‘Dis­rup­tive’ think­ing at HHS im­proves hospi­tal

The Washington Post Sunday - - TAKING STOCK - CASE IN POINT

The big idea: De­spite wide­spread skep­ti­cism about the ability of the U.S. gov­ern­ment — ar­guably one of the world’s most in­tim­i­dat­ing bu­reau­cra­cies — to in­no­vate, work is un­der­way that is mak­ing a dif­fer­ence in ci­ti­zens’ lives and sav­ing tax­payer dol­lars. At the Department of Health and Human Ser­vices, the Ig­nite Ac­cel­er­a­tor is invit­ing HHS em­ploy­ees at ev­ery level to iden­tify and pur­sue op­por­tu­ni­ties for in­no­va­tion and pro­vid­ing them with sup­port to suc­ceed. Busi­ness or­ga­ni­za­tions, take note!

The sce­nario: Long wait times plagued Whi­teriver In­dian Hospi­tal on the Fort Apache Reser­va­tion in Ari­zona. Qual­ity con­trol su­per­vi­sor Mar­l­iza Rivera rec­og­nized that few Whi­teriver pa­tients had family physi­cians, so they came to the hospi­tal for rou­tine care as well as emer­gen­cies. But ur­gent ar­rivals pushed non-ur­gent re­quests to the back of queue and led to dis­cour­ag­ingly long waits. Pa­tients would leave without be­ing seen, only to re­turn days later in more se­ri­ous con­di­tion. The process was bad for pa­tients and added to the hospi­tal’s costs to de­liver care. When the Ig­nite in­vi­ta­tion ar­rived in Rivera’s email, she de­cided to act.

The three-month Ig­nite Ac­cel­er­a­tor pro­gram of­fers em­ploy­ees like Rivera an ed­u­ca­tion in de­sign think­ing (along with men­tor­ing and a small stipend) to boost projects that aim to solve agency prob­lems, large and small, with in­no­va­tive ap­proaches. Equally im­por­tant, it puts HHS’s ex­ten­sive net­work of ex­perts at their dis­posal and guar­an­tees that their ideas will be heard by some­one who can make a go/no-go de­ci­sion. Many of these projects aren’t meant to ad­dress the big, messy prob­lems we hear about. But they do make a dif­fer­ence to the ci­ti­zens who ex­pe­ri­ence the prob­lems that, cu­mu­la­tively, also add up in costs to tax­pay­ers.

Rivera and her team con­sid­ered a best prac­tice from Johns Hop­kins Hospi­tal in Bal­ti­more — us­ing an elec­tronic kiosk to sep­a­rate out true emer­gency pa­tients and quickly send non-emer­gen­cies to other hospi­tal de­part­ments. But as her team mem­bers tested as­sump­tions on their big idea, they re­al­ized that this so­lu­tion wasn’t ideal for pa­tients who aren’t com­puter-lit­er­ate. The Whi­teriver team piv­oted to the idea of plac­ing an EMT or nurse at a new check-in desk at the ER door. That clin­i­cian would direct pa­tients to the fastest, most rel­e­vant ser­vice, even be­fore sign­ing in. Quick, real-time tests of the idea pro­duced im­pres­sive results.

The res­o­lu­tion: Rivera’s team es­ti­mated that the change would not only re­duce wait times, but could — af­ter a small ER ren­o­va­tion cost­ing $150,000 — also create cost sav­ings and rev­enue of more than $6 mil­lion an­nu­ally. That ren­o­va­tion, as part of a larger re­build, is un­der­way.

The les­son: San­jay Koy­ani, HHS’s in­no­va­tion di­rec­tor, de­scribes the Ig­nite Ac­cel­er­a­tor’s goal as “lib­er­at­ing great ideas.” Best of all, it’s in­spir­ing em­ploy­ees at ev­ery level to de­velop what IDEO founders David and Tom Kel­ley have called the “creative con­fi­dence” to make a dif­fer­ence while us­ing de­sign think­ing’s “em­pathize, ideate and it­er­ate” process to avoid spend­ing re­sources to solve the wrong prob­lem.

Ig­nite helped the Whi­teriver team de­velop that creative con­fi­dence. Rivera’s own words cap­ture the con­cept best: “My ex­pe­ri­ence with Ig­nite will def­i­nitely help me to be fearless in ‘dis­rupt­ing’ the sta­tus quo and look­ing for new and in­no­va­tive ways to find so­lu­tions.”

All or­ga­ni­za­tions, in busi­ness and gov­ern­ment, could use more of that. Liedtka is a busi­ness pro­fes­sor at the Uni­ver­sity of Vir­ginia Dar­den School of Busi­ness. Salz­man is a writer based in Char­lottes­ville.

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