Breaking the Rules to Innovate

April, 2015

In our recent survey of almost 100 senior-level experience leaders across US and Canadian hospitals and health systems, 63% of respondents said their organizations do a good or excellent job at sourcing and spreading innovations that improve experience. Having worked closely with organizations struggling to implement change and with mavericks who describe all of the barriers to changing the status quo, we think the data paints a rosier picture than the reality. That’s why we convened 35 executives from 12 health systems (all members of the Experience Innovation Network (EIN)) at the University of Colorado Hospital campus to tackle the question of innovation – What is it? Where does it come from? How do you make it happen? Some of the most the most valuable insights of the day came from the experienced innovators from the University of Colorado Health team. These lessons included:

• Intrapreneurs are different from entrepreneurs.

  Arlen Meyers, MD, MBA, a head and neck surgeon and the founder of the Society of Physician Entrepreneurs, talked to the group about the challenges of driving innovation from within an organization. According to Dr. Meyers, when innovators are working within an organization (intrapreneurs), they face a two-front challenge: First, they need to find the right solution to drive substantial value (just like an entrepreneur); Second, they need to fight off the corporate immune system that tends to extinguish any disruption to the status quo. “Find a sponsor,” counseled Dr. Meyers. “A sponsor is different from a mentor. A sponsor runs cover (a boss, a dean). It’s someone up the food chain who will invest in you. A sponsor will step up to the plate and give you the resources and cover you need. If you don’t have one, you run the risk of failure.”

• To drive innovation across all facets of the organization, find a back door in.

  When Read Pierce, MD, and his team set out to create a curriculum that would create a capable workforce (not just innovators, but everyone) to improve and create models of care to transform the clinical enterprise, they found that leading with innovation was a non-starter. Frontline leaders were interested in learning methods for improvement, but with caregivers already pulled in a thousand directions and frontline leaders feeling they didn’t always have the skills they needed to succeed in their leadership roles, the idea of embracing innovation was overwhelming. So the Dr. Pierce and his team offered a course focused on helping frontline leaders succeed in the jobs they were already being asked to do. “The hook was to enhance leadership skills and support projects to improve care,” said Dr. Pierce. “We embedded innovation a layer deeper so they didn’t have to face it head on.”

• Organizational commitment is key.

  Pierce’s course requires a substantial commitment of time and resources – an investment that wouldn’t be possible without support from senior leaders like Tom Gronow, MHA, University of Colorado Hospital COO. Mr. Gronow and his team are working to implement a dyad leadership approach (pairing medical directors with nursing and administrative partners) across the UCH system to help drive local ownership of system improvement and innovation. But simply appointing dyads is not enough – Mr. Gronow is overhauling the system’s leadership structure to ensure success. “In the current model,” he said, “it’s not sustainable to give them the tools and support they need to succeed. We’re in the process of changing job descriptions to get the right leaders in place.”

• Charismatic frontline leaders can change a culture.

  Members of the EIN were given the opportunity to sit down with the leaders of University of Colorado Hospitals Acute Care for the Elderly (ACE) unit. The ACE unit has won awards for innovation, thanks in part to the stewardship of unit leaders like Dr. Ethan Cumbler, Jan Hagman, RN, and Laura Samuelson, RN. Together with the staff on the unit, Dr. Cumbler, Ms. Hagman, and Ms. Samuelson have built an interdisciplinary rounds process that helps ensure a team-based approach to patient care. They worked with system leaders to get access to data that helps them manage the unit to a better patient experience and better outcomes, and they’ve implemented a hand-hygiene approach that got them to a sustained 95% compliance. “Innovation is a journey,” Dr. Cumbler said. “It doesn’t happen overnight, but by empowering people to tap into their potential.  Creating a culture of innovation is about trying to do things on a small scale that make you uncomfortable but that are still worth trying.”

• Teamwork makes the impossible possible.

  Like on the ACE unit, team work and mutual respect were evident in abundance in the University of Colorado Hospital’s new no-wait ED. The ED features a highly efficient tracked flow that sends acute walk-ins and EMS patients straight back to a bed, and fast-tracks less acute patients directly to a physician for initial diagnosis and treatment and/or orders that help advance the treatment plan. When acute patients arrive, the entire care team (doctor, nurse, pharmacist, etc.) descends for the initial evaluation, ensuring that all members of the team get the same information and are aligned on the treatment plan. Beyond the care team, the ED physician manager, Dr. Chris McStay, showed clear appreciation and respect for critical roles such as charge nurse, flow nurse, ED call center, and ED transport staff and the role they play in making the ED run smoothly to deliver an optimal patient experience.

The Experience Innovation Network members and staff are extremely grateful to the University of Colorado Health team for their generosity and graciousness in hosting our innovation xLab. Special thanks to Patrick Kneeland MD, Medical Director for Patient and Provider Experience, Amy Searls, Executive Director, Service Excellence, and Echo P. Vogel, Administrative Assistant, Service Excellence Department for their exceptional hospitality and amazing insights.

The full xLab recap is available to EIN members. Please contact Liz Boehm (eboehm@vocera.com) for access.