1. 1. By Robert Anderson Arizona State University College of Nursing and Healthcare Innovation
2. 2. Introduction Healthcare (HC) in a state of flux due to technological advances HC innovation comes from the top-down, instead of bottom-up Point-of-service innovation is subdued, not championed Decisions are unilaterally made by providers/managers/execs Employee buy-in suffers from lack of ownership of initiatives Compensation/equity is based on the market, not performance Patient care is driven by process/reactive instead of value/adaptive Patient care is judged by financial metrics vs. patient satisfaction Overall, there is an illegitimate locus of control for authority and autonomy that should rest with the professions who own it (Porter-OGrady & Malloch, 2015, p. 131).
3. 3. D.I.D.E. Democratizing Innovation Program for independent, daily experimentation or tinkering by staff, managers, executives; participation is optional but encouraged Patient satisfaction (HCAHPS) monitoring with additional patient care, financial, & time metrics evaluation; requisite to participation Experimenter is allocated dedicated daily time for experimentation, evaluation, & presentation of projects w/in operational constraints Democratizing Decision-Making System of team, departmental, & organizational forums where experiments are evaluated & initiatives voted into implementation by forum members Voting is only available to members & presenters w/in each team, departmental, &/or organizational forum where experiment is presented Team leaders, departmental heads, & executives preside over team, departmental, & organizational forums, respectively; awarded veto power
4. 4. D.I.D.E. (Cont.) Democratizing Equity (Compensation) Equity in the form of recognition, bonuses, pay raises, profit-sharing, company shares, & allocated funds may be awarded to individuals, teams, & departments for participation, performance, & loyalty Individuals, teams, & departments are all awarded proportionately according to initiative successes, patient satisfaction scores, financial savings; individual performance evaluations & seniority also considered Individuals, teams, & departments are compensated (after trial period of 6 months) for each proceeding forum (e.g. team -> departmental -> organizational) in which their initiative is implemented & yields results Link to Current D.I.D.E. Mindmap https://mm.tt/550192675?t=Esnp9jPGEO
5. 5. How is this Innovative? By referring back to the Introduction, you see: DIDE is a program that essentially revolutionizes HC operations, democratizing innovation, decision-making, & compensation structures Bottom-up innovation is used by companies such as Google, 3M, & innovative giants yet only very few HC organizations practice it today; When theres no experimenting, theres no progress. Stop experimenting and you go backward (Gelb & Caldicott, 2007, p. 68). This shifts the balance of power in decision-making to the point-of-service, empowering employees, increasing input & buy-in, & overall giving employees ownership of their work & the patients care Compensation becomes performance-based, allowing exceptional employees to excel, attracting a better standard of worker, increasing motivation & feelings of recognition, & improving patient outcomes In effect, patients receive better, more-invested care from nurses & providers b/c staff compensation is tied to their value/satisfaction
6. 6. Desired Outcomes Implementation of DIDE in a healthcare organization yields: Increases in patient HCAHPS scores, satisfaction & care value metrics, better outcomes, overall health & awareness Increases in worker well-being, motivation, buy-in, autonomy, initiative, productivity, consistency, community, loyalty to organization, communication, adaptive capacity to constantly changing conditions Increase in provider ratings, patient reviews & recognition Increase in organization innovation, community & industry recognition, revenue, job applicants Decrease in patient complaints Decrease in employee errors, turnover, career entrenchment, & retiring in place
7. 7. Beneficiaries Patients Patients are the main beneficiaries; they receive better care by linking employee performance & compensation to patient care value & satisfaction Nurses Nurses benefit by receiving the ability to innovate, make decisions, receive recognition, & be compensated for their creativity & hard work Providers Benefit from happier & healthier patients, better patient outcomes, increased operational efficiency, & employee motivation, well-being, & initiative Managers Managers benefit from a decreased workload & less stress by having motivated employees who are self-directed w/ similar goals & initiative to themselves Executives Executives get the industry recognition for being innovators, along w/ company success, financial well-being (thus, executive perks), & operational autonomy.
8. 8. Aligning Passions with Goals DIDE SMART EDISON (Gelb & Caldicott, 2007, p. 50) (S) I want to implement DIDE in a small healthcare facility w/in three years of today. (M) I will measure my progress using a GANTT chart of projects & tasks. (A) I am accountable to my mother & an advisor that I will choose by the end of the Fall 2015 semester. (R) I feel my purpose in life is to dedicate my career to creating a better, more efficient system of healthcare in the United States; my goal of implementing DIDE is relevant to my overall purpose. (T) Within three years, I want to have implemented some form of DIDE in my healthcare organization. (E) I am passionate & dedicated to improving the lives of nurses & patients; my mother has been a nurse for 40+ years, I grew up in hospitals, & see nothing more noble than improving their lives by implementing DIDE (D) For that reason, I will not stop until nurses have more power over innovation, decisions, & compensation in healthcare. (I) Implementing DIDE integrates perfectly into my goals of obtaining my MHI degree, starting my healthcare career, & becoming an innovative leader/administrator in a hospital. (S) I can see myself presiding over the first team forum, seeing my colleagues faces, & hear them presenting their solutions to problems, knowing that this program could result in employee autonomy. I feel excited! (O) I am going to achieve this. My mom loves the idea. Its a great Capstone project, & its beneficial to so many. Im going to do this. (N) I am doing this right now!
9. 9. Potential Barriers General resistance to change To overcome general resistance, I will outline DIDEs potential risks & benefits, represent it visually, & cultivate charismatic optimism Executives uneasy to relinquish control The most probable barrier; to overcome executive resistance, I must be able to show the benefits of DIDE, that it is profitable, well-thought-out, & ultimately, the executives are still in charge Establishing an equitable-yet-profitable compensation system To overcome this barrier, I plan on studying models of compensation systems used in other industries/companies and applying what Ive learned to create something that will work in a HC organization Difficulty in organizing forums & getting staff together Technology may be the answer; maybe creating an online forum system with discussion boards & voting on the website would work
10. 10. Literacy Blueprint Barriers Express Ideas Visually I need to be able to show people DIDE visually for them to buy-in; to do so, I will make diagrams & schematically outline the program Become a Master Networker In order for DIDE to gain supporters, I must keep in touch w/ colleagues; to do so, I will network regularly w/in the industry & aim to develop positive relationships w/ contacts w/ particular backgrounds Understand Scale-Up Effects To make truly innovate & revolutionize HC operations in an organization, I must budget & plan for scale-up; thus, I will start small, monitor & evaluate, & outline scale-up incrementally in steps
11. 11. References Gelb, M. J. & Caldicott, S. M. (2007). Innovate like Edison: The five-step system for breakthrough success. New York, NY: Penguin Books Ltd. Porter-O'Grady, T., & Malloch, K. (2015). Quantum leadership: Building better partnerships for sustainable health. Burlington, MA: Jones & Bartlett Learning.