The Covid-19 pandemic has put healthcare practices in the global spotlight. And we’ve seen extraordinary innovations take place, within and across organisations and countries, and in streets and communities.
But the innovation market has been rising for years, in healthcare and beyond. Organisations want people who can turn ideas into value. Employees want these skills because they can help with their employability in the coming years: they are hard to automate, in demand, portable and learnable. Business schools and consultancies have expanded greatly their creativity, innovation and entrepreneurship offerings. But how do leaders coordinate this innovation and make it work?
At an institutional level, the International Standards Office has developed an innovation standard, reflecting a growing, global interest in innovation as a discipline.
Mel Rhodes described a holistic innovation model 1, which has proven influential:
- Products: new products, services, experiences, safety, processes, business models – outputs of work.
- Process: learning the thinking skills, to shape ideas through problem defining, idea generating and selection, prototyping, business case, to demonstrable value.
- Press: work climates that support idea development.
- People: bring diversity perspectives into conversations, so that debates are richer.
In the examples below, to build on the innovations accelerated by COVID-19, we describe recent innovation initiatives led by groups from the UK and Netherlands healthcare systems.
From 2018 – 2019, the University of West of England (UWE) delivered a leadership development programme for North Somerset Community Partnership (NSCP) 2. Aside from the content of the leadership programme, the NSCP executive team also wanted to create a healthy organisational climate for innovation. So, we measured this at programme start and end.
Goran Ekvall made a major contribution to the concept of climate for innovation. Ekvall’s model covers nine dimensions, and is measured through the Situational Outlook Questionnaire: 3
- Challenge and involvement: The degree to which people are involved in daily operations and long-term goals.
- Freedom: The independence in behaviour exerted by the people in the organizations.
- Trust and openness: The emotional safety in relationships.
- Idea Time: The amount of time people can (and do) use for considering new ideas.
- Humour and Spontaneity: The spontaneity and ease displayed within the workplace.
- Conflict: The presence of personal and emotional tensions in the organisation.
- Idea Support: The ways in which new ideas are treated.
- Debate: The occurrence of encounters and disagreements between viewpoints and ideas.
- Risk-taking: The tolerance of uncertainty and ambiguity exposed in the workplace.
Organisational climate matters because ideas develop in context. People may be trained in new skills, but local climate will influence whether they are applied. Climate influences innovation performance because it affects people’s levels of discretionary effort: in a healthy climate we simply want to give more.
In our work, NSCP improved their organisational climate on eight of nine dimensions, including all they targeted. Combined with their improving staff survey data from 2017, 2018 and 2019, this showed they’d achieved a substantial shift.
Rob has seen team climate for innovation improve in months. With poor leadership it can also worsen rapidly. We have summarised our learning in a book chapter, with insights from six UK healthcare cases 4.
Geert is an innovation consultant, with a background as a mental health nurse. His reflections here are on applying the FORTH methodology to healthcare organisations in mental health and community care settings. The FORTH approach was developed by Van Wulfen 5 and combines design thinking and business thinking.
First, the context must provide a degree of urgency for innovation. For example, the speed of technological development is high; patients are increasingly empowered, expecting genuine participation in decision-making, and deserve the best possible care. Meanwhile, there is increased competition for contracts between healthcare institutions. This context will help shape a clear and compelling innovation assignment.
Early In the innovation process, attention should be paid to opportunities arising from emerging strategies and trends in technology, the market and wider society. What are the trajectories here that can broaden our thinking, shaking us from our current patterns? In talking to patients, experts and other interested parties, we can uncover frustrations or frictions that are relevant to the innovation challenge.
These ‘frictions’ will be a strong influence on later solutions. Having involved relevant stakeholders from the beginning, our later concepts can be shared with the same people at the testing stage, increasing the odds of their support.
Crucially, right from the beginning, and throughout there must be explicit, consistent support from the senior management team. In common with most sectors, many healthcare organisations lack a central unit with innovation responsibility. Employees want the best for their patients, and to offer the highest quality care. With limited time and resource for innovation, they don’t want to get caught up in bureaucracy and hopeless project plans that yield poor results. Feedback from innovation facilitators reveals that the structured approach of FORTH, can give the confidence needed to develop new concepts for products and services.
Rob and Geert agree on some common challenges facing UK and Dutch healthcare. First, highly motivated and deeply committed employees find it easy to generate many ideas. However, ideation is only one part of the process. There is much less evidence of the wider innovation skills, such as linking ideas to strategy, securing senior support, breaking thinking out of the groove of current practice, selecting concepts to prototype and test, and presenting commercial business cases to launch and resource ideas.
As co-authors, our common experience of the COVID-19 pandemic is that it has not only driven an interest in innovation but has led to online experimentation and learning. Much of this has taken place through networks. The International Society for Professional Innovation Management (ISPIM) is a well-established international network of innovation academics, organisational leaders and consultants. It recently chose to run a virtual event, with more than 200 innovation-themes sessions running over three days: https://www.ispim-virtual.com/
The FORTH network has also been active. In recent months. More than 20 FORTH facilitators worldwide took part in an online challenge, yielding five new solutions to reduce the impact of COVID-19. (See https://www.forthinnovation.com/ and scroll to the annotated map for detail.)
How might your organisation develop the ambidextrous agility it needs to deliver efficient, operational reliability as well as more radical change when you need?
1 Rhodes, M. (1961). An analysis of creativity. Phi Delta Kappan 42: 305:310
2 Headed by NSCP’s Director of People and Organisational Development, Jenny Turton, with programme responsibility for Kemi Oladapo (Head of Learning and Development). On the UWE side, the delivery team was Dr Rob Sheffield, Jane James, Jane Hadfield, Mark Patterson, and Professor Carol Jarvis.
4 (Draft chapter, publication date and publisher to be confirmed) Sheffield, R. Jarvis, C, Kars, S. Climate for innovation: a critical lever in the leadership of Innovation, in Contemporary Issues in Innovation, Agarwal R., Green R, Patterson E. and Pugalia S. (Eds)
5 Van Wulfen, Gijs (2014): The Innovation Expedition, a Visual toolkit to start innovation, version 3, BIS PUBLISHERS, Amsterdam
Rob Sheffield is a Director at Bluegreen Learning and a visiting fellow at the University of West of England. He has over 25 years’ experience in leadership development, and his particular interest is in helping leaders create productive and sustainable climates for innovation. Web: https://bluegreenlearning.com/ Twitter: @rsheff
Geert Schols has over 30 years’ experience as a nurse, policy advisor and innovation consultant in mental health care. As the founder of SAMEN EEN innovatie, he helps organizations in healthcare and profit companies to come up with products, services and process innovations. Web: www.sameneeninnovatie.nl Linkedin: https://www.linkedin.com/in/geert-schols-8a96355a/
Declaration of interests
We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.