‘Disruptive’ thinking at HHS improves hospital
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.