BY: GLENN KARWOSKI, M.A.
Innovation is a hot topic in business circles these days. It follows a natural progression of management strategies that began with the quality movement, evolved into employee empowerment, then cut everything but the essentials and scrutinized process.
Catholic health care has mirrored those trends, concentrating on improving quality while controlling costs, all without losing sight of mission and ministry — that is, improving the overall level of patient care delivered while caring holistically for the sick and vulnerable.
Now it is time to focus on growing the ability to innovate — a quality that health care will increasingly need in an era of health reform and demographic shifts.
Although the first instinct may be to look at traditional strategies for innovation that drive growth, every health care organization has a myriad of innovation sources that largely remained untapped — its employees.
Employees are perhaps the greatest sources of innovation for any organization. Nurses, scheduling specialists, maintenance people — they're all sources of creativity and innovation, yet most organizations lack a regular practice for tapping the ideas employees have to offer.
Yet inviting participation in the idea-generation process engages employees at a higher level, and research has shown a direct correlation between high engagement and retention, productivity and customer satisfaction. So, before you look outside of your organization for innovative ideas — and there is a reason to do that at times for different perspectives — start by asking the people who are serving patients every day. And be sure to go beyond the obvious choices, because everybody has ideas and insights unique to their unique position within the enterprise.
It's an often-repeated line that a business can't cut or reduce its way to greatness, meaning that at some point institutions need to improve and/or expand their offerings in order to keep pace with new technologies, changing service demands and to remain relevant to the populations they serve.
A Harvard Business Journal case study found organizations that took innovative leaps became what the study authors called "value innovators," more successful than competitors. These were organizations that grew by introducing new and innovative business strategies, as opposed to reducing costs. In fact, the concept of value innovation became the basis for the popular "blue ocean" strategy, an expanded version of the value innovation cited by the case study.
For readers unfamiliar with the blue ocean strategy, the basic premise is to not use old, traditional strategic thinking to play the same game your competitors play. Change the competitive game by creating a value proposition that significantly differentiates you from everyone else. Think about organizations like Southwest Airlines Co., Apple Inc. and Target Corp. — all companies that literally created categories.
It would be easy to dismiss the relationship between these organizations and health care, but doing so would be a big mistake. Innovation can be applied to any company, regardless of its size or whether it is for profit or not-for-profit.
Take a look at the early days of the world-famous Mayo Clinic. Its team approach to treating patients was, at the turn of the 20th century, very innovative in health care. It represented a value innovation in medicine because no one else was using the same integrated clinical practice approach to diagnosing and treating patients.
Similarly, Catholic health care can build upon a unique base of differentiation that includes its approach to caring for the whole person, body, mind and spirit. So, by looking for additional creative ways to promote its mission, Catholic health care can continue to create meaningful differentiation, critical to the ongoing success of any brand.
Differentiation is the most important variable in creating powerful brands and also the hardest to achieve, because it requires continual innovation. In and of itself, differentiation isn't enough to create a powerful brand. That requires two additional variables — relevancy and consistency. But for purposes of this article, differentiation is the most important because it is closely linked to innovation.
Organizations make the mistake of thinking innovation primarily applies to marketing, with product and service development being subsets. Innovation, however, can be applied to every facet of an organization from human resource hiring policies to logistics. By deliberately tying it to overall business strategies, innovation can become part of the cultural fabric — necessary for creating the kind of ongoing innovation that results in brand differentiation.
STAGES OF CULTURE CHANGE
An organization goes through a variety of stages in order to build a culture of innovation. Identifying where you are on the innovation continuum provides the perspective to see where you need to go next.
The starting point is when innovation occurs on a random basis, which usually happens when there is a crisis. Organizations that operate in a fire-drill mentality usually get stuck in this phase and find it very difficult to make progress beyond it.
The next phase of innovation is developing an effective process for generating ideas and bringing them to fruition — and using it consistently. While many organizations brainstorm or ideate, most do not tap the group's full creative potential because they aren't using a properly designed and executed process.
