What’s the secret to jarring an organization from being a slow-moving giant to a nimble idea machine?
Give folks a ridiculously short amount of time — we’re talking less than 24 hours — to solve a major problem.
It might sound crazy in this city more accustomed to bureaucracy and gridlock, but it’s one of the lessons officials learned at D.C.’s Sibley Memorial Hospital last year. A year ago, they launched the Sibley Innovation Hub, a place to encourage employees come up with ideas to improve health care.
“We don’t want to ramrod ideas. We don’t want to be a bull in a china shop. But it gets you past that past hurdle where people get stuck,” said Nick Dawson, the Hub’s executive director about the tactic. “In 24 hours, you can say, ‘There’s an idea here. We have something.’”
I caught up with officials this week to talk about some of the lessons from The Innovation Hub, which they say resulted in new inventions, improved safety, better patient satisfaction scores and a design-driven culture when it comes to problem-solving.
What are some of the other lessons for the Johns Hopkins Health System hospital? Here's what officals said:
1. Try to understand what really different industries are doing: After seeing a spike in accidental needle sticks last year — likely due to improved reporting, officials said — Sibley decided to hold one of its 24-hour "sprint" events around the serious and costly health care problem. Officials started by talking to the surgical nurses. "We brought them bagels and said, 'Show us everything you can about how needle sticks happen in surgery,'" Dawson said. Before long, nurses were acting out the scenarios in the operating room for them.
Armed with the information, the Hub team raced to a local Chipotle to see how workers avoided hurting themselves as they quickly cut meat for burritos. An employee showed them a chain-mail glove used to protect their hands. The nurses balked at the idea. There was no way they could sacrifice that dexterity in their hands during surgery, they said. So dressed in their work attire, the Hub team headed through throngs of tourists to the Smithsonian National Zoo. "We cornered a reptile room worker and said, 'How do you protect yourselves?'" Dawson said.
The secret, the Hub team learned, was not in protecting the zoo workers' hands. It was in “neutralizing” the snake’s fangs by covering their teeth. The reptile team also used a call-and-response process to increase communication while handling the snakes, Dawson said.
Time ticking down, the team raced back to the hospital and — borrowing an idea from the Apple iPad cover — created specially magnetized needles that would land point side down when dropped on an array of magnets. It was a rudimentary prototype. But it was something. “When the nurses saw that, they said, ‘That could work,’” Dawson said. Sibley’s team filed for a patent the next day.
2. Discuss some terrible ideas: Back in January, the hub began a one-month project at the request of Sibley’s Chief Nursing Officer Joanne Miller to find ways to improve the hospital discharge process.
It's a difficult problem across health care as patients — anxious and still healing — forget their most important questions as they head home from the hospital. “People have been trying to take a swing with this bat for years,” said Sibley’s Chief Medical Director Lawrence Rammuno. “I’m not sure anyone has gotten it quite right yet.” The Hub team started with an idea to create a Candy Land-inspired game where patients "follow the journey" to discharge. The idea was not well-received. "People said 'That's really childish,'" Dawson said. "But sometimes you have to throw out these sacrificial ideas and say, 'Just react. We'll start there.'"
They tested having individual “discharge ambassadors” as each patient left the hospital. It worked in theory, but was totally unsustainable, Dawson said. Finally, the team examined some of the ways hotels improve guest satisfaction. Many have small questionnaire cards in their rooms, asking for feedback with suggested prompts to help guests remember specific issues they want addressed.
It inspired what was dubbed the “Ready to Go" card at Sibley. Nurses began giving a small sheet of card stock to every patient prompting them to mark which questions they had before they were discharged.
“We thought it was just a first step along the way,” Dawson said about the idea. Instead, they saw a notable jump in internally reported patient satisfaction data, not yet publicly available. Between March and May, for instance, the hospital's patient satisfaction score regarding its discharges rose to the 66th percentile of all hospitals, up from 47 in the quarter between December and February.
They are working to further improve the process, Dawson said.
3. Give a serious deadline — then g et out of the way."Sprint" challenges don't replace longer-term projects. But they create serious energy and buzz, Dawson said. They force those in problem-solving mode to consider possible solutions when they might usually find 100 reasons why it wouldn't work.
"Speed forces people to clear their minds and focus," Rammuno said. It also helps creates a safe environment where failure is a learning tool. That may be cliche in Silicon Valley — but it's still pretty new in the health care world. I asked Rammuno what it was like in the room during the needle-stick challenge. He couldn't tell me because he stayed out of the way once health workers got into problem-solving mode. “The last thing senior leadership should do is go in the room and say 'What's going on?'" Rammuno said. "We're trying to break down that hierarchy. We want them to know it's OK to try something."
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