The critical few: Injecting a dose of innovation into your culture

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Simply put, culture is what it feels like to receive care from, or be employed by a healthcare organization, and it manifests itself in both the words and behaviors of frontline staff and leaders.

As Peter Drucker famously stated, culture eats strategy for breakfast. This is especially true when it comes to innovation strategies. As many healthcare leaders can attest, cultural resistance can be one of the main barriers to innovation. This is partly driven by the typical value system of a healthcare organization, comprised of traits such as 'focus on safety', 'rigor', and 'risk minimization'. These are all things that are desirable when it comes to patient care and safety, however, they are not traits often associated with what we would consider highly-innovative organizations. For contrast, consider the culture of, which is characterized by maintaining an entrepreneurial and hungry "Day 1" mentality and the ability to "disagree and commit" in order to move quickly. At first glance it might appear innovation is incompatible with the core cultural tenets of healthcare organizations. 

However, don't give up yet. In working with some of the leading and most admired organizations around the world, our firm's Katzenbach center has alit on some critical insights that can help foster a culture that can support innovation. It turns out wholesale culture change is not really possible without blowing up the organization completely. What is possible, however, is a readjustment that finds and emphasizes the desirable traits (such as entrepreneurship) and dampens the less desirable traits (such as the "not invented here" mentality). The key is finding the "critical few" — the individuals and the behaviors that will get the ball rolling.  

The critical few individuals don't necessarily have to be formal leaders — but they do need to be influential and respected. These critical few can alter the organization's attitude towards innovation — either for the best (if they are acolytes) or for the worse (if they are resistors). Identifying and engaging them can be key in catalyzing change. Some of the most innovative people we have met are physicians and nurses with experience in battlefield medicine, who have an uncanny ability to solve problems with speed and inspiration despite extreme stress, time pressure and resource constraints.

The critical few behaviors are also important, and here you do need the formal leaders of the organization to step up and model these behaviors. When the organization observes its leaders saying and doing something out of ordinary, it takes notice. It may be something as simple as publicly recognizing and celebrating innovators and innovations inside and outside the organization and sharing their stories. This behavior sends a strong signal that innovation is valued and expected — and not confined to the research wing of the hospital. Below are several of the "critical few" behaviors that culturally-minded leaders could model to foster innovation:

  • Recognize and reward challenging "the way it has always been done." Incremental innovation is often the result of improving existing processes. Leaders who empower staff to suggest improvements and changes, in the appropriate context and forum, can unleash a groundswell of innovation. The key is recognizing that innovative ideas can come from anywhere — from the head of an academic department to a food services coordinator. Organizational leaders should embrace the opportunity to listen, share back with the rest of the organization, take action on the most promising opportunities and celebrate success.
  • Identify and cultivate the critical few individuals. Regularly celebrating the accomplishments of innovators is a powerful signal to staff that entrepreneurial spirit is recognized and rewarded in the organization. Furthermore, the transparency into the work of others (either in their own, or other departments of the hospital) may inspire staff in other wards or departments to propose their own ideas. This is one of the easiest ways for leaders to embrace innovation and recognize the "critical few." As they interact with you and with each other, innovation will become further institutionalized.
  • Highlight collaborative successes. Hospitals, especially academic medical centers, can be notoriously siloed. Leaders who embrace cross-functional collaboration will be setting an example for and providing permission for their staff to start thinking along cross-functional lines as well. Thinking across departmental silos will truly enable patient-focused innovation and drive towards meaningful improvements for patient (and staff) satisfaction.  
  • Celebrate small victories. Fostering a culture that supports innovation in healthcare is no small feat. Significant hurdles impede innovation at every step and thus celebrating small wins is essential to building momentum. While rigorous metrics are required to measure the overall impact of innovation, nothing is more impactful to staff morale and motivation than celebrating small wins. By highlighting these, leadership signals the "singles" and "doubles" are just as meaningful as the "grand slams." 
  • Acknowledge failures and emphasize lessons learned. How leaders address setbacks in the innovation process is as, if not more important than how they address the successes. Failure is not to be swept under the rug. In fact, it is to be embraced for the rich learning opportunity it presents. A hallmark characteristic of entrepreneurial and innovative efforts is their iterative and trial and error nature, and innovation in a healthcare setting is no different. By embracing learnings from failure, leaders are acknowledging the fundamental nature of the innovation endeavor, and furthermore, are providing permission for staff to take risks and place bets they may have otherwise avoided. Ideally, each failure should lead to the tightening of the selection and evaluation criteria for innovation — to avoid throwing good money after bad.

Healthcare leaders can make large strides towards enabling a culture of innovation through simple actions. Once they embrace the fact that wholesale culture change is unlikely, they can focus on modeling and encouraging the critical few behaviors that will move the needle on culture. The key is finding the "critical few" behaviors that will get the ball rolling in your organization. 

Igor Belokrinitsky is a principal with Strategy&, PwC's global strategy consulting team, and John Petito is a manager with the firm.


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