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Helping Organisations to Think Better Creativity and Innovation in Healthcare
Paul PlsekSenior Ko Awatea Visiting Fellow on Innovation and Co mplexity,
Ko Awatea, Auckland NZ
Innovator-in-Residence, MedStar Health Institute for InnovationWashington, DC USA
Chair of Innovation, Virginia Mason Medical CenterSeattle, WA USA
Independent consultantAtlanta, Georgia, USA
[email protected]: @paulplsek
Special acknowledgement to
my colleague Lynne Maher
at Ko Awatea
Connect all nine dots, with just 4 straight lines, without lifting your
pencil once you start.
Rules, Boxes, 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
Edward deBono’sMental Valleys Model for Thinking
Streams of thinking Valleys
Creativity: A Composite Definition
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.
Creative addition…
+
Creative addition…
+
Creative addition…
+
Ferrari Formula1-Critical Care Handover
Purposeful channel Random jump
“Creative thinking involves breaking out of established patterns
(valleys) in order to look at things in a different way” de Bono
Example: Simple Rules For Access to Care(Roger, Maher, Plsek (2008, BMJ ) New design rules for driving innovation in access to secondary care in the NHS )
1. Only a professional can make diagnosis, treatment and recovery decisions2. Care is delivered by clinicians, face-to-face with patients3. Access to services is through a system of “gates” controlled by
professionals4. Supply is limited, demand exceeds supply, and both are unpredictable; so
place buffers in the system to smooth out the flow5. Because professionals’ time is more valuable than patients’ time, patients
are seen in ways, at times, and in places that are convenient for the service or clinician.
… and so on
Accessing a Doctor
1. Patient has problem2. Make appointment to see GP3. Patient goes to GP Surgery4. Go to registration desk on arrival5. Receptionist verifies information on file6. Wait in waiting room7. Nurse or GP takes you into the room8. Doctor takes history and examines the patient9. Doctor decides plan of care
Seven Levels of Change• Level 1: Doing the right things
• Effectiveness, focus and working to priorities
• Level 2: Doing things right• Efficiency, standards and variation reduction
• Level 3: Doing things better• Improving, thinking logically about what we are doing and
listening to suggestions
• Level 4: Doing away with things• Cutting, asking why do we do this?, simplifying, stopping
what doesn’t matter
• Level 5: Doing things that other people are doing• Observing, copying and seeking out best practice
• Level 6: Doing things no one else is doing• Being really different, combining existing concepts, and
asking why not?
• Level 7: Doing things that cannot be done• Doing what is commonly thought to be impossible,
questioning basic assumptions, breaking the rules and being a bit crazy
Adapted from Rolf Smith (2007) The Seven Levels of Change: Different Thinking for Different Results, 3rd Edition. Tapestry Press
{Logical thinking
{Clever, analogous
thinking
{Higher-level creative thinking
Standardisation and innovation are mutually supportive, not mutually exclusive…
© 2004 Paul E. Plsek
Ever-increasing Quality, Service, & Attraction
Receptive Culture
Standard work
Innovation and change
Innovation and changeStandard
work
Standard work
Albert Einstein
“You cannot solve
a problem using the
thinking that got
you there”
