Managing Innovation: Changing our Mental...
Transcript of Managing Innovation: Changing our Mental...
Managing Innovation: Changing our Mental
ModelsMarian Johnson with Carol Haraden and John WhittingtonApril 14, 2016
Session Objectives
• To describe the value of an innovation process
to solve tough problems and redesign care
• To differentiate between the goals of innovation
and improvement in your organization
• To learn about different types of innovation and
IHI’s methods for innovation
Delivery System Innovation: Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product
Innovation is not an event
Innovation is not a product
Innovation is a process…
Moen, R. Idealized Design Process
…with many
visualizations
Our Initial Innovation Process
• Integrated into project teams
• Created great ideas from
improvement work
– Bundles
– Reliability
– ‘Move Your Dot’
• Good, but not good enough
What Was Missing
• Pace
• Staff with dedicated time
• Predictable results
• A forum for problems that needed innovation
• A reliable mechanism to transfer an idea into a
prototype or pilot test
IHI Innovation Process
• A specific challenging question to be
answered
• A network of innovators, along with
other traditional methods (literature
search, prototype testing)
• A specific timeline, in this case 90
days
• A set of recommendations at the end
of each cycle
Huston L and Sakkab N. Connect and Develop. Harvard Business Review. March 2006. pp 58-66
Components of a 90-Day Learning CycleQ
ue
stio
n Pose & refine question to be answered
Sca
n Review literature, conduct interviews, identify exemplars T
he
ory
Bu
ildin
g Identify core underlying principles & theories
Fo
cu
s &
De
sig
n Develop a new concept design for testing
Te
st
Work with one or more settings to test new concept
Using improvement science and lots of learning cycles we improved the design
From
Observation
to Proven
IdeaDevelop
a theory
(Hypothesis)
Organize and Apply Observations
Observe a Dynamic Raw Event (Phenomenon)
Transition Point
Pilot
and
Spread
Prototype test
(Find anomalies and update theory)
Validate the
theory
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a Process
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a Process
Innovation & improvement are separate
Improvement and Innovation
Improvement
The act of raising to a more desirable quality or condition—to make better
Refinement and extension of existing competencies, products, and paradigms exhibiting returns that are usually positive, proximate, and predictable
Mental model = elimination; remove existing system faults
Limitations: Lack time of existing staff; limited to the existing business model
Innovation
Introducing new methods, ideas, or products—to make new
Experimentation with new alternatives having returns that are often uncertain, distant, and negative
Mental model = creation; remake the system
Limitations: resources & ability to manage and execute on innovation
Why do we need delivery innovation in health care?
European Observatory, 2001
Quality Control Quality Improvement
Innovation
A Simple Innovation Map
LargeSmall
InnovationImprovement
The challenge for leadership
Burden
Time
Current
State
Future
State
Transition
State
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a Process
Innovation & improvement are separate Innovation & improvement co-dependent
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement are separate Innovation & improvement are co-dependent
Innovation is everyone’s job
The Critical Resource: TIME
People
Fracti
on
of
Tim
e
10%
80%
90%
70%
60%
40%
50%
30%
20%
100%
Ongoing Operations
0%0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Part Time Contributions from All
People
Fracti
on
of
Tim
e
10%
80%
90%
70%
60%
40%
50%
30%
20%
100%
Ongoing Operations
0%0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Innovation
Primary Limitation = Project Size
Full Time Contribution from a Few
People
Fracti
on
of
Tim
e
10%
80%
90%
70%
60%
40%
50%
30%
20%
100%
Ongoing Operations
0%0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
In
no
vati
on
Innovation with Full Timers
• Projects linked to strategy
• Resources are reliably available
• Ability to practice clean slate team design
(in a less disruptive way)
Discussion: How to free up resources?
• Catalogue your current ‘innovation’ activities to.
