The COVID-19 pandemic has resulted in unprecedented acceleration of new (and waiting) innovations in patient care delivery. It’s important for health care organizations to learn from the rapid transformations they are making and how it can be applied and sustained in the future. Some factors that have contributed to this rapid adoption in our health systems in recent months include alignment and urgency, flexibility, collaboration, and having a public health lens.[i]
By March, 2020, the health care system was overwhelmed with challenges created by the COVID-19 pandemic. Our health care organizations participating in the A3 Collaborative were required to adapt swiftly to their rapidly changing environment, with added stressors and risks to implementing their programs and a need to maintain or increase patient access to comprehensive medication Management (CMM) services. Although organizations join the collaborative because they embrace innovations, circumstances forced them to find creative ways to implement safe, yet effective, means to continue to support delivery of comprehensive medication management services to patients with chronic diseases, many of whom were at highest risk for serious illness and death from the virus. To capture current experiences and build on the immediacy of health care transformation, A3 Collaborative teams participated in a virtual event to surface contributing factors that foster and manage innovation, to accelerate progress. Organizations shared their stories of CMM innovation, and through facilitated group processing, the group uncovered six drivers to foster innovation.
A3 Collaborative participants were inspired by innovator extraordinaire and featured guest speaker, Dennis Wagner, who encouraged teams to embody bold goals in both work and life. Wagner, former Director, iQuality Improvement and Innovation Group (iQIIG) at the Centers for Medicare & Medicaid Services (CMS), has spent more than 30 years in civil service, using effective leadership and innovation to transform health care. He offered A3 Collaborative participants firsthand experience from the Health Resources and Services Administration (HRSA) sponsored Organ Donor Collaborative, which launched by participating stakeholders committing to and signing a Contract for Results, with the intended result to save thousands of lives a year. Dennis detailed the collaborative’s mobilization from innovation breakdown to innovation breakthrough, resulting in substantial increase in organ donations over a three-year period. Dennis’ story for innovation and his effective embodiment as a leader framed a vibrant, group processing session and was the catalyst for the developed drivers of innovation. The following are the six drivers and accompanying tactics to foster innovation; these are applicable to CMM services and across all levels of health care delivery.
Culture of Innovation
- Lead with a Bold Aim – Develop a bold goal that motivates and unites others and requires innovative solutions to meet defined goals.
- Cultivate Commitment – Create opportunities to garner a commitment to change from each person in the organization.
- Support and Promote Experimentation – challenging established routines and current beliefs to promote the identification and spread of new ideas.
- Be of the “Yes, And…” Mindset: “Yes”: acknowledge and affirm challenges, concerns and frustrations; “And”: identify solutions and maintain the commitment to bold aims.
Purposeful and Deliberate Ideation
- Understand the Problem – Always seek to identify the right problem or unmet need for the right customer.
- Believe Answers are in the Room – Breakdown silos that isolate solutions by creating a collaborative space to share ideas and best practices.
- Learn from Experience – Constantly capture “What’s is working” and “What are opportunities for improvement?” to help propel innovative ideas.
- Innovation Drives Innovation – By seeking the “right solution” to the “right problem,” new, unforeseen opportunities may surface, promoting more innovation.
Empower with Knowledge and Data
- Measure Impact of Innovation – Need an effective measurement strategy in order to articulate impact and value.
- Take the Deep Dive – Outcomes are not taken at face value. Deep dives into data to validate and acknowledge what is truly happening.
- Use Data to Identify the “Right Patient”– Leverage data to identify the patients that represent the right fit for your program.
- Make Data Transparent – Create open channels to share data and results with patients, families, healthcare providers and external partners.
- Listen to the Customer – Build the relationship with customers (e.g., patient, providers and internal leadership) in order to understand “where they are” and “what value looks like to them.”
- Look Outside your Four Walls – Form new partnerships to obtain assets and resources that are beyond the capacity of your team or organization.
- Be Flexible and Adaptable – Be willing and prepared to adapt as needs and resources change.
- Sell Innovation Through Storytelling – Stories that capture life situations and the personal journey help create empathy, understanding and buy-in for an innovation.
- Capture the “Aha” Moment – a personal experience shows the importance on the value of the service.
- Share the Voice of the Customer – The customer voice (e.g., patient, families and providers) can be more powerful than performance metrics.
- Think Value – Translating the impact of personal experiences into value propositions so others may see and hear it.
- Drive Persistently to Reach a Bold Aim– In the face of frustration and roadblocks, always maintain the commitment to reach your bold aim.
- Embrace Barriers – Barriers to change are guaranteed, so embrace them and find roads forward.
- Be Unwilling to Tolerate the Status Quo – Create an environment that doesn’t accept the “status quo” as “the way it should always be.”
The A3 Collaborative is a national learning and action collaborative that supports organizations in making comprehensive medication management (CMM) a critical part of their strategic plan and in response to the new value-based payment environment. Organizations participate in a 12-month transformational experience that guides them through the development, advancement and spread of innovations within their organizations and their CMM delivery systems. Innovation is a core element of the A3 Collaborative “all teach, all learn” model where each team works to achieve bold aims and design, build and/or grow Comprehensive Medication Management delivery systems. After defining the six drivers to foster innovation, each of the A3 Collaborative teams articulated a clear way forward to how they will immediately use one or more of their drivers in current work.
[i] . Ryu J, Russell K, Shrank W. A Flower Blooms in the Bitter Soil of the Covid-19 Crisis. June 24, 2020. Accessed July 3, 2020. https://catalyst.nejm.org/doi/pdf/10.1056/CAT.20.0321