Building a Culture of Innovation From the Inside Out

A Kaiser Permanente Perspective

by Jennifer Ruzek Liebermann (via THCB)

“How do you inspire and enable innovation in a large organization?”

That’s the question I grapple with daily as director of Kaiser Permanente’s health care innovation center. I’ve observed that it isn’t sufficient to have a dedicated Innovation Center, an Innovation & Advanced Technology Group, or in-house Innovation Consultancy design group – all of which Kaiser Permanente has. The real question to solve is: “How do you create a culture that enables innovation throughout an organization?”

To explore answers to that, this week I am joining with physicians, nurses and design thinking, quality and innovation experts from the United Kingdom’s National Health Service and Kaiser Permanente for three days in South Devon, England, at the NHS Horizon Centre for Innovation, Education & Research in Healthcare, to share successful failures and best practices in innovation.

One contribution the NHS already has shared with the extended health care innovation community is a guide that helps leaders enhance the conditions for innovation: “Creating a Culture of Innovation.” Given that organizational leaders’ behaviors have a disproportionate influence on creating a culture that either hinders or aids innovation, Lynn Maher and Helen Bevan of the NHS Institute for Innovation and Improvement and Paul Plsek distilled the organizational research on innovation into a helpful “how to” guide outlining the seven dimensions of culture that support innovation. These principles, summarized below, can be applied to any organization.

So how can you begin building your own innovative culture — and how have we used these principles at Kaiser Permanente?

Risk-taking: Establish a climate in which people feel OK trying out new ideas by not shutting down ideas before they’ve been vetted. Leaders should demonstrate they are more interested in learning from failure than punishing people for it.

To foster innovative thinking at Kaiser Permanente, our Information Technology leadership created an Innovation Fund, an internal program that provides seed funding and support to teams of doctors and employees to facilitate the rapid prototyping of novel IT ideas and diffusion of successful innovations. Leadership also created iLabs, an innovation lab that serves as a technology research, advisory and software prototyping group that works with Kaiser Permanente innovators to help develop technology solutions for health care.

Resources: Resources are meant in the broadest sense of the term here. The traditional definition signifies an organizational commitment to innovation, but resources need not always be concrete. Time, permission and autonomy to innovate may be what is needed. For example, Kaiser Permanente’s Innovation Fund not only provides seed funding, but access to mentors and tools to jumpstart innovation.

Knowledge: There must be free-flowing information inside and outside your organization on what’s effective, what is not effective, and what others are working on. It is particularly helpful to see what industries outside of your own are doing because knowledge from dissimilar organizations helps you see new connections between concepts. In that vein, I’ve brought innovation teams from Kaiser Permanente to visit innovation labs at McDonald’s and Bank of America; our learnings from those visits most inspired the design of our Sidney R. Garfield Center Health Care Innovation Center.

That’s also why my team visited the Mayo Clinic Center for Innovation in March and why this week we’re visiting the NHS Horizon Innovation Centre at Torbay Hospital in South Devon, England, where we’re learning how the NHS has enhanced the recovery process after colorectal surgery and how virtual reality surgical simulators are used for training in ophthalmology and inner ear surgery.

As the experts from the NHS remind us, consumer giants outside the health care industry recognize this. That’s why Procter & Gamble has a stretch goal that 50 percent of its new product ideas must be inspired from the outside. That’s why research of scientists’ notebooks has shown that the most creative scientists are the ones who get inspired from a broad array of external sources.

Goals: When aspirational goals are clearly defined, leaders signal that innovation is important. These goals clarify why concepts are important but how they should be implemented. An overarching Kaiser Permanente goal is to help shape the future of health care – and we look to our employees to figure out how we will do that.

Rewards: Rewards for innovation are symbols and rituals whose main purpose is to recognize innovative behavior. They signal how much value is given, or not, to the efforts of individuals and teams who come up with new ways to help an organization achieve its strategic goals, Maher, Bevan and Plsek explain in their guide. But be aware that monetary incentives are not the primary drivers for innovative thinkers. Two proven incentives that drive innovation are more autonomy to innovate, and professional development opportunities that support an innovator’s career path.

Recognition: Giving innovators a chance to present their innovations in a larger group is a powerful form of recognition. Kaiser Permanente created an internal innovation-sharing group called the Garfield Innovation Network so employees can present their projects and feel recognized for their efforts.

Tools: Give people a set of tools with which they can innovate. At Kaiser Permanente, our Garfield Health Care Innovation Center is a tool. Other tools are the IDEO-inspired human-centered design methodology and the Institute for Healthcare Improvement metrics methodology used by Kaiser Permanente’s Innovation Consultancy. (IDEO is a design group that pioneered a human-centered design process involving observation, storytelling, synthesis, brainstorming, prototyping and field-testing.)

Relationships: The final characteristic of an innovative culture is relationships among people. Research shows innovation is rarely the product of a lone genius – instead it comes from enabling diverse and divergent opinions to come together to holistically solve problems. That is something we do really well at our Garfield Center by encouraging networking among innovators both within and beyond Kaiser Permanente.

Once you’ve built your innovative culture with the building blocks above, you will likely create surprising projects to improve health care in new ways you did not think possible.

For example, here are three Kaiser Permanente projects born from innovative thinking on the front lines of clinical care:

• Text messages sent to members reminding them of upcoming appointments has led to a decrease in no-shows and gives members the information they need in the format they want
• A human-centered design program that equips nurses with neon-yellow, non-interruption wear and a sacred process and space for drawing medications has significantly reduced medication administration errors
• A technology-enabled Microclinic being rolled out in shopping centers and suburbs was designed in part by patients with foam boards, plywood and electrical tape acting out scenarios in a low-fidelity, rough mock-up prototype model.

To learn more, go to www.kp.org/innovationcenter.

To join a network of innovative health care organizations, check out the Innovation Learning Network, a non-profit sharing the joy and pain of innovating in heath care.

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Jennifer Ruzek Liebermann is the Director of the Kaiser Permanente Sidney R. Garfield Health Care Innovation Center. She has been involved with the Garfield Center since January 2005.