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Successful health care delivery innovation requires disciplined processes rather than divine inspiration or vast resources.
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Innovation Is No Lightning Strike: How to Maximize the Value of Your New Ideas

By Kedar Mate | Friday, November 6, 2015
Kedar Mate and Mara Laderman

“Innovation” is a word you hear often in health care these days — and it means different things to different people. 

There are many categories of innovation in health care, including biomedical, payment, technology, communication, and engagement. Some of these sustain existing business models, while others are more disruptive. At IHI, we concentrate on health care “delivery innovation” — innovations that improve outcomes but also reduce costs. 

In our work on IHI’s innovation team, we’ve noticed increasing interest in delivery innovation over the years — and while some excel, others struggle. Why is this? The common wisdom is that innovation efforts fail because of a lack of good ideas, but our work has shown that disciplined execution is usually the hardest part of innovative work. And the role of leadership is especially critical to ensure that innovation efforts are well-supported and connected to the strategic priorities of the organization.

How Innovation Aligns with Improvement
IHI focuses on innovation because different challenges require different solutions. Improvement work seeks to create reliable systems that produce consistent, predictably high performance on a routine basis. The mental model is one of defect elimination, or things that upset the predictability of the system. Innovation starts with a different mental model — one that focuses on creating something new that may be upsetting to the current model. At IHI, we believe today’s health care systems need both improvement and innovation, in concert. 

The Affordable Care Act, other legislative actions, and fluctuations in the global economy have accelerated the pace of change in health care, both in this country and overseas. In response, many organizations are reinforcing their investments in improvement activities and making new investments in innovation. So how can we bring improvement and innovation together? How can these important activities better reinforce strategic priorities?  

IHI has a long history of both innovating and improving in health care. Based on these years of experience, and on our studies of innovation engines elsewhere, IHI’s Innovation Team developed methods to rapidly identify innovative ideas, assess their potential, and turn them into systems and processes that work in the real world. Using this innovation management system, IHI has worked with dedicated partners to devise now-familiar tools and concepts that have been critical to improving health care quality, including clinical bundles and the Triple Aim.

Three Key Elements of Innovation
We believe that all organizations can use this same approach to do innovation in their own settings, and our study of innovation management has revealed three critical elements to integrating improvement and innovation:
  1. Start with a clearly defined structure with a dedicated team, an established technical method for innovating, and a mechanism for ensuring alignment with the organization’s strategic priorities. 
  2. Put in place a disciplined, time-bound process for executing innovation activities.
  3. Invest time in reliable implementation to link new ideas with normal operations of the organization. This often involves borrowing key staff during the innovation process, and cultivating understanding of newer ideas along the way.
Unlike the cliché of the lightning strike out of the blue, a health care organization can develop the innovation management system needed to take a good idea, vet it, adapt it or adopt it, contextualize it, and make it relevant for the local environment and local populations. Importantly, both large and small organizations can do this, because you don’t need massive investments to start pursuing these ideas. 

Some health care delivery systems are setting up their own innovation centers, while others are redirecting resources to do innovative work. Either way, leaders must make sure that those innovation and improvement activities are understood and well-utilized. Effective management of innovation can catalyze much needed change to generate better delivery of care for patients, families, and communities.

Senior Vice President for Innovation Kedar Mate, MD, and IHI Senior Research Associate Mara Laderman, MSPH, are members of IHI's Innovation Team. Dr. Mate will be a featured speaker at the upcoming IHI Change Conference.

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