Innovation is all the rage these days. The October 2013 issue of Harvard Business Review’s cover story was “The Radical Innovation Playbook: How to Engineer Breakthrough Ideas.” Consulting companies such as Accenture have placed a major effort on innovation for their clients. And innovation had clearly made its way into healthcare, with Duke, Kaiser, UCLA, The Cleveland Clinic, and others forming innovation teams to accelerate the pace of change in their organizations. And EmCare’s 2013 strategic planning meeting was largely focused on how best to innovate and implement (a key word we will come back to it repeatedly) strategies that differentiate EmCare and transform our practices.
Innovation is not new - it is the heart and soul of medicine and the future of our clinical practices. It must focus on improving patients’ lives, improving the lives of those who care for the patient, and creating hope for the future of both. But innovation without implementation across the entire practice is a waste of time, energy, and resources. It is important to understand the mission, vision, and strategies as the context in which the innovation efforts are embedded. Without that context, innovation can seem disruptive simply for the sake of disruption and not as serving the core values we hold.
I believe healthcare innovation must be driven by three other reasons:
- Measurably improving both the clinical and service outcomes for our patients
- Making the job of doing so easier for our physicians and clinicians who provide that care
- Creating hope for the future of our Practices
Let’s consider each one of these.
First, the patient always comes first, and our innovation efforts must always keep that at the forefront of our efforts. Whether clinically or from a service standpoint, we must always ask, “How does this benefit the patient?” And if it doesn’t benefit the patient, why are we doing it? we should be unafraid to make the results of our performance transparent and open to analysis on how they can be improved.
Second, we must also consider how we can make implementing those best practice innovations in a way in which it makes our jobs easier, not harder. Implementing scribes is an example of an innovative solution that benefits the patient and those who care for the patient.
Third, what do I mean by “creating hope for the future of our practices?”
Most of us would agree that there are fundamental elements of our daily practice which, despite our passionate commitment to our patients and their families, are sources of major dissatisfaction. We need only think about boarders, delays, bottlenecks, and shortages in order to remind us of how frustrating our lives can be on a daily basis. That requires a combination of a somewhat maniacal commitment to implementation and audacity.
One of the earliest examples for emergency medicine is an evidence-based approach to patient safety called “Creating the Risk-Free E.D.” (CRFED) CRFED is a protected, internet-based educational protocols comprising roughly 30 of the most commonly encountered and high-risk clinical entities in emergency medicine.
Following the implementation of the CRFED concept, our loss runs, loss reserves, and malpractice insurance premiums dropped 70 percent! The CRFED program now comprises both adult and pediatric modules, as well as a “Nurse’s Guide to the Risk-Free E.D.,” since it is critical that our nurses know how we intend to approach and treat these patients.While watching David Letterman’s “Top 10” list one night, it suddenly struck me that we already know the “Top 10” clinical entities constituting our risk of having a malpractice suit filed against us. Why not risk-proof our practice by developing evidence-based approaches to these patients and assuring that all of our clinicians were exposed to them and complied with them.
Dr. Thom Mayer is founder and CEO of BestPractices®, Inc., an EmCare affiliate, and executive vice president of EmCare. Dr. Mayer is recognized as one of the nation’s foremost experts in leadership and management in emergency medicine. His work has been recognized by the American College of Emergency Physicians (ACEP) as well as the American College of Healthcare Executives (ACHE). Dr. Mayer has twice been honored by ACEP as its Outstanding Speaker of the Year and three times for its “Over the Top Award.” He has lectured on key clinical and leadership issues for ACEP for each of its past 32 Scientific Assemblies. He is the Keynote Speaker for ACEP’s Emergency Department Director’s Academy (EDDA) and is the chief editor of the landmark textbook, Emergency Department Management: Principles and Practices. He has also written Leadership for Great Customer Service, Hardwiring Flow, and Leadership for Smooth Patient Flow, the latter of which won the 2008 James Hamilton Award from ACHE for the best book on healthcare leadership. Dr. Mayer is also the Medical Director for the NFL Players Association, where his work on concussions has transformed the understanding of sports concussions.
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