I had the opportunity to work with a leadership group from Minnesota's Benedictine Health System last spring and shared with them the keys to effective brainstorming. The keys are:
- Make sure the question you are asking or the challenge you wish to address is clearly defined and not overly general in nature. I met with the leadership team from Benedictine for several hours to make sure we had specific questions.
- Pose a detailed question or challenge. For example, this question is too general: "How do we increase the quality of care we provide without increasing expenses?" A better, more specific brainstorm question would be: "Without adding to the cost of patient care, how can we increase the quality of care we provide to our memory-care patients when they are experiencing stress and confusion brought about by Sundowner's Syndrome?" So, spend some time in advance developing what you want to ask in order to make the most of the time you have to generate ideas.
- Try to have a diverse group of people in the session. We all have different cognitive thinking styles; that's what tests like the Myers-Briggs personality assessment identify. Generating new ideas and advancing them to implementation require a variety of skills not usually found in just one individual. For brainstorming, you need blue-sky thinkers to see all the creative possibilities. You also need highly analytical, linear thinkers to crunch the numbers to see if an idea is possible. In the complex world of health care, having different areas of expertise adds richness to the brainstorm.
There is not an ideal single number of participants for a session, but having too few or too many can work against productivity. I try to have a minimum of six people in addition to the facilitator, and no more than eight per group. I have run sessions with up to 10 groups of eight people per group, providing detailed instructions to the groups and then monitoring progress.
- To make the best use of time, give participants information in advance. That will help avoid spending the first 15 to 30 minutes debating what the brainstorm question should be. Also, when people receive background information on the subject of a brainstorm, they consciously or subconsciously begin thinking about ideas. Leaders can even ask participants to come to the session with a predetermined number of ideas to discuss, which always helps to provide stimulus.
- Allocate enough time for the session. Most groups grossly underestimate the amount of time they should spend on brainstorming. I recommend a minimum of three hours for an effective session on a single question. If possible, a half-day or more, including an experiential component, is ideal.
When it comes to adding something experiential, use your creativity. One major retailer wanted to make its children's department more appealing to kids. I had the group put on kneepads and crawl around the area for an hour so they could experience the department from the perspective of the target audience.
Applying an exercise like that to the health care arena, I'm reminded of the film "The Doctor," which starred William Hurt. In the film, Hurt plays a physician who is diagnosed with cancer. He develops greater empathy when he experiences medical care from a new perspective. So participants might ask themselves, "What could we do to change our perspective or have a new experience that can lead to new insights and ideas?"
- Try a change of venue. A change of scenery often does more than just provide time away from the office. Holding a brainstorming session off site sends the message that a different kind of thinking will be done. Also, people aren't subject to usual distractions when they are away from the office.
- It helps to use a brainstorm facilitator who is not directly tied to the project. Managers and supervisors may inadvertently stifle creativity or otherwise affect the brainstorming if they are the bosses of participants.
- Generate ideas by using a variety of techniques to help participants think and see differently. Standing in front of the group and writing ideas on a whiteboard or flip chart is not the best way to foster creative thought. There are a number of idea-generating techniques that can be employed in a brainstorm, and a simple search on the Internet can guide you to many of them.
- At the beginning of a brainstorm, go for quantity, not quality. Too often groups get bogged down trying to find THE right idea immediately instead of searching for all the possibilities. By generating many ideas, you'll have more stimulus and increase the potential for combining ideas and having participants build on each other's thoughts.
- In brainstorming, the more outrageous the idea, the better. You can always tone something down, and by generating wild ideas you are stretching imaginations and opening up more possibilities.
- Don't judge any of the ideas during the brainstorming process. Not only does it take up valuable idea-generating time, it quashes creativity. Try to limit participants' and your own voice of judgment; discuss it up front and ask people to be aware if they find their internal critic speaking up.
- Discuss the concept of creative abrasion as an effective, positive factor in brainstorming. Differing opinions often result from different cognitive thinking styles. They stimulate a variety of ideas and prompt new thinking, and that's to be encouraged in a brainstorm, but make sure to talk to participants about de-personalizing conflict. A facilitator who isn't closely tied to the project and who can recognize conflict detrimental to the process can help keep creative abrasion effective.
