The Experts:

Dr Lynne Maher

Dr Lynne Maher is director of innovation at Ko Awatea. She is a recognised international leader in healthcare improvement and innovation, with an extensive career ranging from critical care nursing to operational and board posts at local and national level. Dr Maher has published guidance on innovation, patient experience, improvement and change management, and has worked with a wide range of healthcare organisations and charities to provide advice in these fields.

Paul Plsek

Paul Plsek is the senior visiting fellow on innovation and complexity at Ko Awatea. He is also the chair of innovation at Virginia Mason Medical Centre in Seattle, innovator-in-residence at the MedStar Health Institute for Innovation in Washington DC, and is an internationally recognised independent consultant on creativity, innovation, leadership and the management of change in complex systems. He has an extensive list of healthcare clients in the US, UK, Norway, Sweden and Canada, and has authored or co-authored eight books and numerous journal articles.

Their View:

Innovation is vital to deliver higher quality and lower costs in the complex, rapidly changing environment of healthcare.

While innovation exists in healthcare, it is not systematically applied, and the current rate of innovation is unlikely to achieve the change we want and need. Efforts at innovation in healthcare will continue to move at the same slow pace and yield the same mixed results unless we explicitly address the organisational culture required to support innovation.

Leaders at every level have a disproportionately large effect on organisational culture. By their behaviours, leaders create the conditions that either aid or hinder innovation.

Literature on organisational transformation suggests that leaders can support innovation by paying attention to seven key dimensions of an innovation culture.1,2


1. Risk taking

Innovative human services organisations, social services and healthcare organisations are willing to experiment, and are quick to take advantage of opportunities and complete balanced risk assessments. Innovative leaders are open to new ideas and emotionally supportive of risk takers. Failure is viewed as a learning process rather than something to chastise, and the only true failure is failure to learn.

Tips for creating a culture where risk taking is acceptable include sharing widely how the organisation has taken reasonable risks on innovative ideas in the past, and establishing a process to publicise and learn from ideas that ‘fail’.


2. Resources

Innovation requires access to some funding, time to spend on innovation, and empowerment to test ideas.

Reinforce the expectation that individuals and teams should feel they have the authority to act on innovative ideas and seek to understand why they might feel they do not. Turn strategically important innovative efforts into formal projects with allocated resources, and seek resources from non-traditional channels.


3. Knowledge

Typically an innovative idea combines ideas that exist elsewhere, so information and knowledge should be drawn from a wide number of sources and beyond industry bounds.

Encourage staff to look for and share new ideas from other industries, organisations or departments. Consider asking people from other industries how they might approach similar challenges or opportunities that you have.

Encourage staff to share their experiences and learning from visits or conferences widely.


4. Goals

Goals are a call for innovation which specifies what the target is, but not how it should be achieved. Goals should be tied to the organisation’s strategic plan to ensure resources and follow-through, and present a clear case for need. Time-specific goals help to focus attention on what needs to be achieved and why.

Try setting out organisation- or system-wide challenge topics that call for innovative ideas in specific areas of need, and identify and publicise strategic issues where there is a need for innovation. Leaders can also require staff to try out a number of innovative ideas and report back on what they have learned as part of their personal development plan, contract or annual appraisal.


5. Rewards

Innovative effort should be recognised. Recognition may involve thanking individuals or teams, or giving staff opportunities to spend time on projects of their own choosing or develop their own ideas. Rewards and recognition should be personalised to the individual or team involved. When rewards appeal to an individual’s intrinsic motivation and values, motivation is more easily maintained and increased.

Seek to understand what intrinsically motivates innovators, and set up structures and processes to enable peer, patient and carer recognition for innovation. Reward and recognise ‘failed’ attempts at innovation where you can celebrate learning. Be wary of competitions and grand prizes – they create more losers than winners. Instead, seek to reward all legitimate innovations and attempts.


6. Tools and methods

There are a variety of tools and methods for incremental improvement, value stream mapping and data collection. While people should be trained in these tools and methods, they should also be trained creativity, design and innovation tools as well to further stretch thinking. For example, formal training in cognitive abilities and formal brainstorming sessions are effective for increasing creativity. Training should be flexible and deliberate.

Develop a cadre of people who can facilitate creative thinking and innovation processes, require innovators seeking resources to explore how innovative their idea really is and how they could make it even more innovative, and introduce new tools or methods for innovation periodically.


7. Relationships

Each person has something to give and something to learn. Diverse teams, and an emphasis on team-based work, are common features of innovative organisations.

Create opportunities for diverse individuals to work together. Use job shadowing, short-term rotations and longer secondments to increase awareness and valuing of different way of thinking and working. Start a dialogue about what teamwork should look like and use personal style instruments to get people to honour their differences.

These seven dimensions can be applied to any collection of individuals, from an event to multi-organisation systems, where innovative output is desired. Pay attention to them and you will maximise the potential of your team or organisation to be innovative.

This article is adapted from Dr Lynne Maher and Paul Plsek’s session at Ko Awatea’s APAC Forum 2016.

The APAC Forum 2017 will be held on the Gold Coast, Australia, 20-22 September. For further information, please visit



1. Mannion R, Davies HTO, Marshall MN. Cultures for performance in health care: evidence on the relationships between organisational culture and organisational performance in the NHS. Centre for Health Economics, University of York; 2003.

2. Plsek P. Accelerating health care transformation with Lean and innovation: The Virginia Mason experience. Boca Raton, FL: CRC Press; 2014.

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