How do I create a culture of innovation in my organization?

How does an organization create a culture of innovation? It is an exceedingly common question. Indeed, in more than fifteen years of researching, writing, teaching and speaking on the topic of innovation, I'm certain that no question has been asked of me more often.

In order to get a good answer, however, it's important to first be sure that you have a clear eye towards what sort of innovation activity you are trying to generate. Almost always, when people ask about a "culture of innovation" they have something very egalitarian in mind. Everyone can be an innovator. Every employee, at every level, can come up with ideas. Every employee can even take some initiative to drive improvement.

Such an approach can be powerful, but note that it also implies very small projects. After all, what are the resources available to "every employee?" Generally speaking, it is a little bit of fee time and not much more.

Is this the kind of innovation that your organization is looking for? Is your aim to make progress by taking tens of thousands of tiny steps? If so, then by all means, create a culture of innovation. By and large, doing so is a matter of stimulating the circulation of ideas and insights, providing the analytical tools and support that can help generate such insights, and creating incentives that motivate action on the front lines.

My research suggests, however, that we can do so much better in driving innovation in healthcare delivery if only we are willing to make somewhat larger bets. Allocating little slivers of slack time is not enough. What's needed is the commissioning of small full time teams – often just three or four people – whose job it is to completely redesign care from scratch and deliver that better care for a particular patient population.

Full time teams are powerful because they have unparalleled flexibility. The members of such a team are not locked into existing roles or existing care processes. They can truly reinvent care and recast their jobs – what they do at work each day – from a clean slate. Where such teams are put in action, the results are typically spectacular. Very often, these teams deliver double digit percentage improvements in both outcomes and costs.

Does this sound more like the type of activity you'd like to stimulate in your organization? Innovation in the form of projects at this somewhat-larger-but-still-modest size? If so, it is crucial to understand that the roles for senior leaders change dramatically. In the specific context of healthcare delivery, and in order of importance, senior leaders can support innovation by:

1. Pushing Towards Accountable Care. Sadly, most care redesign projects are unsustainable under a fee-for-service payment structure. It can seem crazy. You innovate, you improve care for patients, you do a great thing for the system by reducing total costs ... and you get penalized financially for your outstanding effort. The good news is the steady and even accelerating transition to accountable care. Value based payments have the potential to unleash innovation in healthcare delivery.

2. Make a Call for Proposals Within Your System: You are looking for aspiring innovation leaders, predominantly physicians, who are willing to give up their current job and invent a new one – leading a clinical team who is doing the same thing – in order to redesign care for a selected patient population. You might be surprised by just how many proposals you receive.

3. Make Bets on Small Full Time Teams that Redesign and Deliver Better Care. Examine closely how resources are allocated to innovation and you might find that almost all activity is either in the form of the very small projects described above or in special innovation labs or innovation centers that focus on high-technology and "breakthrough" thinking, but are not adequately resourced to bring their ideas to fruition.

4. Help Cut Through Standing Policies That Block Progress: Beware of "one-size-fits-all" policy guidelines, especially in human resources, that streamline ongoing operations but inhibit innovation. Be prepared to make exceptions for full time teams pushing forward with new care models.

5. Provide Assistance in Collecting and Analyzing Performance Data: Both innovation leaders and the senior executives supporting them ought to be anxious to gather data to prove that the innovation is on track to success – both improving outcomes and reducing costs. But existing data systems, because they are grounded in existing care processes, are likely to be a mismatch for the new initiative. As such, a fair amount of manual and labor intensive data gathering and analytical work may be necessary. Innovation teams are likely to be grateful for all of the help they can get.

Finally, in addition to taking the above steps, senior leaders that are effective at supporting innovation never lose sight of the fact that even the best innovation leaders need an ally at or near the top of the organization. Innovation and conflict go hand-in-hand, and the deck is generally stacked against innovation leaders. Their programs are small and nascent, the rest of the organization is large and established. The best senior leaders are ready to engage in conflict and even actively adjudicate those conflicts with an eye towards what is best for the organization's long-term health.

Chris Trimble is an adjunct professor at the Tuck School of Business at Dartmouth and The Dartmouth Institute for Health Policy and Clinical Practice. He is the author of six books, including How Physicians Can Fix Health Care: One Innovation at a Time (American Association for Physician Leadership, 2015).

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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