10 Rules for Strategic Innovators

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Transcript 10 Rules for Strategic Innovators

Leading Innovation in Health Care Delivery Presented by:

I have no conflicts of interest to report.

We need a new type of innovation.

Innovation is a two-part challenge: IDEAS EXECUTION

These two parts of the challenge … … have almost nothing

to do with each other

IDEAS: invention, creativity, brainstorming, serendipity, out-of-the-box-thinking, science, technology, strategy, disrupting your competition

EXECUTION: the blood, sweat, and tears of getting the work done.

Oh, by the way … …you must succeed at both to win.

The EXECUTION challenge is a lot harder than (most) people imagine.

Innovation in Health Care Delivery:

The Ideas are Simple; The Implementation is Hard

Innovation in Health Care Delivery: Four Common Team Charters

1. Standardize, delegate, maximize efficiency (Think: Henry Ford) 2. Coordinate care across the full cycle of care for a medical condition. 3. Prevention: “Hot Spotting” 4. Improved Medical Decisions

The EXECUTION challenge: Tackle two tasks at once – 1) Sustain what exists 2) Build something new

These two tasks are: very distinct, and inevitably in conflict.

Business Organizations Are Designed to be

Performance Engines

Ongoing Operations

Performance Engine

• Today’s Customers • Today’s Competitors • Efficiency • Accountability • On-Spec • On-Budget • On-Time • Profitable

Fundamental Incompatibilities Method of the Performance Engine Realities of Innovation

Repeatability Non-Routine Predictability Uncertain

Health Care is Different

Ongoing Operations

American Health Care Engine

• Cutting Edge Science • Cutting Edge Technology • Advanced Diagnostics • Advanced Therapies • Every Patient Deserves Best • Get Payers to Pay • No Margin, No Mission

The system we have has been… … perfectly aligned for innovation in the biosciences … … and perfectly misaligned for innovation in health care delivery (though that is changing) 20

Fundamental Incompatibilities: “Two Canoes” Volume

vs.

Value High Tech

vs.

Low Tech Fix Custom Individual

vs.

OK, so how do you simultaneously: 1) Build something new 2) Sustain what exists

How can I identify the

real innovation heroes

in my organization?

How can I knock down at least some of the barriers that they will face?

Sure, one person can come up with an idea … … but can one person EXECUTE?

It takes a TEAM.

Not just any team ...

but a team with a

very specific structure.

The team structure is a PARTNERSHIP between a DEDICATED TEAM and a SHARED STAFF.

Dedicated Team?

Innovation in Health Care Delivery

generally requires

Innovation in Team Design

Yes, Dedicated Team!

A Special Kind of Team Shared Staff

PARTNER SHIP

You CAN ask the Shared Staff to do MORE work … But you CANNOT ask the Shared Staff to do DIFFERENT work.

The Shared Staff Can Only Take on Tasks that: 1) Are Familiar or Quickly Learned 2) Fit Existing Workflows 3) Fit Existing Roles

A Special Kind of Team Shared Staff

PARTNER SHIP

A Special Kind of Team Shared Staff

PARTNER SHIP

The Work of Innovation in Health Care Delivery

Define Mission 2.

Specify the Work 3.

Design the Team • • • • • Divide the Work: Dedicated vs. Shared What are the roles on the Dedicated Team?

How many are needed in each role?

Who can succeed in each role? With how much training?

Prove it Works: Lower Costs, Better Outcomes

Example: Essentia Health Heart and Vascular Center

Mission: Keep CHF Patients as Healthy as Possible 2.

The Work: Patient Engagement, Ensuring Patients Stay on Proper Medications, Regular Contact, Home Health Monitoring (via telescales), Acting on Early Warning Signals of Trouble 3.

The Team: Dedicated – 1 NP for every 300 Patients. 1 Nurse supporting 2 NPs. Shared Cardiologists 4.

Results: Lower System Costs, Better Hospital Profits, Better Outcomes for Patients

experimentation

Running a disciplined experiment is hard.

The Payoff: If you run a disciplined experiment, you learn as quickly as possible.

Learning is a process of

making predictions

and then improving them.

Wild Guesses Informed Estimates Reliable Forecasts Years Learning 50

Better Predictions lead to Better Decisions which in turn lead to Better Results

Formalize the Experiment

Each innovation initiative needs a separate, stand-alone, custom plan with custom metrics that assess outcomes and cost. 2.

Discuss plans, results, and lessons learned in a

separate forum.

Try to spend a little, learn a lot.

The Biggest Challenge:

How do you evaluate an innovation leader?

Accountability for Learning Nine Evaluation Points

Is the innovation leader taking the planning process seriously?

Is there a clear hypothesis of record?

Does everyone on the team understand the hypothesis?

Are the most critical unknowns clear to everyone involved?

How has the hypothesis been revised? On the basis of a clearly identified lesson learned or on a whim?

Nine Evaluation Points (cont’d)

Is the leader finding a way to spend a little, learn a lot?

Has the leader reacted quickly to new information?

Is the innovation leader willing to face the facts?

Are predictions improving?

Questions?

Successful Teams Have: 1.

Shared Goals 2.

A Clear Structure 3.

Mutual Respect & Empathy 58

Leading Innovation in Health Care Delivery Presented by:

– Chris Trimble – Professor, Tuck School of Business at Dartmouth

10 Rules for Strategic Innovators

Transcript 10 Rules for Strategic Innovators

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