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.
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?
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.
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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,
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.
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.
lightly salt and pepper,
lay six slices of garlic,
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).
Enjoy with side of pasta, salad and a good red Italian table wine.
HOW TO MAKE AN ENVELOPE:
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!
“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.
For those of you interested in implementing NKEplus you can signup and get more info here: http://goo.gl/FhwW8
Last fall, my partner in crime, Christi Zuber and I had the opportunity to present on why we think human-centered design is so important…and so huge for healthcare. In an amazing event designed by Adaptive Path, UX Week took many of us on a journey of exploration, from comics to starships and behavior to dancing. I loved that the organizers made the week theme-less; instead they focused on bringing together cool, inspiring stuff.
Since the conference I’ve received several emails sharing that the video was an excellent “intro to HCD” for their organization. Although it was certainly not designed for that purpose I am thrilled it is finding a second life.
In any case, here is the video in its entirety…thanks to the folks at Adaptive Path (and you can get the Transcripts here).