Penicillin. Viagra. Aspartame. X-Rays. No, this is not the world’s strangest shopping list. One began with mould on a petri dish, another with an inconvenient side effect, another with an accidental sweet taste, and another with a mysterious glow from a fluorescent screen. We often tell these stories as accidents, side effects or lucky breaks. But perhaps the more interesting part of the story is not that something unexpected happened. It is that someone noticed. Someone thought it was worth paying attention to.
When we talk about innovation in healthcare, we rightly spend a great deal of time discussing ideas, implementation, adoption and scale. Those are important conversations, but they often begin after the first idea has already appeared. Before there is an idea to implement, a service to redesign or a technology to adopt, there is a quieter act of leadership: someone has to pay attention.
By attention, I do not mean looking harder, collecting more data or staring intensely at a dashboard until it reveals the secrets of the universe. I mean something more uncomfortable: the willingness to let reality interrupt what we think we already know. This is what makes attention one of the harder disciplines of leadership, especially in systems that reward decisiveness, expertise and rapid explanation.
Consider how often reality refuses to cooperate with our expectations. A patient does not respond as anticipated. Staff react differently from what we expected. A community programme fails to reach the very people it was designed for. A new technology produces an outcome nobody predicted. These moments rarely feel exciting. More often, they feel inconvenient, ambiguous or even annoying. Our instinct is understandable. We explain. “We’ve seen this before.” “It’s just staff resistance to change.” “It’s a communication issue.” Sometimes these explanations are right, but sometimes they arrive suspiciously quickly, closing the inquiry before we have properly understood what we are looking at.
Experience matters. Healthcare depends on people who can draw on what they have seen before, make difficult judgements and act under pressure. The risk is not the experience itself, but what happens when what we expect becomes all we see. When that happens, it becomes all too easy to squeeze unfamiliar observations into familiar explanations. Reality may be waving its arms frantically trying to get our attention, while we nod politely, label it an outlier, and carry on.
Perhaps this where innovation is lost, not because there were no new ideas, but because we explained away the observations from which those ideas might have emerged. Attention, then, is not passive observation. It is the willingness to let reality change your mind. It is staying with an unexpected observation just long enough to ask whether it is pointing towards something your current explanation cannot account for. It asks us to hold our explanations lightly enough for reality to have a chance to teach us something before we rush to make the discomfort go away.
The next time something does not fit, perhaps resist the urge to ask, “How do we fix this?”, at least not immediately. Instead, stay with it a moment and ask: What surprised me? What am I taking for granted? What have I stopped paying attention to? This is not about delaying decisions; it is about delaying certainty, just long enough for reality to get a word in.
Innovation certainly needs ideas. It needs implementation, resources and leadership. But before any of those come into play, there is an earlier, less visible discipline that receives far less attention. We remember penicillin, Viagra, aspartame and X-rays as discoveries. We rarely remember the attention that made them possible.
This blog is contributed by the Centre for Healthcare Innovation, Singapore.
The CHI Leadership Council is an international advisory panel comprised of distinguished thought leaders in their respective fields, committed to pioneering systems innovation and driving change. They provide thought leadership to CHI and its partners in spearheading transformation across the health system, while fostering co-learning, collaborations, and facilitating innovation.
Author
Vanessa Audris Lim
Vanessa is an Assistant Director in Learning and Organisation Development at the Centre for Healthcare Innovation (CHI), Singapore, where she works with leaders and health systems to build capability for learning, adaptation and change. She co-leads CHI’s Future Leaders and Young Innovators Guild (CHI FLYING) and is most interested in questions that have life in them: the kind that make people pause, look again, and occasionally make the plan leave the room.
Declaration of Interests
The author declares no conflict of interest in relation to this article.