Innovation in Action E-Book

D. Scott Endsley

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 163

Veröffentlichungsjahr: 2011

Beschreibung

It is now recognized that innovation in healthcare needs to be a primary strategy for dealing with the challenges of pressure from consumers and the effort to control costs.This practical guide describes key issues surrounding innovation, such as the barriers to innovation in healthcare, the opportunities of working across boundaries in open innovation, and the process and tools of exploring the innovation approach.

The highly-regarded author follows a five-stage process model that presents a systematic base for understanding, and -- more importantly -- performing innovation work:

1. Defining the innovation design challenge

2. The process and tools of exploring the innovation

3. Generating innovative ideas

4. Prototyping and testing innovations

5. Creating a diffusion plan

This user-friendly guide is ideal for all healthcare professionals and healthcare teams, both in training and in practice.

Leseprobe

Table of Contents

Cover

Title

Copyright

Foreword

Chapter 1: Introduction to Innovation

What is innovation?

Why is innovation so hard in healthcare

Design thinking

The innovation model

Innovation teams

Your innovation skills

Open innovation

An innovation story: Greenfield Health System

How to use this guidebook

Appendix A: clinical innovation self-efficacy

References

Chapter 2: Defining the Innovation Challenge

A strategy for defining the innovation challenge

Step 1: information gathering

Step 2: prioritization

Step 3: writing your innovation statement

Step 4: mapping your innovation strategy

An innovation story continued

Appendix A: Innovation challenge question bank

Appendix B: Innovation Challenge Statement & Strategy Map

References

Chapter 3: The Deep Dive

Learn

Look

Ask

Try

An innovation story continued

Appendix A: activity/spaghetti diagram

Appendix B: behavioral archeology form Behavioral Archeology

Appendix C: process mapping form

Appendix D: customer survey template Customer Interview Summary

Appendix E: mind map process

Appendix F: role-playing process

INTRODUCTION

PHASED ROLE PLAYING

DOING IT

ACKNOWLEDGMENTS

REFERENCES

References

Chapter 4: Generating Innovative Ideas

DirectedCreativity model

Finding new ideas

An innovation story continued

Appendix A: Plsek depth of innovation scale How Creative Is That Idea? Thoughts About Creating A Depth of Innovation Scale

Appendix B: Six hats innovation evaluation

References

Chapter 5: Prototyping and Testing Ideas

Tool 1: physical models

Tool 2: computer-aided design

Tool 3: paper prototyping

Tool 4: experience prototypes

Tool 5: mathematical models

Tool 6: rapid cycle tests of change

An innovation story continued

Appendix A: worksheet for planning/conducting rapid cycle tests of change

References

Chapter 6: Creating Your Diffusion Plan

Diffusion of innovations

Use of social networks

Creating your diffusion plan

Tools for communicating your innovation

Creating your story

Measuring the reach and impact of the innovation

An innovation story continued

Appendix A: tips for healthcare innovation diffusion

Appendix B

Appendix C

Appendix D My Diffusion Scorecard

References

Appendix

Index

End User License Agreement

List of Tables

Chapter 1: Introduction to Innovation

Table 1.1 The 10 faces of innovation

Chapter 3: The Deep Dive

Table 3.1 Five whys example

Table 3.2 KAP survey example

Table 3.3 Behavioral archeology template

Table 3.4 Customer survey template

Chapter 4: Generating Innovative Ideas

Table 4.1 Depth of innovation rating

Table 4.2 Six hats thinking

Chapter 5: Prototyping and Testing Ideas

Table 5.1 Flowchart symbols

Table 5.2 Improvement tips

Chapter 6: Creating Your Diffusion Plan

Table 6.1 Innovator types

Table 6.2 Six buttons of buzz

Table 6.3 Innovation scorecard

List of Illustrations

Chapter 1: Introduction to Innovation

Figure 1.1 Model of design thinking.

Figure 1.2 Phases of innovation.

Figure 1.3 A model of innovation in action.

Chapter 2: Defining the Innovation Challenge

Figure 2.1 Innovation challenge process.

Figure 2.2 Appreciative inquiry cycle. (used with permission of author)

Figure 2.3 Scenario planning matrix.

Figure 2.4 Innovation strategy map.

Figure 2.5 Example strategy map.

Chapter 3: The Deep Dive

Figure 3.1 IDEO four strategies.

Figure 3.2 PubMed.

Figure 3.3 Clinical Microsystem.

http://dms.dartmouth.edu/cms/

Figure 3.4 Spaghetti diagram.

Figure 3.5 Process map.

Figure 3.6 Mind map example.

Figure 3.7 Figure 10: From left to right: Working with a financial services company to design new travel services, working with the NIH to envision optimal research collaboration strategies, working with a hardware manufacturer to explore new PDA services.

Chapter 4: Generating Innovative Ideas

Figure 4.1 DirectedCreativity model. (Reproduced with permission from Paul E., Plsek & Associates, Inc. www.directedcreativity.com.)

