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?

1. 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).
2. 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.

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…..