DesignThinking

Getting to Transformation

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

1. Mandate empathetic design activities
2. Involve and incentivize patients and the public
3. Partner with patients to co-design

 Teach design thinking principles to every staff member

4. Mandate empathetic design research and prototyping training for accredited healthcare professionals
5. Incorporate human-centered design training for the entire workforce
6. Facilitate bottom-up problem solving

 Invest in targeted design expertise

7. Embed design teams in healthcare organizations (and government)
8. Sponsor design challenges in healthcare
9. Sponsor a human-centered design community of practice

 

Read the full report here.

Special thank you to Aaron Sklar who led and organized the committee and the production of this report.

 

 

 

(Some) Takeaways on Innovation Capability Building

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?

ILN Insights Magazine: the Blurry (R)evolution Issue

Get your Insights copy here ==>  goo.gl/1AOspQ

Director’s Message

I ended last year’s ILN director’s message with “The year ahead of us promises to be exciting and turbulent. If ever there was a time that innovation and design are needed, it’s now.” Little did we know how exciting and how turbulent, nor how much innovation and design are still needed. We spent most of the year with an anxious anticipation for the ACA Exchanges. And their launch was messy to say the least. Big change and big innovation are messy, but this also points to the lesson we all know well: fail early to succeed sooner.

So 2013 for the ILN was a year of experimentation, with little failures guiding us to bigger success. The Spring InPerson hosted by Boston University and the Center for Integration of Medicine and Innovative Technology (CIMIT) is a great example. We learned from past meetings that the basic Open Space format is great, but there was something missing to jolt the work to the next level. And so, we added seed funding distributed by crowdsourcing. The jolt was felt. Via experimentation the theme of (R)evolution inspired three projects to move forward. You can explore one of these (r)evolutionary projects on page 80.

The experimentation continued with the Autumn InPerson co-hosted by the UCLA Institute for Innovation in Health and the Center for Care Innovations. This meeting’s experiment was size. Just how big can an ILN InPerson get and still be meaningful? Over 160 attendees proved that bigger is sometimes better. It also was fitting that our theme was Blur. Although it was intended to suggest the disappearing line between care and life (and wow, were there some cool ideas!), it also doubled as an inflection point for ILN InPerson Meetings. The ILN meetings are getting big. Do we constrain them or open them up? It’s blurry. There are no right answers. But we have some surprises in store for 2014 and 2015. Stay tuned.

And so here is to celebrating the blurry, the unknown, and the experiments; it’s where great things live.

Yours in innovation,

Chris McCarthy

The Lowly and Mighty #Anecdote

There is a mantra that I’ve been hearing:  “No data without stories, and no stories without data.”  At first blush, this sounds awesome.  It honors the art of storytelling; elevating it to the powerful level of data.  And it also helps the storyteller fully grasp the power of data; their stories now pack a powerful data-driven punch.

However those of us who live in the world of innovation, this mantra can be crippling. There often is little to no data to pair with the stories we discover. And many stories in the early phases of innovation work are just anecdotes. As the innovator accumulates knowledge and more anecdotes, opportunity areas start to emerge; and from opportunity, innovation springs.

And that is the conundrum.  In a data driven world, the simple anecdote is looked down upon, but often is where the richest untapped insight exists.

“No stories without data, and no data without stories” is a great rule of thumb. But it is not a law. For the vast majority of what business does, this rule of thumb will keep us safe. But for the innovator, the company rule breaker, the anecdote is a mightly lens to view the system cracks and failings.

So this blog is dedicated to the lowly and often maligned innovator tool: the anecdote.

Use it well.

Use it wisely.

Bob’s Braciole (Or How Improv Wrecked A Childhood Memory)

I love improv. I love it for the laughs, for the nuance, for the unexpected, for the discovery. As much as standardization makes our lives easier on a grand scale, improv is the one constant that makes life simpler moment-to-moment.   The classic “workaround” is usually when an improv unintentionally becomes a standard.  Workarounds are neither good or bad, they are simply coping mechanisms.

The most celebrated improviser is the chef.  He is continuously enhancing his recipes, pushing his knowledge, and testing new methods, all with the explicit goal: to make it taste good.  Which takes me to my newly wrecked childhood memory.

