Catholic Health World

Ministry nurtures innovation, advances high-value, high-impact ideas

By JULIE MINDA

As a highly complex, scientifically based and heavily regulated enterprise, the U.S. health care system has traditionally rewarded standardization and caution, not creativity.

But health care is changing quickly, and adaptability will increasingly equate with viability. Catholic health systems and facilities are among the providers that are straining toward the future rather than planting themselves in the past.

"As we look to the future, we believe that the traditional organizational model has risk — risk that transforming innovations will come from others rather than ourselves," said John Doyle, general manager of transformational development and chief strategy officer for St. Louis-based Ascension Health.

If Catholic health care merely follows as others lead, he said, the innovations that come forth may not be "consistent with our mission to serve all with special attention to those who are poor and vulnerable."

As not-for-profit providers, ministry systems and facilities have not always had the margin or the risk tolerance to devote significant funds to leading-edge ideas, and thus they have not necessarily been known as change-leaders. But attitudes are shifting. Now, many of them are recognizing that innovation is the lifeblood of a thriving organization, and they are finding effective ways to nurture emerging ideas, programs and technologies.

Free radicals
CHRISTUS Health of Irving, Texas, invites fresh perspectives in its strategic planning process, said Anne Messbarger-Eguia, CHRISTUS senior system director of strategy, research and innovation. "We use scenario planning. We bring into our strategic planning retreats what we call free radicals, or people that will challenge our assumptions, so we don't fall into the trap of only talking to people who think exactly the same way we do."

Ascension Health also places a premium on creativity and intellectual rigor in its planning process. Like many other ministry organizations, that system has headquarters-level departments tasked with fostering innovation. One such unit, focused on "transformational development," explores concepts that may come into play five years or more into the future. The department works with partners inside and outside of Ascension Health to assess "far-horizon" concepts and pilot the best ones.

Doyle said having dedicated units, with funds earmarked specifically for innovation, helps ensure that creativity does not fall by the wayside when other priorities press in.

Test markets
In March, Catholic Health Initiatives of Englewood, Colo., opened the Center for Healthcare Innovation and charged it with taking an intentional approach to innovation by incubating new programs at CHI facilities and then spreading successful ones to other CHI locations.

Marc Larsen, the center's national director, said CHI awards grants to the facilities with promising ideas. Programs that prove to be aligned with CHI's strategic goals and mission and are financially feasible and replicable get attention. CHI leaders talk up these innovations in meetings and publicize them on the system's website. While CHI does not mandate that its facilities adopt the programs, said Larsen, it supports the ones that do.

He said while it can be a challenge to implement new ideas — after all, change can be an irritant, he noted — the pilot approach has helped CHI to move concepts rapidly through the system. One pilot program the center is working on with its facilities is an "accountable care readiness" project through which hospitals will work with physicians to reduce the incidence of readmissions. Larsen said that changing how care is delivered is a "really exciting, high-value, high-impact approach to meeting your goal of providing high-quality care in your community." 

Staff buy-in
San Francisco-based Catholic Healthcare West also uses the pilot approach to spread innovative programs quickly from facility to facility.

Rich Roth, Catholic Healthcare West senior director of innovation, said to foster change, it is important to "harness your own employees and your own physicians as champions."

That system's "Greenlight" pro-ject solicits forward-thinking business plans from its facilities. It receives hundreds of applications and invests heavily in a handful of the most promising ones. The plans with the best outcomes are promoted for replication at other Catholic Healthcare West facilities.

Catholic Healthcare West is experimenting with using social media to quickly share successes throughout its network and beyond. For instance, it is looking at how to document successful programs on video and share them via a channel like YouTube. 

Hardwiring creativity
Over the last several years, Via Christi Health of Wichita has been undergoing a culture change, and one of the goals has been to encourage more creativity, said Janell Moerer, vice president of business development.

Moerer said Via Christi encourages leaders to look at new ways of providing care — particularly to the underserved — including outside of the hospitals' four walls.

The headquarters keeps an eye out for solid ideas, invests in the work and provides system-level support, such as help with research, analytics and resources. Via Christi often uses a "decision accelerator" approach, packing high-level decision makers in a room for a day or two to figure out how to make new concepts work.

Halo effect
Innovative thinking and calculated risk taking is credited with reviving Sacred Heart Hospital in Eau Claire, Wis. In the late 1990s, the hospital faced operational challenges and deft competition from a high-profile facility in town. It needed to change or risk further decline.

Dr. Kamal Thapar, a neurosurgeon who is medical director for neurosurgery at Sacred Heart, said hospital leadership took an unconventional tack and started a neurosurgery program, recruiting top surgeons, investing in cutting-edge technology; and infusing the institution with the intellectual vibrancy of an academic medical center — an attitude shift that permeated other departments.

Today it hosts innovation conferences to spread ideas around the hospital and beyond. "We have a critical mass of people in these various areas here that are doing innovative stuff," said Thapar. "We are bringing people to our institution and showing them what can be done here" to dispel the notion that Ivy League institutions have a lock on bright ideas. 

Branching out
CHRISTUS' Messbarger-Eguia said it is important to seek out ideas within and outside a health system.

A task force CHRISTUS assembled several years ago to plan for the future trotted the globe, visiting health care sites. The group learned about medical tourism in India. It studied Canada's health finance system, and examined system reform in Boston. It went to New Orleans for an up-close look at the evolution of a Post-Katrina medical delivery system, and it kicked the tires on advanced biomedical technology and learned about research innovations in San Francisco. Along the way, the group got insights into risk tolerance and emerging trends likely to impact CHRISTUS downstream.

Messbarger-Eguia said a key learning has been: "When people are really stretched, their natural inclination is to retrench, but really that's your greatest opportunity to try something different, to try something new. There's bigger risks, but there's also really potentially bigger rewards."

CHRISTUS and other ministry systems also tap into formal and informal networks to share innovations and talk through their successes and failures. Some are part of an Innovation Learning Network focused on health care; some are part of an informal group of ministry leaders tasked with fostering innovation.

"Everybody's got a different approach, but our end goal is the same — we're living in a time of such tremendous change, and we're not mapping out our path to the future from today, we're making a conscious decision to create that path as we move along," Messbarger-Eguia said.

Copyright © 2010 by the Catholic Health Association of the United States
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