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Developing and Testing an Idea | AHRQ Innovations Exchange

Developing and Testing an Idea | AHRQ Innovations Exchange



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Developing and Testing an Idea

by Paul Plsek, MS, Paul E. Plsek & Associates, Inc.; Author, Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience; Former Member, Innovations Exchange Editorial Board





Developing and Testing an Idea




By Paul E. Plsek, MS, Paul E. Plsek & Associates, Inc.; Author, Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience; Former Member, Innovations Exchange Editorial BoardAn
innovative idea has no value until it is put into action. Developing
and testing an idea are the initial steps in a change management process
that will transform the idea into a reality that advances patient care.



Strategies for Change Management




The innovator who is preparing to develop and test an idea needs to
strike a balance between creative enthusiasm and realistic assessment.
During the initial stage of idea generation, it is important to suspend
judgment, avoid being overly critical, and brainstorm without
constraints. After all, creative thinking often requires that you
temporarily escape from your organization’s structures and rules. During
development and testing, however, it is time to start applying critical
judgment, and ask whether an idea will actually work. In order to
successfully implement an innovation, you need to engage your
organization’s structures and rules—at least enough to get permission to
do something that might be radically new. An effective innovator must
both “rock the boat and stay in it,” in the words of Helen Bevan, a
quality improvement specialist with the United Kingdom’s National Health
Service.1
Development and testing are key parts of the change process, because
they allow you to gradually engage the organization so it can embrace a
new way of doing things.



The literature on change management (such as the work of John Kotter2) points to factors that facilitate the process of developing and testing an innovation, including the following:




  • Have an idea champion. An innovative idea needs
    a champion to lead development and testing of the idea. The champion
    may be an individual or a group—or often a combination of both, such as
    someone who is in a leadership position. The idea champion must have
    enough power to allocate the necessary resources and ask for
    constructive participation by others.
  • Communicate skillfully. The innovator who is
    excited about an idea may forget to answer the “why?” question. It is
    essential to address the concerns of those who will participate in
    testing and who will eventually implement the change. The innovator
    should be able to explain the innovative idea clearly and compellingly
    in 5 minutes or less. (In order to better frame and clarify the message,
    refer to the list of idea development questions in the next section.)
  • Understand others’ reactions. The innovator
    must be prepared for defensive reactions and attempts to sidetrack the
    conversation in response to an innovative idea. People tend to be
    comfortable with the status quo, and they often perceive a suggestion
    about a new way to do something as a criticism of their current
    approach. The innovator should be patient with others, keep the
    conversation going, and insist on at least conducting a test that could
    convince skeptics that the idea is worthwhile.
  • Set deadlines. Deadlines can help move the
    process forward by creating a sense of urgency about change. The
    innovator needs to exert a healthy pressure to move forward, but should
    not use deadlines as a way to run over people, remembering that
    involvement is critical. Obtaining constructive engagement helps ensure
    that the idea will at least get a trial.
Idea Development



When developing an idea, the innovator needs to cultivate
support for it, while inviting constructive criticism. “Think before you
speak” is a good motto during the development stage, because most
people are better at idea criticism than idea creation. Initial
criticism of an incompletely thought-through idea can dampen the
innovator’s enthusiasm, encourage “piling on” by other critics, and
cause those who might otherwise support the idea to withdraw. The idea
champion should carefully select a small, representative group of people
who can be constructively critical, and ask them to participate in
developing the idea before it is shared more widely. Keep in mind that
idea development takes time; shortcutting the development process is a
common pitfall, and it often leads to half-baked ideas that will fail.



The goal of development is to strengthen the idea’s strong points, while
shoring up its weak points. When conducting a SWOT (strengths,
weaknesses, opportunities, threats) analysis of the idea, be sure to
address the following questions3, many of which are derived from the work of Edward de Bono4:



Strengths

  • How can we enhance the idea to increase its power or value, and make it fit our needs even better?
  • How can we demonstrate its value compared with the current system?
Weaknesses

  • Think about the weak points you have identified. What can you do about them?
  • What weaknesses does testing reveal? What can we do to improve the idea?
Opportunities

  • How can we test the idea on a small scale, and learn how to increase the probability of successful implementation?
  • What new possibilities does the idea open up? How can we capitalize on those?
Threats

  • What could go wrong when we try to implement the idea? How can we avoid anticipated problems?
  • Who will raise objections, and what might the objections be? How can we modify the idea to prevent such objections?
By working with a small development group to address these questions,
you can refine the innovative idea before talking about it more widely.
The goal is to have a well–thought-out idea that is ready for testing.



