The War on Interruptions, an Excerpt from “Switch: How to Change Things When Change Is Hard” – A discussion of innovation created at Kaiser Permanente around medication dispensing in the hospital. A lot of the innovation that may happen in organizations who have completed rollout of electronic health records may not be a new piece of software or more programming. Great validation of design-thinking.
Posts Tagged ‘innovation-learning-network’
The War on Interruptions, an Excerpt from “Switch: How to Change Things When Change Is Hard”
February 8th, 2010 | Popularity: 3% 0 comments | Leave a replyInnovation Learning Network : The Care Anywhere Tapestry
November 2nd, 2009 | Popularity: 3% 0 comments | Leave a replyAs I mentioned last week, I was impressed by the Care Anywhere concept being developed within the Innovation Learning Network.
Why? Because it describes a host of activities that organizations can embark on to empower patients where they live work and play. The projects are not tied to a financing model or a certain organization, which makes the tapestry appealing not to me, and hopefully to you, too.
This is a pre-release copy that the ILN is allowing me to post here. Enjoy
Innovation Learning Network In Person Meeting – Boston
October 28th, 2009 | Popularity: 4% 2 commentsI enjoy participating in the Innovation Learning Network because it brings parts of health care and other industries interested in the improvement of the art, science, and technology we use in health care rather than in those things themselves.
Plus the people are great; and I don’t mean “great to spend time with,” I mean challenging to me in ways that gently reboot the kernel here and there. One of my favorite quotes is from Marilyn Chow, RN, DNSc, FAANVice President of Patient Care Services.
Care Anywhere, my second look
Unlike the last meeting which was held at the Steelcase Learning University, this one was more inwardly focused, on ourselves. And, away from the glow of Steelcase Nurture, I got a second glimpse of CareAnywhere, which is a cross-organizational concept this group has been developing over the past two years.
A nice definition has been created:
Care Anywhere exists to help me live to my fullest, on my terms by providing ubiquitous access to my health information and providers in order to maintain my health where I live, work and play.
Around the concept, a tapestry has been created, which has been filled with the innovations of several member organizations.
And guess what, a lot of them aren’t Kaiser Permanente projects.
I like this a lot. It helps with the “only Kaiser Permanente can do that (deliver care where patients want it)” conversation (see my quote from Jack Cochran, MD, CEO of The Permanente Federation about that). It also creates a realistic framework for any organization to pull from in re-imagining that care doesn’t happen in a hospital, or even in a person’s home – “live, work, and play.”
I don’t have access to the URL’s of all of the projects I saw (yet), but here’s one – Hospital at Home, which originates from Johns Hopkins University.
UnConference within an UnConference – a conversation about professionalism
The Innovation Learning Network in person meetings are tied to the concepts of UnConferences or at least not-your-standard-conference, which are provocative, stimulating, attention-holding.
A few of us, however, unintentionally had an UnConference within the UnConference, where our continuous-partial-attention was not very continuous, not very partial, to the content at the front of the room. However, not less relevant to our passion to improving health care for patients.
We had an interesting conversation about what a physician is and what it means for them to be in a room of their “professional” peers. “Professional” is in quotes because there was some discussion about the expectations of physicians versus others. In a world where “professional peer” doesn’t equal “having an MD” any more, does this change?
I don’t know the answer to this question; it was good to hear the issue raised, though. Perhaps our friends at American Board of Medicine Foundation might have thoughts on this. Or not. I think of ABIM Foundation because I know they are developing a significant competency in the area of professionalism in medicine.
After the Innovation Learning Network meeting, we went into the CIMIT Innovation Congress, which kicked off in an auditorium. Now, one thing I learned at the HealthCamp SF Bay UnConference was, “don’t have attendees attend a regular conference the day after an UnConference. They won’t sit still.” And…it’s true.
