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Skip to 0 minutes and 5 secondsIAN KIRKPATRICK: Hello, I'm with Lynne Maher from New Zealand, and we are going to talk now about the general topic of innovation, innovation in health systems. Lynne, what do you understand by the term innovation? (Just to start this discussion.)

Skip to 0 minutes and 20 secondsLYNNE MAHER: Yeah. Innovation is when a new idea is actually put into practice, and that new idea adds value or makes a difference to whatever service-- or product for that matter-- that we want to achieve. And innovation comes after creativity, because of course, creativity is the act of having some ideas, testing some of the ideas, identifying what works best. And then innovation comes when we implement that idea or those ideas, and they seem to add value.

Skip to 1 minute and 0 secondsIAN KIRKPATRICK: So, in the context of health services, is it useful to make a distinction between, say, clinical innovation and service innovation? Are they both the same thing, or are they distinctive?

Skip to 1 minute and 12 secondsLYNNE MAHER: I think, basically, they both run with the same process. And really what's the important thing is understanding what you want to be innovative about. Of course, random innovation can reap rewards, but in organisations, it's much better if you can understand what your challenge or problem is, and then say, how can we think differently or be innovative to bring new ideas to solve that problem or create an opportunity.

Skip to 1 minute and 44 secondsIAN KIRKPATRICK: You hear lots of people say, don't you, that innovating in health systems is really, really hard. Yet, we have all of this knowledge and expertise, all of these toolkits, and all of this guidance. Why is it such a problem to encourage innovation in health systems?

Skip to 2 minutes and 3 secondsLYNNE MAHER: I actually think health care staff are naturally really creative, and therefore, creativity can lead to implementation of great ideas. But tools and techniques and courses are one thing. What often happens is people don't think they've got permission to innovate-- "nobody wants good ideas around here". And of course, in health, we have to be really, really careful about risk. Anything new carries a risk, and when I work with colleagues in health services, it seems to be, oh, well the new thing is too risky. And so we have to be careful, but I think there's a slight risk averseness. However, we can take risks easily.

Skip to 2 minutes and 54 secondsWe can make it safer, and one of the things I always say is, what's the risk of the current service? Is that current service perfect? No. So let's take our knowledge of how to do small scale testing, when we want to mitigate risk of implementing a new idea. But it's that notion of sensible risk taking that sometimes detracts from our ability to be innovative, because we just go, no, it's too risky, without assessing it properly. And I call that a cultural aspect, and those cultural aspects are often what detracts from people-- who are inherently creative-- from using that creativity. As leaders, we need to say that we're looking for innovation. We want to take sensible risks.

Skip to 3 minutes and 53 secondsWe're able to support people who want to be innovative, want to have ideas and implement them, and we're going to thank them. And even if those ideas and the implementations don't work as well as we want them to do, they fail, failure is an important part. We want to say, look, this didn't quite work, but thank you for taking the time and effort to try to make our health services better. We are not good at that. We hide failures, typically.

Skip to 4 minutes and 29 secondsWhereas if you go to any organisations outside of health who are innovative, they've usually got a bookcase with all their failures, right as soon as you walk into their organisation, because they're proud of them, and they say it didn't work in this time and place, but actually, we've got learning from that. And that's really, really important.

Skip to 4 minutes and 51 secondsIAN KIRKPATRICK: So essentially you're saying that the knowledge of tools and techniques is necessary, but not sufficient to bring about innovation. You also have to have supportive leadership, and supportive culture. Is that right?

Skip to 5 minutes and 6 secondsLYNNE MAHER: Absolutely.

Skip to 5 minutes and 7 secondsIAN KIRKPATRICK: So how do you achieve that, I suppose would be my next question? How do you get to that point?

Skip to 5 minutes and 14 secondsLYNNE MAHER: Well, I think one of the key points is being aware of it.

Skip to 5 minutes and 21 secondsIn many industries, what we do is, say, if we can enable people and give them tools and techniques, that means they're competent, and they can come back and make changes. And that's just not so. People need to be supported. They know, particularly with innovation, they know they're going to be taking quite a risk, and it's about being publicly supportive. Say, OK, yes, let's talk about this risk, but I'm going to support you in taking it. Let's agree how we're going to go forward. And I'm going to be there if you've got any challenges. And I'm going to enable you to have some time to do this. And time is another important part. We expect...

Skip to 6 minutes and 7 secondsIt would be lovely if we have innovation and improvement as a core part of our day job, but in fact, we don't yet. And it means people often need to do that type of work on top of their day job. But supportive leaders, I think part of their role is to help individuals find time that's not on top of their day job, because it's essential. We need innovation and improvement to continually move health services forward and make them the best they can be.

Skip to 6 minutes and 45 secondsIAN KIRKPATRICK: For sure. Perhaps just, yeah, could you just reflect on any examples of where you've seen this supportive culture really taking off, really developing?

Skip to 6 minutes and 56 secondsLYNNE MAHER: I think there are some good examples around the world. The examples are particularly where leaders are very open about the need for innovation. In the Virginia Mason hospital in the USA, they're very well known in terms of their leadership capability for supporting innovation. And what they do is they make it obvious. We want different ideas to solve this problem. We are going to be openly supportive. And there's a consistent narrative about that. In organisations... In health care organisations in England, I've heard that too. Absolutely open to innovation, and the senior leaders would say, we want it, come and talk to us, and we'll give you permission. And it's the same here.

Skip to 7 minutes and 54 secondsIAN KIRKPATRICK: Thank you, Lynne. That's really informative. Thank you.

Understanding innovation in healthcare

In this video we focus on the question of how to foster and sustain innovation in healthcare.

The benefits of innovation are plain to see, both with regard to new technologies and innovations in service design. In Singapore for example, the creation of an Agency for Integrated Care, in 2008 to provide more joined up care for the country’s ageing population had led to a 67% reduction in hospital admissions from targeted groups. In the US, a recent initiative called TeamStepps has helped to improve multi-disciplinary working between clinicians and foster a stronger safety culture, leading to a 37% reduction in hospital perinatal mortality. In some health systems, stimulating innovation in service delivery is now actively promoted by governments and regulatory agencies. In the UK, for example, the National Institute for Clinical Excellence (NICE) provides extensive guidance on how to improve the quality of health and care and examples of how it has been used.

Please now watch the video interview above with Lynne Maher, Director for Innovation Ko Awatea, New Zealand and add your comments below. You might also find it useful to read the supporting document on the nature and theory of innovation in healthcare.

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This video is from the free online course:

Leadership for Healthcare Improvement and Innovation

The University of Warwick

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