Idea Testing



Evaluation of an innovative idea will remain an abstract and intuitive
process, until you test the idea in a concrete way to find out what will
actually happen. By using the language of “testing” instead of
“implementing,” you can allay fears and lower resistance to the new
idea. Be sure to approach testing in a genuine way: You must be willing
to abandon the idea, or dramatically modify it, if the initial test
doesn’t go well. Remember that testing is a way to engage others: it
gives them the opportunity to tweak the idea and make it their own.
Encourage people to provide input during the testing process, and avoid
reacting defensively to suggestions. When people see that their input is
being used to modify the idea, they will be more likely to put in the
effort required to make the idea work, implement the innovation more
widely, and sustain it over time.



In order to learn and to gain confidence, start by testing the idea on a
small scale. This may mean testing it for just a few hours, or during
just a few cycles of the process, or with just a few patients. Here are
some suggestions for planning and conducting the testing process:

  • Consider conducting a simulation of the change. (For example,
    the Virginia Mason Medical Center in Seattle used full-scale cardboard
    mockups to test the configuration of inpatient units in a new hospital
    wing.5)
  • Choose a testing approach that is appropriate for the nature of the innovation.
    • Consider using plan-do-study-act (PDSA) cycles to refine a process improvement.
    • Consider using a more formal, small-scale clinical trial for
      a therapeutic innovation. (Note that clinical innovations are outside
      the scope of the Health Care Innovations Exchange. Also, such a trial
      may require Institutional Review Board approval.)
  • After completing the initial testing, go back to the development
    SWOT questions to address any problems that surfaced and strengthen the
    idea. Then do another round of testing.
  • Most ideas go through several iterations of testing before a
    final evaluation and a decision as to whether to “abandon and learn” or
    “implement and spread.”
  • Whatever the outcome, be sure to celebrate the result of the
    development and testing process as a contribution to your organization’s
    culture of innovation.


About Paul Plsek, MS





Mr. Plsek is an internationally recognized consultant on innovation in
complex organizations. A former research engineer at Bell Laboratories
and director of corporate quality planning at AT&T, he now operates
his own consulting practice and is the developer of the concept of
DirectedCreativity™. His health care clients have included the National
Health Service (NHS) in England, Kaiser Permanente, the Veterans Health
Administration, the SSM Health Care System, and the Mayo Clinic. Mr.
Plsek is the Chair of Innovation at the Virginia Mason Medical Center
(Seattle), an innovator-in-residence at MedStar Health (DC–Baltimore),
Director of the NHS Academy for Large-Scale Change (UK), a former senior
fellow at the Institute for Healthcare Improvement, an active research
investigator, a popular conference speaker, and a former member of the
Innovations Exchange Editorial Board. He is the author of dozens of
peer-reviewed journal articles and seven books, including Creativity, Innovation and Quality; Edgeware: Insights from Complexity Science for Health Care Leaders; and Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience.



Disclosure Statement: Mr. Plsek is an independent management consultant who advises health care organizations on innovation strategy.


Footnotes

1
Bevan H. Rocking the boat and staying in it: how to succeed as a
radical in healthcare. BMJ blogs;2013. Available at:
http://blogs.bmj.com/quality/2013/08/19/a-call-to-action-helen-bevans-blog-2.
2 Kotter JP. Leading change: why transformation efforts fail. Harvard Business Review. March-April 1995: 59-67.
3 Plsek PE. Creativity, innovation, and quality. Milwaukee, WI: ASQ Quality Press; 1997.
4 de Bono E. Serious creativity. New York: Harper-Collins; 1992.
5 Plsek PE. Accelerating health care transformation with lean and innovation: the Virginia Mason experience. Portland, OR: CRC Press; 2013.








Last updated: March 12, 2014.

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