By far my favorite dish growing up was my dad’s Braciole: cheese and garlic rolled into thinly sliced steak, tied into a roll, and simmered in tomato sauce until the meat nearly falls apart. (my mouth is already watering). Decades of these delicious rolled morsels dot my memory.

On a recent visit home, I encountered a bit of blasphemy.  My dad no longer rolled his Braciole; he made them into envelopes.  How is this possible? Braciole MUST be rolled. His simple answer, “The meat browns more easily as a flat envelope.  And I don’t have to tie the rolls which is a lot of work. I just put two and only two toothpicks to hold the envelope shut.  When they are done cooking, I know to pull out two and only two toothpicks from each one.”

I didn’t like his answer.  He was screwing with my delicate childhood memories. But what his answer reveals is the truism: simple wins over complex.  Workarounds are simply trying to find the path of least resistance from A to B. It doesn’t matter if you are a doctor, mechanic, engineer or chef; accomplishing our tasks with less pain (and more joy) is what we’re all shooting for.  So, with a big sigh, I must confess I love the envelopes too.

Bob’s Braciole

 Ingredients:

• Flank steak or top round or bottom round (sliced 1/8 to 3/16 inch think)
• Salt and pepper to taste
• Thinly sliced garlic
• Bread crumbs
• Grated Pecorino Romano cheese
• Dash of Oregano
• Dash of Parsley,

Lay each steak out on wax paper,

lightly salt and pepper,

lay six slices of garlic,

spread a 1 tablespoon of breadcrumbs,

spread 2 tablespoons of cheese, a sprinkle of oregano and parsley.

Fold the each steak into an envelope, and secure it shut with two toothpicks (scroll to bottom to see video).  Contents of the steak should be sealed in.  In a hot pan with olive oil, quickly sear the steaks on each side (about 90 seconds a side).

Submerse the steaks in tomato sauce and simmer for 4 hours. Or place into a crockpot and cook on low for 8 hours.   Remove steaks from sauce and remove all the toothpicks.

Enjoy with side of pasta, salad and a good red Italian table wine.

 

 

 

 

HOW TO MAKE AN ENVELOPE:

Touch the Insight Part 2

The wait is over.

Here is the long promised conclusion to Touch the Insight. Recall, that that posting was about an attempt to use physical prototyping not to get to a solution but to better understand the complexities in a challenge.  And I happy to report that it was not a flop.  Turns out that prototyping insights is not that different than prototyping solutions.  The main difference is the mental acrobats the design team performs in order to craft prototypes that give the sense of the insight.  The best prototypes were the ones that used analogies. For example we compared one of our work process against traditional mopping (difficult) and the Swifter (mopping made easier).   This allow the participants to consider how might we make our difficult process more Swifter-like.

Most remarkable, was the rich and often heated conversations that the prototypes generated.  Both are important elements.  It is in the deep discussions that real meaning is discovered allowing the insights to move to the action level.  The participants who played with the prototypes (and together) were more connected more deeply.

Our Insight Prototypes are becoming a “Mars Rover” of sorts; they were designed for two 1-day immersions.  However by popular demand they are lasting far beyond that original intention by a magnitude of at least 2 and up to 10. And that brings us to the final learning on prototyping insight: build for durability.  It does not need to be indestructible, but should be usable for a period of time longer than you think.

So here the top learnings:

1)   Analogies are awesome for insight prototyping (see first paragraph)

2)   Flow is REAL important. Ensuring participants move through the insights at a thoughtful pace must be planned for

3)   Good insight will challenge convention.  And when experienced en mass, healthy confrontation can occur.  Be prepared for emotional exchanges, and be prepared to capture them.  We used large stickers that participants could write their thoughts and then stick to the exhibit.

4)   Build the prototypes to last longer than you think. (see last paragraph)

5)   Build the prototypes for easy setup and take down.  (this, we did not do)

The Big Bold Future

Wow. The Autumn 2011 Innovation Learning Network InPerson Meeting was a chaotic magical dream state. I am not quite sure if I’ve woken back up. 150 innovators and leaders from around the country gathered to build the future of healthcare. The theme was complex yet simple: connected health. And it encompassed broad reaching policies and deep, yet to be developed technologies.

