A little over a year ago Nottingham University Business School hosted a creative problem-solving session for managers and staff from a major NHS trust. The tale of the most successful idea to emerge from the exercise offers some important lessons about innovation.
The story began when a podiatrist took to the stage to talk about the risk of renal patients, especially those also suffering from diabetes, losing their legs because of circulation issues or pressure sores. As she explained, preventive treatment is known to be highly beneficial but has traditionally been extremely hard to provide.
The principal difficulty is that lack of mobility makes it tricky for these patients to attend clinics; in tandem, the amount of time they spend on dialysis means home visits are also challenging. So what about a new approach, she suggested, whereby dedicated renal podiatrists could see patients during dialysis, allowing more of them to receive in-clinic care?
The pitch was greeted with applause and won the immediate backing of senior managers, who vowed to support the concept through commissioning routes. They were true to their word. The new service was fully implemented just three months later and has since been shown to improve savings, enhance patient satisfaction and allow staff to work more efficiently.
Given how rare it is for any initiative within the NHS to tick all three “triple burden” boxes – cost-effectiveness, patient-centricity and high quality – interest in adopting this breakthrough elsewhere is now growing. But this is where we need to pause and consider the bigger picture.
Naturally, it would be marvellous if the scheme were to be used widely. There’s no doubt about that. Yet to replicate it without appreciating how it came about in the first place would be to overlook the broader merits of nurturing radical innovation at a time when the need to do more with less in any setting is arguably unprecedented.
Understand how creativity works
A “great idea” doesn’t just appear by magic. We usually start by having a bit of a good idea, which, combined with another bit of a good idea, a refinement of someone else’s bad idea and a criticism of someone’s else utterly daft idea, forms the beginnings of a feasible idea, which is then examined and honed. In other words, we need to have lots of ideas and be willing to throw away almost all of them.
It’s a process of collaboration and elimination. The podiatrist’s proposal was one of 40 put forward during the session, and the fact that the other 39 fell by the wayside doesn’t diminish their contribution to the final outcome. Genuine waste doesn’t lie in investigating novel concepts that might lead nowhere: it lies in deterring them before they’ve even been aired.
Grant frontline staff a voice
Paul Lutus, who designed equipment for NASA missions before writing some of the most significant programs in the history of personal computing, argues that there are “idea producers” and “idea consumers”. He once said of the latter: “The central organising principle of this class is that ideas come from somewhere else – from magical persons, geniuses, ‘them’.”
A key lesson for any organisation is that the more it encourages “idea producers” – and, by extension, the less it unwittingly cultivates “idea consumers” – the more likely it is to achieve success through innovation. In this case the trust was ready to grant its own employees an audience, to have faith in their input, to help rather than hinder and to tolerate the uncertainty that inevitably comes when unfamiliar avenues are explored.
Dare to look beyond the spreadsheets
Inflexible metrics frequently scupper potentially beneficial initiatives, sometimes even before they’ve made it to the drawing board. The old adage that you can’t improve what you don’t measure is true enough, but at the same time it’s worth remembering there are still some things that are beyond metrics’ ever-distending reach.
This is particularly so with pioneering endeavours. Pioneers should be forgiven for lacking reams of relevant data, for the fact is that they’re working in uncharted territory. The podiatrist’s idea would never have been realised if her trust hadn’t been prepared to transcend the putative wisdom of its spreadsheets and concede a little wriggle room.
The first lesson, then, is that many of the people best able to sustain any organisation are often already working within it. As such, they need to be afforded the freedom to contribute – without fear of being ignored or, worse still, scorned.
The second lesson is that if one of their contributions should turn out to be brilliant then the default reaction elsewhere shouldn’t be an unthinking “Let’s do what they do”. It should be “How did they come up with that?”, because that’s the only way to understand the conditions that foster innovation. To mix our axioms: imitation is the sincerest form of flattery, but flattery – at least in the long run – will get you nowhere.