Democratizing Innovation, Decisions, and Equity (D.I.D.E.) By Robert Anderson Arizona State University College of Nursing and Healthcare Innovation
Transcript
1. By Robert Anderson Arizona State University College of
Nursing and Healthcare Innovation
2. Introduction Healthcare (HC) in a state of flux due to
technological advances HC innovation comes from the top-down,
instead of bottom-up Point-of-service innovation is subdued, not
championed Decisions are unilaterally made by
providers/managers/execs Employee buy-in suffers from lack of
ownership of initiatives Compensation/equity is based on the
market, not performance Patient care is driven by process/reactive
instead of value/adaptive Patient care is judged by financial
metrics vs. patient satisfaction Overall, there is an illegitimate
locus of control for authority and autonomy that should rest with
the professions who own it (Porter-OGrady & Malloch, 2015, p.
131).
3. D.I.D.E. Democratizing Innovation Program for independent,
daily experimentation or tinkering by staff, managers, executives;
participation is optional but encouraged Patient satisfaction
(HCAHPS) monitoring with additional patient care, financial, &
time metrics evaluation; requisite to participation Experimenter is
allocated dedicated daily time for experimentation, evaluation,
& presentation of projects w/in operational constraints
Democratizing Decision-Making System of team, departmental, &
organizational forums where experiments are evaluated &
initiatives voted into implementation by forum members Voting is
only available to members & presenters w/in each team,
departmental, &/or organizational forum where experiment is
presented Team leaders, departmental heads, & executives
preside over team, departmental, & organizational forums,
respectively; awarded veto power
4. D.I.D.E. (Cont.) Democratizing Equity (Compensation) Equity
in the form of recognition, bonuses, pay raises, profit-sharing,
company shares, & allocated funds may be awarded to
individuals, teams, & departments for participation,
performance, & loyalty Individuals, teams, & departments
are all awarded proportionately according to initiative successes,
patient satisfaction scores, financial savings; individual
performance evaluations & seniority also considered
Individuals, teams, & departments are compensated (after trial
period of 6 months) for each proceeding forum (e.g. team ->
departmental -> organizational) in which their initiative is
implemented & yields results Link to Current D.I.D.E. Mindmap
https://mm.tt/550192675?t=Esnp9jPGEO
5. How is this Innovative? By referring back to the
Introduction, you see: DIDE is a program that essentially
revolutionizes HC operations, democratizing innovation,
decision-making, & compensation structures Bottom-up innovation
is used by companies such as Google, 3M, & innovative giants
yet only very few HC organizations practice it today; When theres
no experimenting, theres no progress. Stop experimenting and you go
backward (Gelb & Caldicott, 2007, p. 68). This shifts the
balance of power in decision-making to the point-of-service,
empowering employees, increasing input & buy-in, & overall
giving employees ownership of their work & the patients care
Compensation becomes performance-based, allowing exceptional
employees to excel, attracting a better standard of worker,
increasing motivation & feelings of recognition, &
improving patient outcomes In effect, patients receive better,
more-invested care from nurses & providers b/c staff
compensation is tied to their value/satisfaction
6. Desired Outcomes Implementation of DIDE in a healthcare
organization yields: Increases in patient HCAHPS scores,
satisfaction & care value metrics, better outcomes, overall
health & awareness Increases in worker well-being, motivation,
buy-in, autonomy, initiative, productivity, consistency, community,
loyalty to organization, communication, adaptive capacity to
constantly changing conditions Increase in provider ratings,
patient reviews & recognition Increase in organization
innovation, community & industry recognition, revenue, job
applicants Decrease in patient complaints Decrease in employee
errors, turnover, career entrenchment, & retiring in place
7. Beneficiaries Patients Patients are the main beneficiaries;
they receive better care by linking employee performance &
compensation to patient care value & satisfaction Nurses Nurses
benefit by receiving the ability to innovate, make decisions,
receive recognition, & be compensated for their creativity
& hard work Providers Benefit from happier & healthier
patients, better patient outcomes, increased operational
efficiency, & employee motivation, well-being, & initiative
Managers Managers benefit from a decreased workload & less
stress by having motivated employees who are self-directed w/
similar goals & initiative to themselves Executives Executives
get the industry recognition for being innovators, along w/ company
success, financial well-being (thus, executive perks), &
operational autonomy.
8. Aligning Passions with Goals DIDE SMART EDISON (Gelb &
Caldicott, 2007, p. 50) (S) I want to implement DIDE in a small
healthcare facility w/in three years of today. (M) I will measure
my progress using a GANTT chart of projects & tasks. (A) I am
accountable to my mother & an advisor that I will choose by the
end of the Fall 2015 semester. (R) I feel my purpose in life is to
dedicate my career to creating a better, more efficient system of
healthcare in the United States; my goal of implementing DIDE is
relevant to my overall purpose. (T) Within three years, I want to
have implemented some form of DIDE in my healthcare organization.
(E) I am passionate & dedicated to improving the lives of
nurses & patients; my mother has been a nurse for 40+ years, I
grew up in hospitals, & see nothing more noble than improving
their lives by implementing DIDE (D) For that reason, I will not
stop until nurses have more power over innovation, decisions, &
compensation in healthcare. (I) Implementing DIDE integrates
perfectly into my goals of obtaining my MHI degree, starting my
healthcare career, & becoming an innovative
leader/administrator in a hospital. (S) I can see myself presiding
over the first team forum, seeing my colleagues faces, & hear
them presenting their solutions to problems, knowing that this
program could result in employee autonomy. I feel excited! (O) I am
going to achieve this. My mom loves the idea. Its a great Capstone
project, & its beneficial to so many. Im going to do this. (N)
I am doing this right now!
9. Potential Barriers General resistance to change To overcome
general resistance, I will outline DIDEs potential risks &
benefits, represent it visually, & cultivate charismatic
optimism Executives uneasy to relinquish control The most probable
barrier; to overcome executive resistance, I must be able to show
the benefits of DIDE, that it is profitable, well-thought-out,
& ultimately, the executives are still in charge Establishing
an equitable-yet-profitable compensation system To overcome this
barrier, I plan on studying models of compensation systems used in
other industries/companies and applying what Ive learned to create
something that will work in a HC organization Difficulty in
organizing forums & getting staff together Technology may be
the answer; maybe creating an online forum system with discussion
boards & voting on the website would work
10. Literacy Blueprint Barriers Express Ideas Visually I need
to be able to show people DIDE visually for them to buy-in; to do
so, I will make diagrams & schematically outline the program
Become a Master Networker In order for DIDE to gain supporters, I
must keep in touch w/ colleagues; to do so, I will network
regularly w/in the industry & aim to develop positive
relationships w/ contacts w/ particular backgrounds Understand
Scale-Up Effects To make truly innovate & revolutionize HC
operations in an organization, I must budget & plan for
scale-up; thus, I will start small, monitor & evaluate, &
outline scale-up incrementally in steps
11. References Gelb, M. J. & Caldicott, S. M. (2007).
Innovate like Edison: The five-step system for breakthrough
success. New York, NY: Penguin Books Ltd. Porter-O'Grady, T., &
Malloch, K. (2015). Quantum leadership: Building better
partnerships for sustainable health. Burlington, MA: Jones &
Bartlett Learning.