We sent the innovators on an innovation safari on Day 1 to fifteen extraordinary SFBay organizations. We exposed them to 10 super cool technologies and concepts in a progressive lunch (we paired finger foods with technology…and wow was that a cool way to learn!). And then we gave six hours to brainstorm and prototype healthcare in 2031.

From SmartBathrooms and SmartSupermarkets, to a Healthcare Political Party and friendly cloud computing the future were as brilliant as they were diverse. All gave us a glimpse of what we know is to come.

Now the hard work: dragging 2031 as fast as we can to the present. Our innovators will coalesce around the most promising ideas, the ones were passion is high and collaboration is needed….and do something about it. Stay Tuned!!

Finally a special thanks to my home Kaiser Permanente and to my dear friends the California Healthcare Foundation. We co-hosted and sponsored this event.

Touch the Insight Part 1

We’re trying something totally new (for us) and totally cool (to us). Rather than prototyping solutions (which is the norm), we are prototyping insights. Same pathway, very different outcome. Solution pathways are meant to solve the problem or create new business opportunities. Insight pathways are meant to assist an organization in deeply understanding the issues they face.

Insights are pieces of the design puzzle and come early in a project. They are what drive opportunity identification, ideation and “solution” prototyping. But what if the problem is so complex, so gnarly, so diffuse that even understanding the insights are challenging? Insight prototyping breaks down this complexity and allows the organization to play, ponder, and plunder the insight; stretching and twisting them into first self meaning, secondly group meaning, and finally  organizational meaning.  They are designed to foster deeper discussion and smarter action, and reduce simplistic reaction.

Now with all this praise for insight prototyping, we’re literally prototyping it. And so far so good.

So this blog is a tease.  You will have to come back for Part 2 to see if this technique is a flop, success, or something in between.  We debut our insight prototypes next week…..

The Play Bow

I had the good fortune to see Barry Kudrowitz share his insights on how play can/should influence every step of the design process. And the myriad of games that just might stimulate different phases of your work from Pictionary & Apples to Apple to Legos and Taboo, each triggers different (and happy) insights. Perhaps my favorite moment was his explanation and demonstration of the Canine play-bow. The play-bow is the playful pose that dogs use to invite other dogs for a rough and tumble play fight. Ass in air, front paws jetted straight out…which of course resembles a bow. And then the dogs are at it! Rolling, romping and……learning. Learning what works and what doesn’t in the very important function of a fight. Seeing a grown man demonstrate this on stage if far more hilarious… both ways, whether man or dog its fun to watch, and you can really feel the “playfulness” barrel through.

And THIS has everything to do with how we design new stuff, try new stuff and make new stuff stick. Being playful invites people to make mistakes, to roll around and tumble with new ideas, and to figure out how to make this important stuff work in important moments. Being playful and messy has been my teams mantra these past several weeks as several hospitals kickoff implementing some of our newest innovations. It’s amazing how disarming/charming being playful can be, morphing the painful process of “implementing a new system” to “tumbling to the finish line”. Which would you rather do?

Asses up, paws out!

Playful and Messy

Christine Richter and I just finished presenting a very special WebEx on KP’s innovative nurse shift change called Nurse Knowledge Exchange Plus (NKEplus). The format of the WebEx was a new feature of the Innovation Learning Network to help diffuse innovation across systems. This blog post is not about that, but about one question that really caught my attention:

“what special skills does your group bring to implementation? Meaning what would we be missing if we tried to implement without you?”

The answer is “being playful and messy”. Too often when implementing new stuff, the “serious factor” rises exponentially. There is pervading sense that all must go right and tolerance for the imperfection plummets. And this is exactly what we combat when we implement new ideas. We try to help the end user and management take on a playful and messy attitude. Get them to smile, laugh and stumble….laugh again, and get it a little more right. Official permission for playfulness goes a long way: stress is reduced, and users become more perfect, faster.
So give it at try. You will be amazed at the serious results from being truly playful.

(and smile).

For those of you interested in implementing NKEplus you can signup and get more info here: http://goo.gl/FhwW8