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© 2007 NHS Institute for Innovation and Improvement International Forum Paris April 20081
© NHS Institute for Innovation and Improvement, 2010
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Dr. Lynne MaherDirector for Innovation and
Design, NHS Institute for Innovation and
Improvementlynne.maher@institute.nhs.uk
To Transform Care
@LynneMaher1
© NHS Institute for Innovation and Improvement, 2010
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Objectives for this Workshop
• Understand the steps of a process for innovation
• Challenge and change usual thinking
• Specify a range of useful concepts and tools adapted from other industries that should be part of your QI toolkit
© 2007 NHS Institute for Innovation and Improvement International Forum Paris April 20082
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Innovation is no longer one of those ‘nice things to do’ if we
have a bit of time to spare. It’s business critical and all of us in
the NHS need to be looking for new, improved ways of using our
resources to deliver the best services, every day.
By innovating however I don’t mean we need to lock ourselves in
darkened rooms, grow pointy heads and invent. We should be
‘stealing’ great ideas wherever we see them – from those in our
networks, the global health system and industry.
David Nicholson, CBE
Chief Executive of the NHS England
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What is the current context for innovation in the NHS?
© NHS Institute for Innovation and Improvement, 2010
• Massive differences in the way we use banking services………
• The transition from traditional surgery to keyhole methods
• Communication systems that are not fixed to a
wire……telephone, e-mail• Communication systems that we can use as
entertainment systems…. • Increase in diagnostic ability reducing the need for
surgery
Thinking Differently has led to……….
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The result of Thinking Differently can be Innovation
Innovation; doing things differently, and doing different things, to create a step-
change in performance………
is essential if we are to deliver against such a rapidly changing environment
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Innovation is typically the result of a structured process…
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Everyone can have new ideas…
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Of course this is what it really feels
like!
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Concepts
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A core concept for Thinking differently…
“Creative thinking involves breaking out of established patterns
(valleys) in order to look at things in a different way.” Edward de Bono
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Thinking differently is about making “creative connections”. It involves challenging, connecting and rearranging information in our mental valleys.
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Synopsis
Many of the basic issues we face are common to other industries and
settings. For example, in health care we talk about “access,” or “patient
flow,” . These are really common issues across many industries.
•McDonald’s deals with “access” by providing a drive-through window
•FedEx certainly knows a thing or two about flow/logistics and how to
match up packages with the correct delivery route and destination.
•Airlines have changed access and flow through self check in mechanisms
via smart phone, internet and machines at the airport
Creative ConnectionsTool: Mental Benchmarking
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Drive-thru flu jabs at the Virginia Mason Medical Center, Seattle, USA
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The best innovators aren’t lone geniuses.
They’re people who can take an idea
that’s obvious in one context and apply it
in not-so-obvious ways to a different context.
Harvard Business Review
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A three step process
Follow in sequence - don’t race ahead
1. STOP Before You Start to really understand the issue
2. Generate LOTS of Ideas rather than running with the first
3. Select and TEST ideas to increase the likelihood of success
A process for Thinking Differently
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“If I had an hour
to save the world,
I would spend 59
minutes defining the
problem
and one minute
finding solutions”
Albert Einstein
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Phase 1: Stop Before You Start
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Purposefully- for a given topic
People do not always do what they say they do
People do not always do what they think they do
People do not always do what you think they do
People cannot always tell you what they need
Things are not always as they seem …….
(adapted from IDEO)
Stop before you start Tool: Pause, Notice, Observe
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HCAIs - What we observed
Inconspicuous gel dispenser A notice about a notice
Staff more frequently use gel when leaving a ward or department
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Observation – Productive General Practice
• How many times do staff look in that pile for notes and diagnostic
results ?
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Hospital Portering services
286 ideas came from using this approach
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Phase 2- Generating lots of ideas…
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The way to get good ideas is to get lots of ideas and throw the bad ones away.
Linus Pauling, Nobel Prize winning chemist
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SynopsisSince others will have different ways of thinking and
approaching challenges, we might be able to make a
novel connection by using “Fresh Eyes” and thinking
like another person, or making links to another industry.
New ideas come from differences.Nicholas Negroponte
Tool: Fresh Eyes
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Don’t forget patients and family members Can bring a “fresh eyes” perspective
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Synopsis
How can a randomly selected word, picture or object possibly help me think
differently?!? The very words and images we use to talk about a topic bring
us into our usual ways of thinking (our mental valleys), resulting in ideas that
are not very different from what we already have.
A randomly introduced word, picture, or object activates thoughts that we do
not usually associate with the topic and therefore gives the possibility of a
new connection and new ideas.
Tool: Random Word, Picture or Object
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Phase 3: Selecting and Testing Ideas to Make a Difference
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Criteria:Be clear about how you will select your ideas
• Return on investment: is it likely to create cost savings?
• Quality: will it increase quality of care?• Likelihood: can we actually do it?
Dot Voting:• Give participants a set numbers of ‘votes’ (eg
sticky dots)• Vote for ideas based on the criteria• Identify the most popular ideas
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The main difficulty of thinking is confusion. We try to do too much at once. Emotions, information, logic, hope and creativity all crowd in on us. It’s like juggling too many balls.
Edward de Bono, Six Thinking Hats®
Tool: Edward de Bono’s Six Thinking Hats
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Tool: Testing New Ideas on a Small Scale
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Prototyping:• A prototype should test the boundaries and also helps to
manage risk
• A prototype is anything that tests an idea and answers a question
• It is not necessarily about the actual ‘product’ it is about the interaction it provokes
Test and Learn
Start small. A prototype needs only to be as good as it needs to be. It helps
you to fail early with some ideas and gather ideas to strengthen other ideas.
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I have not failed, I have merely found ten
thousand ways that won’t work.
Thomas Edison, inventor of the light bulb
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Objectives for this Workshop
• Understand the steps of a process for innovation
• Challenge and change usual thinking
• Specify a range of useful concepts and tools adapted from other industries that should be part of your QI toolkit
© 2007 NHS Institute for Innovation and Improvement International Forum Paris April 200821
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Dr. Lynne MaherDirector for Innovation and
Design, NHS Institute for Innovation and
Improvementlynne.maher@institute.nhs.uk
To Transform Care
@LynneMaher1