Speaking of great people
I watch some of the most interesting people I know connect at this meeting, plus at least a few new Tweeters were born. Please welcome, and/of follow Paulanne Balch, MD, Lyle Berkowitz, MD, Jan Ground, Jeff Hall, Keith McCandless, and Danny Sands, MD, and, do a Twitter/Google search for the hashtag “#iln09″ to find more. The conversation doesn’t end when the conversation ends.
Walking in Patients’ Shoes: My Home Blood Pressure Monitoring Experience
August 18th, 2009 | Popularity: 8% 4 commentsSubtitle: Innovation comes in many forms!
Attached is a series of slides that recap my experience learning about home blood pressure monitoring, by trying it on myself, using an innovative device manufactured by Microlife Medical Home Solutions, Inc., called WatchBP Home. (Note: Please see my About page for my conflict of interest and independence statements)
The whole thing was a great experience in learning about the process, and learning about learning, as I tweeted my experience as I went. On that note, I discovered in putting this together that Twitter may not be the best platform, compared to a hosted blog, to use to store information that you want to retrieve later.
I overall think this is a great case study in thinking about innovation in medicine:
- is innovation in home blood pressure monitoring in bluetooth connectivity and IP addresses?
- Is it in design and coaching/guiding that empowers patients to monitor accurately and with confidence?
Of course the two are not mutually exclusive, but what’s the balance in health information technology right now? I wrote about this a bit at the last Innovation Learning Network in person meeting. Slides are below, see what you think. Comments and questions always welcome.
I’ve prepared a link cloud of scientific articles related to the device and home blood pressure monitoring in general, which you can view here.
With thanks to the team at Microlife for allowing me to enjoy this learning experience, and fellow patients Gilles Frydman, ePatientDave, and Jan Oldenburg, for a few gentle reboots of my thinking during my learning, enabled by Twitter!
If you’d like an embeddable version of these slides, you can get them here.
Photo Friday: In the Digital Operating Room / Seattle Panoramic
August 7th, 2009 | Popularity: 12% 1 comment
I couldn’t choose a single photograph this week, so I chose two. The first is of myself in the “Digital Operating Room” at the Sidney Garfield Center for Innovation in Health Care , which I have written about previously (with an image of Jim Lewis, MD, from the Innovation and Advanced Technology Team, who’s been leading this work for Kaiser Permanente). The side by side image of the home environment (also in The Garfield Center) is a (theoretical) illustration of a future where there could be greater involvement of patients and families in their care, across the spectrum.
The second photograph is a panoramic and Quicktime Virtual Reality (Plugin required if you don’t have it: http://www.apple.com/quicktime) view of the Montlake cut in Seattle, Washington, on a gorgeous summer day this week. This week was a milestone for me in that I moved to Washington, DC for the second (and last) time, ending all of physical ties to the Seattle community (but not my emotional ones!).
“Do you Ride?” – Learning about leadership from Harley Davidson in Oakland, California
July 30th, 2009 | Popularity: 11% 0 comments | Leave a reply
Harley Davidson dealership, Oakland, California
I am back in Oakland, California, at the Sidney Garfield Center Health Care Innovation Center, this time supporting the Permanente Medical Group’s course “Medicine and Management,” which brings physician leaders from across the nation to learn about leadership in all of its facets. This includes providing great care experiences for members, recruiting and mentoring other physicians, and today’s installation of the course, techniques used in innovation.
In this morning’s session, there was a surprise trip to the Bob Dron Harley Davidson dealership in Oakland, California to learn about leadership in a context other than health care. By the way, I misspoke in my twitter feed that we were going to the Harley-Davidson factory – this is where we went, and it was no less impressive. One thing I really enjoy is learning about different ways of doing things from outside of health care.
The question in the title of the post was something we were asked by several of our tour guides – they would ask, “Does anyone here ride?” as a way to identify enthusiasts up front. Despite the fact that most patients wouldn’t call themselves enthusiasts of health care, there are (as with everything I see), parallels to health care. Although not enthusiastic about health care, I’d say most patients are enthusiastic about a great patient-physician relationship.
