Catalyze Innovation that Advances Health

Tips for Improving the Resources Dimension

Synopsis  

The resources dimension considers the broadest sense of the word. The climate for innovation is enhanced if people know that they have the ‘resource’ of authority and autonomy to act on innovative ideas. While innovative ideas do not necessarily need a lot of money or time to develop, staff can become demoralized if these traditional resources are not available and can feel that there is no point in putting forward a new idea. The presence of concrete resources signal that the organization is taking innovation seriously.  

  • In a recent survey, only 11% of front-line staff felt that they had enough time within their roles to dedicate to innovation. Source: NHS Institute (2009)

Re-enforce the expectation that individuals and teams should feel they have authority to act on innovative ideas and seek to understand why they might feel they do not.  Do you know the reasons that staff might not feel able to act on new ideas? Many leaders don’t, nor do they know the process, assuming that one exists, that staff have to go through in order to gain permission to try something new.  

Do a ‘spot check’ during individual meetings or walk-arounds by asking staff to tell you about ideas they have where they feel they need more permission to act. Ask them about the process they believe they need to go through to get this permission. In our experience, we have found examples where staff are required to go through a long and complicated process, or they have no idea what the process is. Be clear that you are very open to feedback and truly want to have an honest dialogue about any past ‘signals’ that might have been sent by leaders. Also make it clear that it may indeed be that, in some circumstances, they do need permission.

In any case, both you and they will learn more about how to take innovative ideas forward.   In the end, the goal is to remove misconceptions and perceived barriers. Be prepared to do something and communicate back to staff to raise their feeling of empowerment.  

In doing this, realize that the very act of coming forward with innovative ideas represents some level of risk-taking. Consistent with that dimension, be careful to provide emotional support and show genuine appreciation of their efforts and any difficulties they face.   The advice here, while framed above in the context of an organization, applies as well to commissioners who might start a similar dialogue asking the organizations they work with if they feel that they need permission to be innovative, and why. Commissioners need to work with providers to decrease the perceived barriers to innovation, which might involve altering such commissioning levers as payment and tariff schemes.  

Caution: Something to Think Honestly About. This tip may require some honest, self-reflection in a leadership team. The premise of the suggestion is that leaders will want members of staff to feel that they have the authority to try out innovative ideas. But this might not actually be the case. Leaders vary greatly in their need to feel that they are in control of things, and in what they would classify as being ‘too risky’. It is important to explore this and gain consensus in your leadership team before telling staff that they have authority to act on their innovative ideas. You may do more harm in the long run if you tell staff that they are empowered, but then have a leader who takes it all back by her or his actions than if you had not said anything to staff at all.  

Turn strategically important innovation efforts into formal organizational projects with allocated resources. The most obvious way to provide resources for innovation is simply to focus innovative thinking on areas where resources already exist, or where there is a strong strategic imperative and resources could be identified. This might occur in one of two ways:

  1. Select existing priority goals and ask staff specifically for innovative ideas in these areas. For example if you already have teams who are focusing on safety, challenge them to massively overachieve their own aspirations by thinking differently about this area. This request might be initiated by commissioners, boards, or departmental and team leaders. The key is to recognize that staff are an important resource and often have ideas from their experience of delivering services. While it is an example of top-down, directed innovation, there is nothing wrong with this. The presence of resources and the clear call for innovation signal to staff that there is an uncommon willingness on the part of leaders to hear about and provide resources for innovative ideas on this particular topic, and that can be quite motivating.
  2. Consider whether an idea suggested by someone in the organization or system is so powerful in terms of its potential impact on quality, patient experience, productivity, costs, or prevention that it deserves to be raised to the level of a strategically important project in the next planning cycle. This is bottoms-up innovation that is then supported top-down with the necessary infrastructure such as authority to act, time and budget.

An innovative organization, health economy or other system should have a portfolio containing both types of innovation.  

Link innovation efforts to waste-reduction techniques that free up resources. In a context of limited resources, it may be necessary to create head room for innovation by first embarking on productivity improvement and then allocating some of the savings to support innovative new ideas. Leaders can signal their strong support for innovation, and perhaps increase staff buy-in to needed changes in other areas, by explicitly ring-fencing some of the savings that come from waste reduction efforts (e.g., quality improvement methods and program such as lean thinking, see the NHS Institute’s Productive Series) in order to fund innovative new ideas.

For example, commissioners might make funding of an innovative pilot continence on savings elsewhere. Or, organizational leaders might retain some headcount from a process redesign effort that reduces the number of staff needed in one area in order to re-direct the newly freed up staff onto innovation projects.   It is important to acknowledge the contributions of staff in both the waste-reduction efforts and the innovation efforts.   Remind everyone that the innovation work would not have been possible without the hard work of those involved in the productivity improvement efforts that freed up the required resources. This also provides a great opportunity to build a sense of teamwork across an organization or system.  

Seek resources from non-traditional channels. Existing budgets and projects should not be the only channel of resources you consider. ‘Think outside the box’ a bit and you may find that there are more resources for innovation that you could access. Also expand your thinking about resources beyond the monetary to include people and expertise (see box below).  

Finding resources to help you innovate…  

  • Become a test site for national initiatives, as these sometimes have additional resources in terms of expert help or small amounts of funding attached to them.
  • Contact your SHA about ‘innovation funds’, for which you can bid.
  • You may be able to secure funds from voluntary sector organizations, or even the National Lottery.
  • Local industries might be willing to volunteer their time and skills to help with innovative efforts. For example, in work done at the NHS Institute, hospital porters were supported by Nationwide Building Society, Orecal, IDEO (a leading design firm), Tesco, and Royal Mail to create new ideas about how they could provide a better customer service.
  • Contact university professors to see if you can arrange a mutually beneficial scheme where students provide support for innovation projects (e.g., designing websites, collecting or analyzing data or undertaking specific communications exercises) that also provides them practical work experience to go along with their course of study. Several NHS organizations have benefited from students of journalism and photography who have provided their time for free and used the work they have done as part of their academic assessment.
  • Members of the community including patients and their families might also be willing to volunteer their time and skills; either in lending a true service users’ perspective to innovation projects, or in helping complete needed tasks (e.g., designing a communication brochure). There are many such success stories documented in NHS Institute publications associated with Experience Based Design.

    More tips that can also help you enhance the Resources dimension can be found in other sections…  

  • Go out of your way to provide emotional support for innovators. 
  • Start a ‘Not Invented Here’ program where leaders, managers, and staff are supported to seek out knowledge and ideas from outside health care that can be adapted to address key organizational challenges. 
  • Set out organization- or system-wide innovation challenge topics that call for innovative ideas in specific areas of need. 
  • Consider goals, contracts, annual appraisals, personal development plans, or job descriptions that require people to try out a number of innovative ideas annually and report back on what they have learned. 
  • Distinguish between, and channel into appropriate processes and methods, issues that need (a) adoption of existing better practices from elsewhere, and (b) truly new ideas. 

 

 

NOTE: This content is adapted from "Creating a Culture for Innovation: A Practical Guide for Leaders", written by Lynne Maher, Paul Plsek, Jenny Price and Mark Mugglestone, and published in 2010 by the National Health Service (England) Institute for Innovation and Improvement.