Figure 4.2 Treasure chest.

Figure 4.3 Bodystorming.

Figure 4.4 Concept fan.

Figure 4.5 TRIZ idea generation path.

Figure 4.6 Stepping stone example.

Figure 4.7 That’s impossible example.

Chapter 5: Prototyping and Testing Ideas

Figure 5.1 An example napkin sketch.

Figure 5.2 Model for improvement.

Chapter 6: Creating Your Diffusion Plan

Figure 6.1 Diffusion curve.

Figure 6.2 Greenhalgh diffusion model.2

Figure 6.3 Storyboard example.

Guide

Cover

Table of Contents

Begin Reading

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e1

Innovation in Action

A practical guide for healthcare teams

D. Scott Endsley, MD, MSc

Director, Innovation and System DesignCleveland ClinicCleveland, OhioUSA

This edition first published 2010, © 2010 by D. Scott Endsley

BMJ Books is an imprint of BMJ Publishing Group Limited, used under licence by Blackwell Publishing which was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing programme has been merged with Wiley’s global Scientific, Technical and Medical business to form Wiley-Blackwell.

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Library of Congress Cataloging-in-Publication Data

Endsley, D. Scott

Putting healthcare innovation into practice / D. Scott Endsley.

p. ; cm.

Includes bibliographical references.

ISBN 978-1-4443-3057-1

1. Health services administration. 2. Medical care-Quality control. 3. Diffusion of innovations. 4. Health facilities-Administration. 5. Organizational change. I. Title.

[DNLM: 1. Health Facilities-organization & administration. 2. Organizational Innovation.

WX 150 E56p 2010]

RA399.A1E53 2010

362.1068-dc22

2009051155

ISBN: 9781444330571

A catalogue record for this book is available from the British Library.

Foreword

In any business, leadership and innovation are essential to success in a competitive environment. We are particularly challenged in healthcare by the complex and often perverse payment and regulatory environment in which we operate. All too often, our mental models of what we have done in the past get in the way of thinking about how things could be in the future. To stay on top, healthcare organizations must constantly find new efficiencies while improving service, quality, and reliability.

Sustained organizational change takes real leadership. Creating and communicating a clear vision that all can understand begins the process of change. Everyone must be empowered to contribute in some way toward the desired future state. They must be able to see day-to-day progress in some meaningful way to stay engaged. This book will serve as a step-by-step guide to begin fostering a culture of innovation in your organization.

Healthcare organizations must intentionally instill a culture of improvement and innovation. It does not just happen by accident. Through a series of building blocks, tools, and scenarios, Dr Endsley has assembled a handy field guide to help your team develop a habit of idea generation and innovation. In succeeding chapters, you will see the importance of prototyping and testing ideas to make sure they work in the real world. Once these innovations have been tested, it is important to integrate and align promising new ideas throughout the organization.

Innovation in Action is the catalyst you need to get your people and your organization started on the important journey to a culture of improvement and innovation.

Bruce Bagley, MD

Past president, American Academy of Family Physicians

Medical Director for Quality for AAFP

February 2010

CHAPTER 1Introduction to innovation

Welcome to Innovation in Action, a guidebook designed to provide insight, concepts, and tools for creating and testing new ideas (or redesigned old ideas) for healthcare. It is intended to help its users transform the practices and products that they use in their everyday delivery of healthcare and create value in the systems in which they work.

Tips for Innovation

Aim for simplicity

Think in verbs, not nouns

Build on ideas of others

Create an idea “treasure box”

Think both spatial as well as process change

Brainstorm often

Bring people together

What is innovation?

Innovation is “the first, practical, concrete implementation of an idea done in a way that brings broad-based, extrinsic recognition to an individual or organization.”1 Innovation goes beyond creativity, which is the production of ideas, to focus on implementation of ideas that bring value to individuals and organizations. It is a rare that innovations comes as “a bolt out of the blue” but more commonly, as Peter Drucker notes, are the result of “a conscious, purposeful search for innovation opportunities.”2 He emphasizes that innovation is a “systematic practice” that draws insights and ideas from interdisciplinary groups who see the innovation challenge from multiple perspectives. Unlike invention, innovation is first and foremost, a value-driven team set of processes with focused objectives.

Building Innovation into Health Systems: Memorial Hospital and Health System. Memorial Hospital and Health Systems in South Bend, IN (www.qualityoflife.org), through senior leadership recognized that they were afflicted by a “creeping sameness,” faced a war for talent, and were financially challenged by local competitors that were eating at their margins. Bringing innovation into their business model allowed them to all three of these. Leadership organized “innovisits” to regional organizations in and outside of healthcare recognized for their innovation (e.g., Proctor & Gamble), established board level policies that set expectations for innovation throughout the organization, created a system training program (Wizards College) in innovation for all level of staff, built innovation into job descriptions, and provided support through “idea propulsion labs” where “WoW projects were worked on.” Memorial tracks costs and return on investments (ROI) for all innovation projects as a board expectation. ROI estimates range from 1.2 to 3.0 (120–300% return).

