding the curve and loving it.
Originally published on the UK Improvement Alliance blog
What would an “innovation learning network” for healthcare look like? Coming off of two successful years of co-launching an internal innovation group at Kaiser Permanente in 2005, it was time to build and connect to a larger community, and it was clear that to be successful, the network had to be different and valuable. The “value” piece emerged quickly in two of the three Innovation Learning Network pillars: 1) Share innovations across systems and 2) Teach innovation and design technique. These were important, valuable and obvious.
Read more here = > http://www.ukimprovement.co.uk/blog/threepillars
Reprinted from InSights.ILN.org
The sprint is on for the final touches of “WEIRD PAIRINGS & ENGINEERED RANDOM COLLISIONS,” where 80 ILNers and friends will descend on Toronto for three days with our hosts, Saint Elizabeth and MaRS Discovery District.
Coffeehouses/Nursing (ANA), Firemen/Rugs (HealthPartners), Dining/Caregiving (Cincinnati Children’s), and many more will bring the magic from these strange collisions to life. Follow us from Oct 27 – 29 on Twitter: #ILN15
Whether or not you can join (admittedly, we filled up fast!), we compiled a list of weird articles to get you thinking:
It comes down to the human experience, passion and real needs. My three takeaways from an evening conversation between Edward Boudrot of Optum, Adam Dole of Better and myself of KP’s Innovation Consultancy/ILN hosted by Continuum’s Augusta Meill in Boston on June 2.
(See Continuum’s Summary of the event here.)
Impressive was Edward’s exploration of people and empathy at Optum and his Fusion! method. One element is “building passion”, and how the very nature of connecting to the human experience is the call to action for change. Rapid change from rapid experimentation, causing a shift from old-fashioned product management to the more progressive experience management. He is pushing on virtuous cycles. His tip: Be tenacious for the possible.
Adam of Better fills a gap that most of healthcare refuses to adequately address. For a small fee, Better provides a personal health assistant to help navigate the complexity of getting, receiving and paying for care. Adam is optimizing the healing/wellness experience. He created a product that addresses a real deep need. I particularly love his singular focus of need and use of design to create a superior service. The first audience question was a concern that this would not be affordable to all. The real question, is why can’t mainstream healthcare deliver this? Until then, Better is here.
I explored how to accelerate innovation and uptake of ideas from a human-centered design lens; uniting design research and minimum specifications. For example, with our nurse shift change innovation, the tools used to discover the need were repackaged so that at each implementation the unit nurses could rapidly (re)discover the need for themselves. Then using minimum specs, they could jumpstart fitting the solution into their environment. It’s a longer upfront cost but tied to longer-term value as the solutions are stickier.
One point of clarification about employee innovation capability building trainings: organizations should not solely rely on this for transformation. It is a piece of the transformation puzzle. It does amp up improvement activities in a big way, and lays the foundation for participating in bigger change efforts. Paired with other puzzle pieces, like honest-to-goodness design teams, clear strategic direction, and end-to-end idea “mentoring”, the puzzle of innovation capability becomes clearer.
And so the evening ended with far more concordance than expected. Although, how can you go wrong with the human-experience as your focus, passion as your driver, and real needs as your compass?
There* was a palpable change in the room. The previous hour ILNers were transfixed in the School for Health & Care Radicals, exploring the differences between rebels and troublemakers. The discussion was fascinating: rebels have a natural energy of change, a “what can we do together?” attitude, and a greater good perspective. The troublemaker on the other hand is negative, grounded in “me”, and focused on success for their chunk of the world.
And then she said it. The “she” being none other than the NHS Chief Transformation Officer Helen Bevan. She made that statement that immediately became the mantra:
“Go for No.”
“What?!?” we all thought-gasped. Heads popped up; keyboards stopped clicking.
If you look at the big, audacious successes, they are built on a stockpile of “no”. No after no, planting seeds. No after no, chipping away at barriers. No after no, offering pivots. No after no, finding back alleys and back doors. No after no, until yes.
