How to Not Kill Innovative Thinking

In an industry desperate for innovation in care delivery, the CEO's job is to encourage employees to think differently, and more critically, to speak up when they see a better way.

Where do you get your ideas?

John Steinbeck, a writer for which my father and I shared a love, like many authors, constantly had to answer that question. Famously, he said to one such query, "Ideas are like rabbits. You get a couple and learn how to handle them, and pretty soon you have a dozen."

The key, it seems is learning how to handle them.

As the ground beneath healthcare organizations shifts in unpredictable ways, who couldn't use a few dozen rapidly multiplying good ideas? But the question to you as a leader is how to handle them, because nothing destroys morale quicker than a CEO (or other top leader) who solicits ideas for improvement, but has no process for evaluating them, or for putting the best ones into action.

That's why writing this month's leadership story for HealthLeaders magazine was so much fun. I interviewed the CEOs of two very different organizations. Dereesa Reid heads Hoag Orthopedic Institute, a specialty hospital joint venture between orthopedists and Hoag Memorial Hospital Presbyterian in Orange County, CA. Michael Dowling leads a rapidly growing integrated delivery system, Northshore-LIJ Health System (soon to be renamed Northwell Health) in the New York metro area.

Innovation Doesn't Magically Happen
Despite the vastly different organizations they lead, what was striking was how similar their approaches to innovation were.

Both told me lasting innovation isn't something that just happens. It's the result of a carefully nurtured process involving dozens of important decision makers who evaluate ideas for prime time, or at least, for further development.

At Northshore-LIJ, Dowling starts with the acknowledgement that healthcare has been extraordinarily innovative on the treatment and technology side of medicine—the science of medicine. But innovation in delivery systems and the administration of healthcare has been highly lacking by comparison.

Let's be honest, much of the innovation in treatment and technology is sparked by the knowledge that there's been money to be made. New treatment modalities and new technology have always had well-understood reimbursement possibilities. The incentives have been in place.

Long-Term Vision
Until recently, and except for a few pioneers, innovating delivery and administration has been somewhat less remunerative. But as health systems grapple with a new gold standard of improving value, however, such innovations have become more common. Those that hope to thrive in the coming years are investing in that form of innovation.

For example, Dowling says one area of innovation that's paid off for Northshore-LIJ—education—was certainly not a no-brainer. But the organization recognized several years ago the value of building and creating the talent it needed for a future where value was king. In that respect, the innovation was building the health system's Center for Education and Innovation, he says.

"Well over a decade ago, we created our own center for learning and innovation, our own university," he says.

A lot of organizations do this now, but Northshore-LIJ was learning as it went, including the creation of a new senior executive title associated with the program: chief learning officer. Now the program has one of the largest training simulation centers, says Dowling.

"These leadership training programs are based upon a commitment that if we're going to deliver a different product 15 years from now, we have to do it differently." Although much credit accrues to him for such programs, he tries hard to deflect it, because he says it's almost impossible to sustain innovation if it's driven by the CEO.

"That said, if the CEO or senior level of the org puts a wet blanket on new thinking, you won't get any new thinking," he says. "You know that quite a few of the things you do will fail, but we misuse the word failure. When you improve based on that you've learned the failure is largely a success."

Reid, tasked with executing the vision for an entirely new organization by both the physician partners and the parent hospital organization, hired a team that matched the vision. That laid the groundwork for innovation, which she says is critical part of the orthopedic institute's original organizational model. One of the more important lessons she learned in a career that began outside of healthcare is that a culture of innovation can be self-sustaining.

"In a startup, you have to recognize all early wins, but as leaders, we can't forget that when people take risk, when they do achieve something, they feel better about themselves," she says. "As they feel more empowered and confident, they treat people better. When souls get fed with personal accomplishments, they take better care of patients."

Rather than driving the innovative spirit, the CEO's role, as well as other leaders in the organization, is to clear the way for the nurturing employees, who are exposed to plenty of areas ripe for innovation that never reach the notice of senior leaders.

If your organization is one that truly values innovation, she says, there should be many more ideas than can possibly be approved or executed. There are only a few things the organization can try to do and that it can do very well.

The process of winnowing down the ideas, testing them and refining them, is an area where senior leaders should make their impact, she says. The highest priority ones best line up with organization's mission and vision, and drive value, she says.

"No," she adds, is a powerful word. You don't discourage innovation by telling folks no, she says. You discourage it by failing to follow up, or by forgetting that working together for the improvement of the organization also requires valuing the impact and importance of the individual to the success of the whole organization.

"They can discover their inner talents," she says. "There's no greater legacy than to create an environment where people are proud of what they're doing."