Why It Matters
Both innovation and improvement are change, and both are trying to make something better.
Improvement is iterative and typically incremental. Each cycle builds on the next. At the Institute for Healthcare Improvement (IHI), we talk about small tests of change and going incrementally forward — building confidence and removing the systematic defects to slowly shift the performance of the system. The mental model in improvement focuses on optimizing existing systems and eliminating defects. Innovation requires a different mental model — creation of something fundamentally new and different from what we’ve experienced before. A different process or end-result that can then be further optimized using improvement.
Going Beyond Improvement
When we’ve reached the limits of an incrementalist approach, and we’re still not exactly where we want to be, or when the context shifts significantly under our feet, or when our patients and end-users’ expectations change substantially, that’s where innovation plays a role.
The two methods work very well together at IHI because we can do incremental improvement work and reach a new level of system performance. If that’s not satisfying our goals or getting patient care to the next level, that’s where we know we need something different.
Whether it’s innovation, as it is classically understood, or improvement using the techniques of innovation to try to create that step change difference, having an understanding of both as levers for change is a distinct advantage in problem solving.
How Can Innovation Be Incorporated into Daily Work?
The key to being a good innovator is being observant. Look for those things that are positive or negative deviants. Find the outliers that are remarkable or give you some insight into a system. Identify a process that will allow you to make a system better. Go to a patient’s home or bedside and watch them go through their daily routines and interactions with health care. Seek out the people who think a little differently or take a fresh approach to problems.
In your daily life, when you go to a restaurant or queue up in the TSA line at the airport, notice the things that you think are being done extremely well or, conversely, extremely poorly. Those examples may hold the lessons to help you solve the problems you’re facing right now. If we pause to be observant and then reflect on those observations — in our daily clinical practice or in our lives outside the clinic — we can make meaningful, important improvements or innovations to our existing practice.
Innovative thinking can go beyond those simple yet revealing observations and become a new mindset and even an organizational function ― a pivot that leads to progress.
Kedar Mate is IHI's Chief Innovation and Education Officer.