No is the indicator that you are provoking. No is the signpost that you are in a space others dare not enter. No is your pathway to Yes.
There was a palpable change in the room: junkyards of no transformed into treasures of no. And we felt… happy …and relieved.
And so, go for no. Keep on inNOvating.
*”Go For No “came from our Ninth Year of ILN InPerson Meetings. May 12 – 14, 2015, Centura Health and the National Health Service co-hosted 80 ILNers who explored how the everyday healthcare person can step up as a change thinker, change maker and change doer.
It was just over two years ago (in Dec 2012) that I heard that employees were pledging to make healthcare better. At the Institute for Healthcare Improvement Forum in Orlando, Helen Bevan of the UK’s National Health Service (NHS) talked about being a healthcare radical. She shared that employees all over the NHS were committing to change and bringing their passion and ideas to life. Furthermore, NHS executives were celebrating and championing the ability and passion for change; instead of choosing the change that all employees would make.
It was a simple and novel approach. And I wondered how this would work in the United States. And over time, so did Tim Rawson, and Mike Lin…and Yasmin Staton and Claudia Perez. So too did Jim Rawson, Richard Corder, Debra Barrath, and Amy Woodrum…Along with Dina Piccoli, Josh Rutkoff…and….
We crafted simple principles to move the work forward 4 months ago (October -2014):
We jumpstarted and divvied the work 3 months ago (November 2014) splitting into technology, marketing and social, and resources.
And so just over two years ago from when I first heard about NHS healthcare employees pledging to make healthcare better, I posted my first pledge “to launch Change Day in the United States”.
Want to make your own pledge? Visit: http://usachangeday.org
And follow @USAChangeDay on Twitter.
Thank goodness for Peter Fuda. More on that in a moment.
For the past decade, the “sky is falling” change management approach seemed to be THE way. The sky did seem like it was falling, and it was a quick way to get employees and organizations to rally around a new concept, initiative or change. And it worked…for a time. But then the sky kept falling more and more, faster and faster, and with little fanfare the sky was perpetually falling. Without exception, gloom and doom ruled.
“It’s like trying to turn the Titanic.”
“Can we link this to a burning platform?”
If innovation is the breath of fresh air to build new, valuable stuff, the burning platform is the life-sucker that stole the joy. I wish I was the one smart enough to know this. But alas, it wasn’t until two years ago when my friends at the National Health Service Helen Bevans and Lynne Mayer (now at Ko Awatea) introduced the ILN.org to a poweful youtube video by a researcher named Peter Fuda. (Please watch it and share widely). He laid the foundation of moving from “burning platform” to “burning ambition.”
Now I have to admit one of my fabulous fails. Ten years ago I proudly used the burning platform metaphor, and didn’t even use it correctly. I thought a burning platform was an intensely important political issue (as in a plank in the Democratic platform). However I actually used the image of a real burning oil rig platform for the presentation. Indeed as most of you know the oil rig is the metaphor. And it’s a dark, scary, death-y one to boot.
And so, two years ago I stopped using it. Then lo and behold while teaching at an innovation event it reared its ugly, fiery head. An attendee shared and asked, “Fear is our motivator. How are we supposed to get stuff done if there isn’t a burning platform?”
Its a good question, and paraphrased, here is my response (knowledge courtesy of Fuda):
The “burning platform” is only a metaphor. Its not real. We are not on fire. We don’t need to jump off a real burning platform into the dark freezing ocean. It is a paradigm shift; an intellectual choice to view our current challenges from a different len and with a different metaphor. You can choose any lens or metaphors you want. But why are we so sure that fear is the only tool we have?
So let me say loud and clear:
We are not the dinosaurs.
We are not on the Titanic.
We are not on a burning platform.
Our asses are not on fire.
We are working really hard to make a difference in the lives of patients and the people who serve them.
We are making healing and wellness the best it can be.
We are doing this work with our hearts, minds and souls.
It’s our Burning Ambition, not a Burning Platform.
Thank you, Peter, for shattering this fear metaphor.