Leading Innovation

Life is not the way it was 20 years ago, or even 
10 years ago, and it will not be the same 
20 years from now. Health care is changing all around us and it behooves us to be informed and proactive to keep up with the inevitable evolution. Awareness of the many factors that currently impinge or will impinge on our daily practice and patient care is a perfect opportunity for innovation.

“Mindless habitual behavior is the enemy of innovation.”
—Rosabeth Moss Kanter

Take a minute to think about a roadblock in your practice or something that occurs every day and ask yourself why it is done that way and if it could be done better. Keep it in mind for later or jot it down on scrap paper. Maybe prior authorizations are monopolizing your nurses’ time, or you have always sutured punch biopsies.

Innovation is not a conscious part of most people’s routine daily activities and is not a focus during the course of medical training. As a matter of fact, “As medicine has become more standardized and increasingly regulated, it turns out there is much less room for innovation.”¹ It often falls into the category of “when I have some time,” but time never seems to come. It may not seem urgent, but it certainly is important and requires attention. Time, however small, should be allotted for innovation.

“Creativity is thinking up new things. Innovation is doing new things.”
—Theodore Levitt

Often people think of new drug and device development or technological advances when they hear “innovation,” but it could come in the form of new job descriptions, new models of care, or better processes and approaches to what we have always done. It can be thought of as fixing what is broken or creating something new.²

Innovation is not just the generation of creative ideas but their distillation and implementation. It is an active process that starts with inspiration; identifying what is broken, or better yet, what we can do better. The challenge that follows from this inspiration is the gauntlet that is thrown down to the team. The group should be given free reign to generate ideas, practical or outlandish, that can then be combined, amalgamated, and considered before implementation.³

“If you look at history, innovation doesn’t come just from giving people incentives; it comes from creating environments where their ideas can
connect.”
—Steven Johnson

We may not be able to teach creativity or dictate innovation, but we can foster it or at least stop hindering it. Innovation typically occurs from brainstorming and interacting when ideas are assimilated and put into action. How do you foster it? Hold meetings, or parts of meetings, on opportunities instead of problems. Improve mingling of participants at all levels to stimulate the collaboration of ideas and acknowledge that everyone’s perspective and creativity is valuable.

It is essential to empower the team and encourage an open, receptive, and questioning culture. Encourage the team to challenge assumptions and inferred rules that really are only habit. Once the ideas start flowing, do not stop with the first “good” idea. Allow the brainstorming to continue and refine it into the “best” idea. Leaders should work to remove as many roadblocks of implementation as possible and strive to tolerate the ambiguity that will remain. Insistence on hard data can result in analysis paralysis and lack of follow-through. Consider any failure to be a discovery of what does not work without looking for blame. Recognize and reward successful and attempted innovation to create a supportive atmosphere.

Creating such a culture is often more about conscious avoidance of actions that stifle innovation. Leaders may naturally avoid conflict by surrounding themselves with yes men, but without the lateral thinkers the team will be stuck in groupthink. If necessary, assign someone to play devil’s advocate. As adults, we tend to compare ideas with our internal database for what is wrong rather than asking what is right about the idea and playing with the possibilities. Avoid playing whack-a-mole with 
ideas and using phrases such as “it will never work,” 
“we tried that before,” “but we have always done it this way,” or “if it ain’t broke, don’t fix it.”

When change is imminent we can argue, complain, and wait for others to find ways to adjust, or we can make innovation a deliberate focus by establishing a culture that fosters it and educates the team about the innovative process. Go back to the roadblocks and/or habits in your practice that you considered earlier, present the challenge to your group, and get innovating!