I was impressed by the level of interest in collaborating to create a good customer experience in all facets of the relationship – from the decision to purchase, to buying add-ons, to service. Because service is such an important part of the relationship, the service area is as clean and welcoming as the sales floor is (and service involves sales, too).
This part of the day was an introduction to observation, in the process of innovation. We were coached in asking useful, open-ended questions, and then went back to the Garfield Center to convert the observations into storytelling. We also did exercises in brainstorming (see photograph below) to acquire as many ideas as possible and sort through them.
Panoramic view of Permanente physicians learning design thinking
Tomorrow, the group will continue to learn about the skills of innovation, or design thinking, led by the Innovation Consultancy group at Kaiser Permanente. The skills being taught to this group of physician leaders are the same ones used to develop the breakthrough MedRite program, which has changed the way people think about (and do) medication administration in hospitals so that it is safer. If you look at the tools used in MedRite, they are not new computers – using design thinking, the tools are simple, effective, and can be spread easily.
I am, of course, a big fan of continuous learning, and think it’s differentiating for medical groups to teach the skills of innovation. Through the work of the innovation consultancy, and more broadly, the Innovation Learning Network, Kaiser Permanente participates in sharing knowledge across organizations, just like our members expect.
More photographs, click on any to see larger size
Innovation Learning Network 2009 In Person Meeting – Learning Innovation in Healthcare
May 8th, 2009 | Popularity: 25% 6 commentsI am back from Grand Rapids, Michigan, site of the 2009 Innovation Learning Network in person meeting, at Steelcase University Learning Center . It’s a beautiful facility and a great place to bring some of our nation’s leading health care organizations and innovation experts together.
I was given the opportunity to attend by Kaiser Permanente to think about the place of innovation and learning about innovation in medical groups, and was not disappointed. I did not leave the meeting with the answer to the question, “how should a medical group (or any group of clinicians) involve innovation in their activities to learn to be better clinicians and deliver excellent care?” I did leave feeling that the question is important to explore, though.
First some specifics:
Our #ILN09 twitterstream shows what we did step by step. On the second day, we were treated to a closer look at the work of the Steelcase Nurture team, from the way they approach their work to the “why?” it is important. Part of this tour included a very enthusiastic look at the products, given to us by Libby Ferin, Director Experience Marketing & Communications.
The thing that I noticed both in Libby’s comments and even in things like which books were selected to be placed in the showroom was an integrated belief in the importance of the role of the patient and family in care. She referred to a prototype hospital room not as a patient room, but as a patient/partner/family room.
In the room itself, note that the patient and family have a view into the electronic health record that is tied to the role of the person in the room (based on a sensor located at the room’s entrance). Every room has spaces for families to engage, in recognition of the fact that “visiting hours” are long-ago concept. The lights over the sink that blink until new visitors wash their hands are a great way for patients and families to be involved in infection control efforts in a soothing way….
Clearly, we were touring a product showroom (and I don’t endorse any third party products or services on this blog, see my about page about conflict interest and independence of financial ties), the essence of my impression is that an organization in an industry outside of health care can be a model for health care organizations in reinforcing the best ways to work with patients and families.
The look at the products was tied to a look at the process, which includes two terms I haven’t heard before, but celebrate: “Evidence Based Design,” and “Participatory Design.” We know there is evidence-based medicine. Now that participatory medicine is becoming a part of health care, it has an analog in another industry, this is good.
As an aside, I really liked the way the Nurture design team presented their process, by printing out the slides and taping them to a board. It’s simple, sets expectations for the audience, and forces a focus on images and feelings rather than words:
What are some specific content things I took away from this meeting?
