What's the difference between innovation and improvement? Kedar Mate, MD, Senior Vice President, IHI Both things are change, and both things are trying to make something better. Theoretically you’re not innovating for a negative impact; you’re not improving to create a negative impact. Both are trying to make the context better. I think that if you look at it, improvement is iterative and typically incremental. Classically, at least. It’s sort of each cycle builds on the next. We talk about it at IHI. We talk about small tests of change and going incrementally forward — building some confidence and moving things forward. I think innovation is a little bit more of a step change. When you’ve reached, sort of — the way I like to think about it is — once we’ve reached those sort of limits of where this incrementalist approach can take us, and we’re still not exactly where we want to be, or when the context shifts significantly under our feet, and we need something different because something radical has changed in the context, that’s where innovation plays a role. So my sense is that they work very well together, that you can do incremental improvement work and reach a certain new level of system performance, but if that’s not satisfying your goal or getting you to the patients you want to get to or the level of help that you want your patients to have, that’s where you need something different. You need to really change the game somehow. That’s where techniques of innovation can be useful. Whether it’s innovation, you know, classically understood, or improvement using the techniques of innovation to try to create that step change difference. I think that’s what we’re referring to when we talk about innovation.