1. Observation Healthcare Associated Infections, what did we observe? Inconspicuous gel dispenser A notice about a notice

2. The way to get good ideas is to get lots of ideas and throw the bad ones away. Linus Pauling, Nobel Prize winning chemist 64

3. A new idea is delicate. It can be killed by a sneer or a yawn. It can be stabbed to death by a joke or worried to death by a frown on the wrong person’s brow. Charles Browder 66

4. Criteria: • Be clear about how you will select your ideas • Return on investment: is it likely to create cost savings? • Quality: will it increase quality of care? • Likelihood: can we actually do it? • Dot Voting: • Give participants a set numbers of ‘votes’ (eg sticky dots) • Vote for ideas based on the criteria • Identify the most popular ideas

5. Tool: Edward de Bono’s Six Thinking Hats The main difficulty of thinking is confusion. We try to do too much at once. Emotions, information, logic, hope and creativity all crowd in on us. It’s like juggling too many balls. Edward de Bono, Six Thinking Hats®

6. The measure of success for a test is whether you learned something Goals of small scale testing: Create confidence and momentum for good ideas Learn more about the idea to enhance it or… Evaluate and eliminate the idea, without major investment of resources, if it wasn’t so good after all I have not failed, I have merely found ten thousand ways that won’t work. Thomas Edison, inventor of the light bulb

7. Test and Learn • Prototyping: • A prototype should test the boundaries and also helps to manage risk • A prototype is anything that tests an idea and answers a question • It is not necessarily about the actual ‘product’ it is about the interaction it provokes Start small. A prototype needs only to be as good as it needs to be. It helps you to fail early with some ideas and gather ideas to strengthen other ideas.

8. Example 1: Productive General Practice How many times do staff look in that pile for notes and diagnostic results ? Basic Processes – Prescriptions, Post Secondary care – referrals, test results, information Shared spaces – clinic rooms Outdated health information

9. Differences made... • Sickness absence fell by 35% in 2011 compared to 2010 (by sharing data with staff) • Collecting data re: arrival and waiting times patterns emerge: • patients tended to come in earlier if they have an appointment with a GP as opposed to a nurse (increasing their ‘perceived’ waiting time) • certain clinicians were more likely than others to overrun in consultations. • Reduce the time spent looking for prescriptions from 118 seconds to just 21 seconds – saving more than 12 hours of reception staff time every week

10. Example 2: The Productive Ward Releasing time to care • Direct care time with patients increased by up to 60% • Medicine round time reduced by 63% • (allowing re investment of time into safer care) • Handover time reduced by 33%, but quality increased • Meal round length reduced by 50%, but nutritional outcomes improved ( £10,000 saved in one year by one hospital in meals) • Unplanned staff absence rates dropped by 6%.

11. Example 3: The ebd approach • 42 improvements to a service which was considered the best in a hospital • Stoma Care • Review of integrated pathway and staff competencies • Role of Health Care Assistant extended to include stoma care • Lean techniques used to reduce wasted time and effort when finding equipment. • Mirrors with lights around them have been purchased. • Confidence has increased, training time reduced • A major review of appointment planning and staff working practices has resulted in a radical reduction in waiting times in clinic • Patient Information written by patients - Staff invited to add their ‘bits’ later

12. Innovation is difficult

13. Dimensions of innovation culture

14. The UK averages @helbax #innovationinhealthcare

15. By Factor showing staff and executive team

16. Innovation is about risk and failure

17. “It is not the strongest of the species that survives, not the most intelligent, but the most responsive to change.” Charles Darwin (1809-1882)

18. Thank you Helen Baxter Helen.baxter@institute.nhs.uk @helbax #innovationinhealthcare