Look for:– Projects that are not resourced to meet goal
– Redundant activities
– Activities that are non-strategic
– High-risks that are unlikely to be met
• ‘Celebrate’ the end of some of these
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement are separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation requires dedicated teams
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement are separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation requires dedicated teams
Innovation ideas come from genius
Innovator’s DNA
• Associating
• Questioning
• Observing
• Experimenting
• Networking
Dyer JH, Gregersen HB, Christensen CM. Innovator’s DNA. HBR December 2009
To harvest you must go
to the fields
“Bi-Directional” Innovation…
• Cataract Surgery at Aravind
Eye Care Hospital
• ‘30 min or your money back’
– Fortis patient experience
29
Positiv
e D
evia
nts
Lead Users
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement are separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation requires dedicated teams
Innovation happens in isolation Innovation works with operations
Innovation ideas come from genius Innovation ideas come from observation
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement are separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation requires dedicated teams
Innovation ideas come from genius Innovation ideas come from observation
Only disruptive innovations matter
P&G’s Four Types of Innovation
• Sustaining
• Commercial
• Transformational-sustaining
• Disruptive
34
Sustaining Innovation
• Incremental improvements to existing products– A little more cleaning
power to a laundry detergent
– A better flavor to a toothpaste
35
Brown and Anthony, How P&G Triples Its Innovation Success
Rate, Harvard Business Review, June 2011
Commercial Innovation36
• Use of creative
marketing,
packaging, and
promotional
approaches to grow
existing offerings
• P&G ads during the
2010 Olympics
– Celebrating Moms
– The campaign covered
18 brands, was viewed
repeatedly by hundreds
of millions of consumers,
and drove $100 million in
revenues
Brown and Anthony, How P&G Triples Its Innovation Success
Rate, Harvard Business Review, June 2011
Transformational-Sustaining Innovation38
• Innovations that reframe existing categories
• These typically bring order-of-magnitude improvements and fundamental changes to a business and often lead to breakthroughs in market share, profit levels, and consumer acceptance
Brown and Anthony, How P&G Triples Its Innovation Success
Rate, Harvard Business Review, June 2011
Disruptive Innovation
• Innovations that represent new to-the-world
business opportunities
• Typically when a company enters entirely new
businesses with radically new offerings
39
Brown and Anthony, How P&G Triples Its Innovation Success
Rate, Harvard Business Review, June 2011
Dis
ruptive Innovatio
ns
General themes for innovation projects
Sound ideas for
improvement exist
outside of health care
Simplification of core
premises and processes
for the day-to-day care
of patients
Removal of accepted
system faults
Improving handoffs Bundles Triple Aim definition
Business case Optimizing stroke care Palliative care
Production system
design
Safe transitions for elderly
patients
Integration of behavioral
health and primary care
Transitions for health
systems
Remote monitoring of
patients
Physician Optimization
for population health
Risk resilience Antibiotic stewardship Execution Framework
High reliability systems Real-Time Demand
Capacity for Flow
Primary Care 3.0
Red=Waiting Green=Became a Program Blue=In Use in Other Programs
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement are separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation requires dedicated teams
Innovation ideas come from genius Innovation ideas come from observation
Only disruptive innovations matter Innovation takes many forms
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation is a dedicated resource
Innovation ideas come from genius Innovation ideas come from observation
Only disruptive innovations matter Multiple types of innovation matter
Only need one innovation method
90-day Learning Cycle is great if…
• We have 90-180 days available
• The “Problem” needs primarily a research
solution
• The output of the project is a set of principles or
framework that can be tested further as part of a
prototype
But what if…
• We have 6 weeks or 3 days
• The problem needs a design solution or requires
a completely new system
• The outcome has to be a working prototype for
immediate testing
Innovation Methods Spectrum
Innovation Lab 90-day Learning Cycle(s)
With Client: Client has dedicated
time for engagement
Need a solution quickly: 6 weeks
Clarity in the problem that needs
a solution
Problem needs a design solution
Prototype is emphasized over
principle
Building and exercising
prototypes leads to learning
Produces a tailored solution
Converge to a solution
For Client: Client has limited time for
ongoing engagement
Not immediate need: 3-6 months
Problem still needs definition and
articulation
Problem needs a research solution
Principle is emphasized over
prototype
Articulating/validating theories
inspires/informs developers
Produces a broader deliverable
Converge to a theory
Start End Start End
Innovation Relay
For Client: Client has limited time but
desires engagement at all levels
Clarity in the problem that needs a
solution
Problem needs a team-based
approach to finding a solution
Prototype is emphasized over
principle
Building and exercising prototypes
leads to learning
Produces an energized set of
creative teams
Converge to a set of solutions
S E
S E
S E
S E
S ES E
S E
S E
Match the method to the question
Innovation Methods Problem
90-day Learning Cycle What does a model of population health look like
for low-income pregnant women?
Innovation Lab What is the best design for an academic training
model to improve patient care?
Innovation Relay How can you diagnose and start treatment for
mental illness before a critical event?
Idealized Design What is the idealized design of perinatal care to
eliminate adverse events that occur in labor and
delivery?
Changing our Mental Models
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation is a dedicated resource
Innovation ideas come from genius Innovation ideas come from observation
Only disruptive innovations matter Innovation takes many forms
Only need one innovation method Match innovation methods to the question
Building your innovation system
Discussion
• What is the goal of innovation for your
organization:
– Enhancing your current position in the market?
– Bringing in new revenue?
– Being seen as a leader in health care innovation?
• What are your current methods for innovation?
– For what types of problems do these methods work
well? Less well?
Where to start?
• State your aim
• Select or build an innovation method (or methods)
• Commission a small team with dedicated time (be disciplined)
• Harvest, observe, associate, question, network, experiment
• Build a learning system to review innovation methods and integrate into operations and improvement work
Building your team
Sample Innovation Project Team:
• System Designer
• Clinical subject matter experts
• Research staff
• Ethnographer
• Data Expert
• Technology Expert
• Business/Policy Expert
Where do you look “outside”
but still internal?
• Who are your natural
innovators?
• Who gets excited by new
ideas?
• Who are your natural
communicators?
• Pair “thinkers” with “doers”
What we have learned…
Old Mental Model New Mental Model
Innovation is an event or product Innovation is a process
Innovation & improvement separate Innovation & improvement are co-dependent
Innovation is everyone’s job Innovation is a dedicated resource
Innovation comes from genius Innovation comes from observation
Only disruption innovations matter Innovation takes many forms
Only need one innovation method Match the method to the question
Build a Way Forward with an Innovation System
Questions?