- Have a plan for what will happen to the ideas generated in the session and share it with the group. We all want to know that our time is going towards something of meaning to the organization.
- Along the same lines, let people know what ultimately happens. Even if the overall project gets put on hold or canceled, keeping the group informed will help avoid participants concluding that their time, effort and ideas went into a black hole. Good communication will make them more apt to participate again.
Once a process for generating ideas is in place, the next phase in building a culture of innovation is aligning idea generation to strategy. Ideas should be tied to strategic initiatives, which demonstrates value and provides a target/goal for new ideas. Leaders should be prepared to recognize great ideas that may lead to the development of new strategies, which is basically accepting the concept of bottom-up marketing.
Highly effective, creative organizations tap into their employees' creative potential by empowering them to contribute to the innovation process. Whether it is crowd-sourcing ideas, forming structured-idea teams in different areas of the operation or creating a single, big-idea team from different areas of the enterprise, such a culture opens up a wide variety of opportunities for innovation.
The final phase of the innovation continuum is cultural adaptation, that is, when the culture defines itself as innovative, and innovation isn't something that just occurs during a brainstorm — it is a part of the organization's fabric.
3M Company, for example, is known for giving its scientists time to pursue whatever projects interest them, as long as the projects are related to some area of 3M's business. The technical term for this is organization slack time, or the time available between the total amount of time in the workweek and the amount of time required to do the work assigned. In 3M's case, it builds in 15 percent of its scientists' time, and the policy has resulted in many successful products.
GOAL: INTRINSIC MOTIVATION
Building a culture of innovation that leads to continuous creativity and product differentiation is like weight loss. The principles are simple — eat less, exercise more, lose pounds; think differently, see differently, innovate. But they aren't easy. People have to be motivated. In fact, research has found that intrinsic motivation is the most important variable in highly performing, creative organizations. Intrinsic motivation is the kind of motivation that occurs when people are engaged and genuinely interested in what they are doing. They are motivated by the work itself.
I know what readers may be thinking — of course it would be nice if everybody enjoyed what they did and could be more creative as a result, but many people aren't intrinsically motivated. However, there are actions leaders can take to encourage them.
Research has found that appropriately matching people to tasks helps maintain what psychologists call flow. Too much challenge and not enough expertise creates frustration, and too much expertise and not enough challenge creates boredom — so balancing the two helps keep people in flow.
Giving people a degree of freedom and autonomy regarding how a task gets done while holding them accountable for the desired outcome encourages creativity and motivation, as does having a diverse mix of thinking styles and skill sets.
Resources of time and funding are critical to motivation, so don't ask the impossible and expect people to be motivated. Also, don't forget to offer encouragement, and make sure people understand how what they're doing provides meaningful impact to the organization.
In summary:
- Be a value innovator to differentiate your brand
- Use ongoing innovation to maintain differentiation
- Innovation can be applied to any part of the organization
- Move beyond random innovation and develop a consistent process to generate ideas
- Tie innovation efforts to strategic initiatives
- Empower the employee base to help create a culture of innovation
- Work on increasing intrinsic motivation to maintain a high performing, creative organization
GLENN KARWOSKI is the founder and managing director of The Business of Ideas, an innovation consultancy based in Minneapolis. He also teaches creative process and innovation at the graduate school of the University of St. Thomas, Opus College of Business, Minneapolis.
Guide to Effective Brainstorming
- Clearly define the question. Make it specific
- Aim for a diverse group. Include different cognitive styles
- Give participants information in advance
- Spend a minimum of three hours on a single question
- Consider holding the session away from the office
- Use a facilitator who is not directly tied to the project
- Use a variety of techniques to generate ideas
- Go for quality of ideas, not quantity. The more outrageous, the better, at least in the beginning of a session
- Discourage judgments and self-censorship
- Have and share a plan for distributing session results
- Let people know what ultimately happens, even if good ideas are put on hold
Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.