Michael Dowling: Building a culture of innovation to avoid the complacency trap

It is dangerous to believe anything in healthcare works perfectly. In fact, I don't believe there is any aspect of the healthcare business that couldn't be enhanced, meaning there's a constant need to reevaluate systems and process, identify opportunities for improvement and employ innovative solutions.

I would argue that the need for innovation exists across the board, especially as healthcare continues down the path of transformation from volume- to value-based care. We must seek ways to innovate care delivery, such as adopting changes that take into account the patient perspective, continuing to invest in ambulatory care and improving access. In addition to changes in the delivery system, our collective approach to education must continue to evolve  — both the internal education of our employees as well as medical education for future physicians and nurses. If you want to deliver a different kind of service, you must change the way you teach, which was why at Northwell Health we embraced a new educational model for our medical and graduate nursing schools focused on experiential learning, teamwork and communication.

If leaders aren't constantly encouraging and supporting innovation efforts, they risk slipping into the complacency trap. And once you've fallen into this trap, it's quite difficult to get out.

To make innovation efforts successful at the system level, there are several key areas that must be evolved, including culture, employee engagement and leadership.

1. Create a culture of innovation. The culture and DNA of an organization has to be one of innovation and transformation. Innovation can't be a one-off project for a small group of people. If it is, it is unlikely that any effort to implement something new on a systemwide scale will yield much success. Instead, innovation must be regarded as a fundamental component of the organization's strategy, of which all employees play an important role.

At Northwell, we created a specific department to oversee the collection, vetting and testing of new ideas. However, this department, called Northwell Ventures, does not operate as a silo. Instead, it functions as a focal point where people from across the system can submit their ideas.

It is important to note there cannot be a culture of innovation if there is not also a strong culture of trust. Clinicians and staff of all kinds and at all levels of the organization must trust that their ideas — whether or not they are ultimately viable — will be listened to and evaluated thoughtfully and respectfully. For every one good idea, there are dozens of others that might not make sense, but people need to feel comfortable enough to share them all. It's scary for a lower-level employee to voice an idea, and if they are immediately shut down, it's unlikely they will ever want to try again. And that would be a real shame — often the best ideas come from the ground level.

2. Encourage employee engagement. Trust is critical because it has a substantial influence on the degree of employee engagement in innovation efforts. Employees want the organization to make positive changes, and importantly, they want to be involved in the process to design and implement those changes. Employees at all levels of the organization have innovative ideas to contribute, and if the leadership doesn't encourage and support their participation, the employees will probably resist change.

We do a variety of things at Northwell to promote employee engagement in innovation. We have a process whereby people can submit their ideas to Northwell Ventures, kind of like a suggestion box. We also have systemwide "innovation days," which are half-day meetings with employees and our senior leadership. We often have hundreds of employees attend these meetings, eager to share their ideas. While we can't possibly enact every idea, the meetings are inspiring and motivate continuous innovative thinking.

3. Choose the right leaders. A culture of innovation, trust and employee engagement is contingent on having the right leaders in place. Senior leaders and managers must possess intellectual curiosity, mental agility and openness to new ideas. People who live in the past and are content with continuing "what has always worked" are not the people who will guide the organization into the future.

One of the most important responsibilities of leaders and managers is to listen. We are all busy, but if we don't take the time to listen to people's ideas, we will miss out on great opportunities. I make it clear to my employees — old and new — that they should not be hesitant about contributing ideas for how the business could be run better. I also encourage them to meet with me to discuss these ideas. I never turn down a meeting with an employee, and people certainly take me up on this.

Putting it all together. It's important to regard innovation as more than a buzzword or passing trend because it is truly imperative for transforming the healthcare environment.

Once you have the right infrastructure in place, allow as many ideas to percolate as possible and then pursue those that present the best opportunities to improve care delivery. Prioritization is key.

Demonstrating new ideas on a small scale is the next step. Although innovation requires higher-risk tolerance, it is often a good idea to first implement new ideas or test pilots within one unit, department or hospital, and then evaluate their success before implementing them across the entire organization.

Innovation includes many moving parts, but the most important thing is to take action. Paralysis by analysis can kill a great idea. It takes strong leaders and a strong culture to take a chance on a new idea, as well as the flexibility to course correct if something doesn't go right. The path to the future isn't straight.

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