- Where is design in the HIT stimulus package? Much like a municipality might have an “arts tax” on public works, I think that a portion of the resource going to place technology in health care should be devoted to supporting the richest environment for its use. This is everything from placement, to lighting, presence or absence of sound (Kristen Juel from Kaiser Permanente hosted a fascinating conversation about the role of music in health care settings).
- What is the role of innovation/design in the success or failure of personal health care? Amy Tenderich has been a leader in thinking about this for diabetes. What about high blood pressure, an activity that is highly recommended but poorly practiced? We saw a great case study of how the “fridge pack” for soft drinks dramatically increased the consumption of aluminum. What’s the “fridge pack” for home blood pressure monitoring?
And on the deeper question…innovation in health care and among clinician groups: I think there’s a role for both learning about the techniques of innovation and applying them to solve problems in health care, and patients and those who care for them (physicians, nurses, allied health) should be involved, especially those closest to the patient(s) and their families.
I don’t know of organizations outside the Innovation Learning Network supporting exploration of this question and some of the answers, so from this perspective it was a great experience. If any of the readers of this blog know of other organizations stimulating these discussions, please feel free to post that information in the comments, or your answer(s) to the question about how and why medical groups or clinicians should integrate innovation learning and skills into their work.
Photo Friday: Not a Workstation, a Walkstation
May 8th, 2009 | Popularity: 20% 1 comment
This week’s photograph was taken by Kristen Juel using her mobile device (hence the blurriness – original photo posted at Twitpic here) of myself and Margaret Laws, Director of Innovations for the Underserved Program for The California Healthcare Foundation, during one of the open space networking sessions at the Innovation Learning Network in person meeting in Grand Rapids, Michigan.
The topic of this session of open space networking was, of course, the walking meeting, which is a simple innovation that can transform everything from business conversations to clinical care (imagine a medical center equipped with a sound insulated walking track in its perimeter, to allow clinicians and patients to walk and talk about their daily lives).
These workstations, called Fitwork, are manufactured by Steelcase and allow users to walk at up to 2 miles per hour, while working on their computers or talking on the phone.
There are so few reasons not to have walking meetings, why not try one this week? I’ve compiled some of the evidence behind their benefits along with a handy guide to getting started.
Gathering with the Innovation Learning Network in Grand Rapids
May 6th, 2009 | Popularity: 19% 0 comments | Leave a replyI am here in Grand Rapids Michigan, for the in person meeting of the Innovation Learning Network , which:
The Innovation Learning Network (ILN) brings together the most innovative healthcare organizations in the country to share the joys and pains of innovation. Its purpose is to foster discussion on the methods and application of innovation/diffusion, ignite the transfer of ideas, and provide opportunities for inter-organizational collaboration.
The list of organizational members is on the home page. This meeting is being held at / hosted by Steelcase , the office furniture manufacturer. I was excited to come to this one (and I was not disappointed), because I have heard about Steelcase’s work in innovation, and when I went to go visit the Institute for Family Health in October, 2007 Neil Calman, MD, told me then about the Nurture product family. I’ve been intrigued since then….
The team managing the ILN have been very open and receptive to new communication modalities (of course), so have encouraged live tweeting of the event, which you can access here. As was done at the Health 2.0 Conference, they projected the live tweets in the room on the wall. This feature will probably be embedded in a lot of conferences to come.
On day 1, we went through a gallery of innovations prepared by members of the network, and got a brief introduction to the Nurture line and the philosophy behind it.
I was especially delighted to sit in the prototype “consultation room,” complete with electronic health record mockup, that demonstrates that through research, the Nurture team, in collaboration with the Mayo Clinic, found that optimal placement was with the patient and the physician sitting next to each other. The philosophy is reflected throughout other parts of the line (discussion tomorrow).
The other interesting thing that has been done is a randomized control trial, comparing ambulatory consultations performed in a room like this (pictured below), to a traditionally situated room, with a corner desk and computer in between doctor and patient. Finally, evidence based design in the era of Health Information Technology…..