So why innovation? It is now acknowledged that the quality of healthcare in United States is average at best. For instance, a study by RAND3 suggests that adults are receiving only 54.9% of recommended care (prevention, acute care, chronic services). “The need for change” as suggested by the RAND report “leads directly to the need for ideas for change.”4

Innovation is distinctly different from invention—that is, the creation of something new. Innovation on the other hand requires that the new idea or creation is used and provides value to the users. It is fundamentally a team sport that involves people and ideas from multiple disciplines focused on an aim. As Peter Drucker has described it, innovation is a true discipline. Becoming an effective practitioner of innovation takes practice. As described by Peter Denning,5 there are eight foundational practices for an innovator.

Awareness

: Ability to perceive opportunities, distinguishing them from your own agenda, ability to overcome cognitive blindness

Focus and persistence

: Ability to maintain attention on innovation challenge amidst chaos and obstacles

Listening and synthesizing

: Ability to hear others ideas, needs, preferences, and to blend them together with your own to create new ideas

Declarations

: Ability to make simple, powerful, moving, eloquent statements about the future that serve as attractors for others

Destiny

: A sense of the future and of possibilities that is powered by a larger purpose

Offers

: Bring value to your customers and stakeholders. Ability to deliver with commitment to results

Networks and allies

: Ability to build and maintain productive relationships with others, especially representing different perspectives and skills

Learning

: Constantly seeking new ideas, skills, and experiences from traditional and nontraditional sources; a mindset of inquiry

Beyond the distinction between innovation and invention, there are four myths about innovation of which to remain aware. These include (a) innovations must be big—often the most successful innovations are small, (b) innovations are the work of a gifted few—anyone can learn the skills and practice of innovation, (c) innovations are about new ideas—innovations are often old ideas in new uses or new audiences, and (d) innovations are only applicable to commercial markets—innovations are applicable in all settings (business, education, government, nonprofit, etc.).

Why is innovation so hard in healthcare

The United States spends over $26 billion on research and development in healthcare, second only to defense research and development.6,7 Yet examples of disastrous failures abound in healthcare—ranging from the various efforts to use managed care methods to manage costs, stock market losses of biotech start-ups, and the painfully slow digitalization of healthcare delivery—represent high stakes and high investment that yielded little in terms of innovations. Herzlinger7 describes healthcare innovation in three sectors: consumer, technology, and business model. She goes onto describe six forces that promote or kill innovation in healthcare. These are:

Players

: The diversity of stakeholders within healthcare is broad. Each has his or her own agendas and various degrees of influence on policymaking and resource allocation. Turf wars between hospitals and doctors and between consumers and health plans as well as other large and small battles compromise efforts to bridge differences and create space for innovation.

Funding

: Two financial challenges confront healthcare innovators. First, technology and pharmaceutical innovations require long lag times and rigorous Federal scrutiny before they are market ready. Second, the current reimbursement models are aimed at controlling cost, not supporting innovation. Insurers’ benefit coverages are slow to integrate new technologies and innovations into their package of reimbursables.

Policy

: Healthcare is a highly regulated industry. These regulations can deter innovation development or dissemination of new technologies, drugs, or services. For example, the Stark Anti- Kickback statutes limited the ability of hospitals and affiliated office practices to collaborate on purchasing and supporting electronic health record systems.

Technology

: New technologies in healthcare are entering the market at lightning speed. Over the last 40 years, new technologies have accounted for 20–40% of the explosion of healthcare expenditures in the United States.

6

This “technological imperative,” as Burns has described, is based on patient and provider demand for technologies that do not translate into healthcare value. Because of coverage and other issues, adoption of these technologies is highly variable, dependent on both market and interpersonal forces that are often difficult to predict with a particular technology. For instance, MRI scanners were highly market driven when introduced, leading to rapid uptake by the medical community. On the other hand, electronic information technologies are highly interpersonal driven, resulting in slower uptake.

Customers

: Over the last two decades, the role of the consumer has dramatically changed—from a passive, unknowing recipient of healthcare to a more active, informed manager of their own healthcare and healthcare dollars. For example, the rise of consumer-driven healthcare plans has ridden both the consumer’s greater involvement and employers desire for lesser involvement. Direct-to-consumer marketing has changed the relationship between the patient and the provider, creating new opportunities for consumer-directed innovation.

Accountability

: Increasingly, healthcare providers, institutions, and payers are being held to standardized metrics of performance, often publicly reported. Moreover, these levels of performances are being incentivized through such programs at Bridges to Excellence or the Medicare Value-based purchasing initiatives. Thus, innovators are faced to helping potential users meet these performance demands.

These are the major forces with which the innovator must contend to be successful in bringing a creative idea to market and provide value to users.

Design thinking