Making the Case for Innovation

Drawing on nearly 30 years of experience, IHI has published IHI Innovation System, a white paper that offers guidance on how a health care organization might create its own internal structure to support innovation. In the following interview, white paper co-author and IHI Chief Innovation & Education Officer Kedar Mate, MD, describes how to make innovation more than a buzzword.

What can I learn from the IHI Innovation System white paper?

The purpose of the white paper is to help organizations become better innovators — that is, to become better at generating and discovering new ideas, adapting new approaches to fit the local setting, and spreading what works. It explores the argument for having a team that is dedicated to innovation, and it focuses on effective processes for translating an innovation team’s ideas into practice.

What, exactly, is “innovation”? (How is it different from improvement?)

There is often confusion between innovation and improvement. The mental model of improvement focuses on eliminating defects — for example, errors, harms, or delays. Improvement classically works within existing systems, to make them better; it is not typically seeking to disrupt the system completely.

Innovation is seeking to fundamentally change the system. The mental model is creation of something that is completely new that offers new value to the end-user. Because it’s not trying to operate within the original approach, you need people who can operate outside of business as usual. Typically, these folks are working on a new model, an innovation, at or near full-time so they can be intentionally disruptive to get to a different result.

How can organizations promote innovation?

If you’re going to focus on innovation, you’ve got to build a team for it. There is this notion that everyone can drive innovation in their work, and it’s just not realistic. There’s a way in which everyone can contribute to innovation activities; however, it’s not practical that people will be able to create completely different models of service if they only have, for example, 5 to 10 percent of their time to devote to thinking about such things. From what we’ve seen, only organizations with teams dedicated to innovating succeed in creating wholly different models of service.

Also, the innovation team must be closely connected to frontline operations. The team will only succeed if it truly understands the needs of the people it’s seeking to serve. To drive value for patients and providers, the innovation team needs to understand how its ideas will work in application.

Can you give an example of an organization that has a successful process for innovation?

The University of Pennsylvania has a dedicated team of innovators — who have design expertise and innovation knowledge — and they partner with frontline clinicians who can contribute necessary clinical knowledge and frontline delivery experience. This helps them create new models of care and service that they can reliably execute at scale.

One of the projects the team is currently working on is changing the discharge process — what we call “flipped discharge.” The team is reviewing how the organization discharges patients from the hospital, especially people with complex needs. It’s looking for better processes to transition patients faster as well as to prevent readmissions.

How do you make the case for creating a team that is dedicated to innovation?

I don’t think you can make the argument for innovation unless you produce some data, so the return on investment (ROI) should be meticulously tracked. The white paper includes instructions to calculate the ROI of an innovation department.

But you can also think about it this way: If the current mantra at the organization is that everyone innovates, taken cumulatively that is a lot of time for innovation. Instead of taking thin slivers of everyone’s time, you could create a few full-time jobs by simply reallocating the work. In our experience, this yields better results.