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May 17, 2017

Providence's 'Shark Tank' has yielded $3M in savings. Here's how they're trying to make it better.

Daily Briefing

Providence Health & Services' (PHS) Innovation Fellowship has generated $3 million in cost savings since it launched two years ago, but despite the success, there's a lingering challenge: Great ideas can be hard to implement. So officials are revamping the program in the hopes of launching more projects that can be put into practice, Rebecca Vesely reports for Hospitals & Health Networks.

8 steps for successful change initiatives

According to Vesely, Providence Health & Services' program for innovation is a helpful touchpoint for other hospitals and health systems. She explained that while many health care organizations are trying to foster innovation to meet the demands of a changing marketplace, it can be difficult to align innovation with an organization's strategic goals.

How the program works

Gwen Conner, director of Providence Health & Services' business accelerator, Oregon region, started the fellowship program in 2015.

The program draws fellows—known as internal entrepreneurs, or "intrapreneurs"—from across the organization. Typically, fellows are individuals at the start or middle of their career who have been recommended by higher-ups as "emerging leaders," Vesely reports.

Over the course of the fellowship, the intrapreneurs spend eight hours a week for one year working on an improvement project, along with access to data analytics and other informatics staff time. There's also a dedicated innovation fund, so the projects don't have to pull from individual departments' budgets. Traditionally, the projects were conceived and proposed by the intrapreneurs themselves, who then pitched the ideas to the rest of the fellows.

In addition to the projects, fellows also receive training on "human-centered" problem-solving skills and hear guest speakers from outside the industry, such as leaders from Whole Foods and Twitter, share their experiences fostering innovation.

In many ways, the fellowship has been a success, Conner said. For instance:

  • 57 percent of program participants in the first cohort were promoted within a year of completing the fellowship;
  • Participants reported a 100 percent satisfaction rate, with fellows saying they have learned skills and garnered the confidence to take on new projects and even transfer to different departments or divisions within the system;
  • Managers of fellows have reported major gains in innovation behaviors among participants;
  • The program has reached more than 2,000 individuals in Oregon with new approaches to care; and
  • The program has worked with 23 partners, including community organizations, technology companies, and regional organizations.

Failure to launch

But according to Conner, the fellowship wasn't as successful as it could be. She explained that while some of the ideas proposed by the fellows—such as a concussion management program and a peer network for seniors—came to fruition, several other ideas were felled by implementation barriers.

Why Brigham and Women's changed its approach to innovation

For instance, one team proposed simplifying the explanation of benefits for Providence Health & Services' health plan, but they failed to make a business case to cover the rollout of the plan, Vesely reports. And another project, a digital platform designed to help patients with behavioral health conditions, was undercut by legal challenges, among other hurdles.

Flipping the script

For the latest fellowship round, hospital officials tweaked the process to overcome any implementation obstacles down the road by having leadership at Providence Health & Services' Oregon network propose the projects, rather than the fellows themselves.

It's called the "reverse pitch," Conner said. The fellows were given a month to evaluate the pitches based on population needs, challenges, and potential impact. Of six proposals, the fellows selected four pitches:

  • Developing care plans for infants treated in the NICU that follow them both immediately after discharge and in the long term;
  • Determining how to direct ambulatory care patients to same-day points of care while cutting wait times;
  • Retaining women who give birth as customers for the health system; and
  • Addressing employee transportation, with the acknowledgement that the city has tasked employers with cutting the number of employees who drive alone to work.

After the final plans were selected, the fellows broke up into small groups that will spend the next year using their fellowship time to implement the winning ideas.  

According to Vesely, the idea was to eliminate financial and administrative barriers to implementation. "We want to make sure our innovation pilots are aligned with our system's targets," Connor said. 

Angi Frary, director of strategic accounts for Accountable Care Oregon at Providence and a member of the first group of fellows in 2015, added, "That's why we flipped it, so the business brings the ideas to the fellows."

But the most important aspect of the program remains the same, Chris Butler—partner at Evolve Collaborative, a human-centered design firm guiding the fellows this year—said. "We expect a lot of failures. And that's OK because we learn a lot from them," he said, adding that failure should never deter from future innovation (Vesely, Hospitals & Health Networks, 5/15).

8 steps for successful change initiatives

Performance improvement seems simple at first: identify a problem, then take steps to solve it. But in practice, many organizations struggle to get change initiatives off the ground, often due to four pitfalls: lack of leadership attention, poor work planning, rocky rollout, and insufficient follow-up.

This overview synthesizes years of Advisory Board research and experience into a single road map for performance improvement and defines eight steps crucial to avoiding these major pitfalls in any change initiative.

Download the Brief

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