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Culture, Creativity and Innovation: Basic Premise for Effective Change and Improvement

Culture, Creativity and Innovation: Basic Premise for Effective Change and Improvement

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Culture, Creativity and Innovation: Basic Premise for Effective Change and Improvement

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  1. Culture, Creativity and Innovation: Basic Premise for EffectiveChange and Improvement Paul Plsek Consultant in Complex Systems& InnovationAtlanta, US paulplsek@DirectedCreativity.com

  2. “I believe that public servants are working flat out, but in a system that shrieks out for fundamental change…If we don’t get the systems and structures right we will never get to the roots of the problem only prune its visible branches.The key to reform is redesigning the system round the user.” Tony Blair UK Prime Minister

  3. “The challenge is to bring the full potential benefit of effective health care to all… this challenge demands a readiness to think in radically new ways about how to deliver health care services.” US Institute of Medicine “Crossing the Quality Chasm”

  4. Culture, Creativity and Innovation • Comments on the Norwegian strategy • Caution: The Door Into Summer • Innovative thinking for making things better • Change in complex systems • Patterns in organizational culture that can hinder or aid transformation • Signs of transformation

  5. Norway’s National Strategy for Quality Improvement In Health and Social Care Opening the door to “…and it’s going to get better”?

  6. Norway’sQuality Strategy Each leg of a three-legged stool is vital… Evidence Based Practice Quality Improvement Research

  7. Norway’sQuality Strategy EvidenceBasedPractice Quality Improvement Research It must all work together… • Goal of any health and social care system: • Deliver evidence-based care in a timely, effective and caring manner • Research feeds evidence based practice • Quality improvement helps to implement evidence based practice and measure performance

  8. Quality services:are effectiveare safe and reliableinvolve users and allow them to have influenceare coordinated and integratedutilize resources appropriatelyare available and equally distributed Strategies and Action Plans Strengthen theuser Strengthen theprovider Improve leadership and organization Strengthen the role of improvement knowledge in education Monitor and evaluate services Strategy for Quality Improvement

  9. Strategy for Quality Improvement • Three legs can build on each other • Aims are excellent • Deeply understand the inward-looking strategies… • Strengthen the provider • Improvement leadership and organization • Strengthen the role of improvement knowledge in education • Transformation drivers… • Truly strengthen the user • Transparently monitor and evaluate services

  10. Norway’s National Strategy for Quality Improvement In Health and Social Care Opening the door to “…and it’s going to get better”? Or… will it be like The Door Into Summer(Robert Heinlein, 1956)

  11. The Road to the Future? Source: Gareth Morgan

  12. We are certainly committed to continuous quality improvement… …we solve the same problems over and over again! QI Director for a major US healthcare system

  13. Odds of transformation increase when we… Avoid simply repeating old patterns… …when we exhibit the courage to take the “path less trodden”… …when we innovate!

  14. Altering Patterns ofThinking and Performance Let’s begin at the beginning with Creativity 101 What is innovation and creativity”? Why are creative ideas relatively rare? How does one generate a creative idea?

  15. Innovation… The purposeful production of creative ideas in a given topic area, followed up by deliberate efforts to implement some of those ideas.

  16. Creativity... The connecting and rearranging of knowledge — in the minds of people who will allow themselves to think flexibly — to generate new, often surprising ideas that others judge to be useful.

  17. Creativity... The connecting and rearranging of knowledge — in the minds of people who will allow themselves to think flexibly — to generate new, often surprising ideas that others judge to be useful.

  18. “Hey, I can hear the traffic!”

  19. “To hear the ocean, press 5… for sea gulls press 6… for…”

  20. Creativity... The connecting and rearranging of knowledge — in the minds of people who will allow themselves to think flexibly — to generate new, often surprising ideas that others judge to be useful.

  21. Edward deBono’s Mental Valleys Model for Thinking Streams of thinking Valleys

  22. “Creative thinking involves breaking out of established patterns (valleys) in order to look at things in a different way.” de Bono Purposeful channel Random jump

  23. Odds of transformation increase when we… • Come up with non-traditional ideas and approaches to the delivery of health and social care • Make novel connections among what we know • Think creatively!

  24. Why don’t creative ideas come more naturally? Because our mind is not optimized for creative thought… But, we can do something about that!

  25. Connect all nine dots, with just 4 straight lines, without lifting your pencil once you start.

  26. 3 2 4 1

  27. Connect all nine dots, with just 4 straight lines, without lifting your pencil once you start.

  28. Boxes, Rules, and Mental Models • Our mental models become natural way of seeing and explaining things • Difficult to see (“like water to a fish”) • Hard to imagine any other way • Filters our perception of reality

  29. How you see things all depends onyour point of view… The Other Coast

  30. Boxes, Rules, and Mental Models • Our mental models become natural way of seeing and explaining things • Difficult to see (“like water to a fish”) • Hard to imagine any other way • Filters our perception of reality

  31. Attention Escape Three Deliberate Mental Processes Movement

  32. Attention! Escape! Yes… and… Patient and client safety is a property of the system that professionals work within. When a safety issue occurs, it is often traceable to failures in the system. Patient and client safety is a personal responsibility of professionals. When a safety issue occurs, someone is at fault.

  33. Attention! Escape! New efforts and investments (spending some money) in one part of the system might better address the cost and quality issues in another part of the system The cost and quality issues in social care, primary care, and hospital or specialist care must be resolved by and within social care, primary care, and hospital or specialist care (“silo mentality”)

  34. Attention! Escape! We may need different processes and systems that utilize our resources better. (“process improvement thinking”) We may have enough resources; let’s look at how we might be wasting them. (“lean thinking”) We need more resources!

  35. Attention! Escape! Measure and reward what is of real value to patients and the public (“value compass”) Measure and reward activity and budget performance

  36. Attention! Escape! Demand is largely predictable and most often does not exceed capacity. Work to understand and match capacity to demand. (“flow”, “SPC”, and “process engineering”) Demand for services is unpredictable and often exceeds capacity; restrict access to services and use waiting states

  37. Odds of transformation increase when we… • Identify and challenge the “rules”, traditions, and “boxes” that have been handed down to us about health and social care delivery

  38. Attention! Escape! Many patients are actually the experts in their unique version of a disease. How can we engage them in dialogue and use their insights to better work with them? Professionals are the experts and patients come to us to find out what they should do.

  39. Attention! Escape! All people are simply living their lives as they do. How can we help them integrate our professional advice into their lives and situations? Some patients are non-compliant with the treatment.

  40. Attention! Escape! Let’s take the risk of at least asking them— not neglecting our duty to educate them— and see how it turns out Patients and carers would make unreasonable demands if we really let them drive the system.

  41. Seeing the SystemThrough a Different Lens • What does it look like to patients and carers? • Beyond surveys, focus groups, and superficial involvement • What would you do if the patient was your loved one? • Use of video walkthroughs • Real patient/carer involvement in system redesign • Beyond product and solution innovation to innovation in “experience space” (Prahalad and Ramaswamy. Sloan Mgmt Review, 2003)

  42. Seeing the SystemThrough a Different Lens • What does it look like to patients and carers? • Beyond surveys, focus groups, and superficial involvement • What would you do if the patient was your loved one? • Use of video walkthroughs • Real patient/carer involvement in system redesign • Beyond product and solution innovation to innovation in “experience space” (Prahalad and Ramaswamy. Sloan Mgmt Review, 2003)

  43. Odds of transformation increase when we… • Learn to look at the system through other “lens” beyond those of the traditional health or social care professional or manager