The COVID-19 pandemic has been widely lauded for the transformative effect it’s had on healthcare delivery, as the extreme circumstances have forced through many innovations that have otherwise languished on the pilot carousel that kills so many startups.
Amidst the more systemic changes, such as the introduction of telehealth at scale, there have been various workarounds that have attempted to rapidly respond to the changing circumstances. For instance, the iComms4ICU project was developed to help COVID patients in intensive care communicate with loved ones after more traditional videoconferencing services were barred due to privacy and security concerns in many hospitals.
It’s an example of the kind of small-scale improvisation that new research suggests is the bedrock of innovation in healthcare. The paper argues that rather than the radical and strategic change that is often envisaged as typifying innovation, the majority of innovations are small and incremental improvements.
Improvised innovation
The study highlights how these improvised innovations were often crucial to allow healthcare providers to continue providing some semblance of normal service during the pandemic. While some of these innovations remained wholly local, others began to be rolled out more widely.
The authors pose the question of whether healthcare leaders can create the conditions to allow this improvised innovation to continue, even outside of the pandemic. The pandemic obviously created the perfect “burning platform” style conditions for change as an urgent need was coupled with scarce resources. Obviously scarce resources have been a factor in healthcare for a very long time, but the pandemic saw formal regulations lifted that allowed innovation to flourish.
The pandemic also created a real sense of community as people rallied around to tackle the virus. Indeed, working in healthcare became a real badge of honor during the pandemic. There were some drivers that were not unique to the pandemic, however, which may help to enable improvisational innovation after the pandemic has passed.
Forgotten places
Interestingly, these conditions often exist in the kind of places that are somewhat forgotten by leaders. The researchers suggest that when departments lack huge amounts of money, resources, and attention to bring about more radical change, they have to resort to the kind of innovations that often go unnoticed by leaders.
The pandemic also created a shortage of manpower, with senior staff often moved around to deal with the huge influx of COVID patients. This forced junior staff to step into more senior positions.
These junior staff can then innovate because they’re not encumbered with the “way we do things” so much and are able to bring a fresh perspective to the situation. Also, the thinned headcount can reduce the barriers to innovating by reducing the complexity of the department. Fewer people are needed to co-ordinate on change, or even approve it in some instances as the chain of command has shrunk.
Of course, this also has implications in terms of spreading any innovations that are created, as a lack of manpower can inhibit any dissemination of what works. The hierarchies of hospitals have also endured, with senior doctors and surgeons often the key gatekeepers for any innovation to pass before it can truly take hold.
The researchers also highlight how the pandemic focused managerial attention on particular departments, which liberated other departments from their restrictive gaze and allowed experimentation to flourish without undue scrutiny.
Skunk works
The researchers explain that small “skunkworks” style teams can be hugely effective in creating innovations as they’re not over-burdened with managerial oversight and are freer to experiment. They believe these kinds of groups emerged unintentionally during the crisis, but that they can also be intentionally forged after COVID to encourage innovation to flourish.
They urge hospital leaders to try and create such “safe spaces” for experimentation and improvisation while tracking both the successes and failures of these efforts to enable key learning to take place across the organization. It’s only when it comes to scaling up the innovations more widely that full managerial support comes into play.
Managers can also help by looking at the inevitable tension that exists between regulation and improvisation. This bureaucracy can severely inhibit innovation, and managers can do well by exploring whether this bureaucracy is really needed or can be rolled back.
Healthcare has struggled for resources for decades, and while scarcity can be the mother of invention, this should not be taken as the green light for officials to starve the sector of funds, but rather that key lessons can be learned from how innovation has flourished during the pandemic in many healthcare settings, and how the sector can change to ensure this continues after COVID passes.
