There's widespread skepticism about the ability of the U.S. Government,
one of the world's largest bureaucracies, to innovate.
But we're finding exciting work underway in Uncle Sam, at the FDA,
the Federal Drug Administration and the VA, the Veterans Administration.
There is also great work at HHS,
the Department of Health and Human Services,
one of America's largest agencies,
where the Ignite Accelerator,
a program of the Innovation Design Entrepreneurship and Action Lab,
the Idea Lab, is introducing design thinking and lean startup methodologies.
Many projects that Ignite supports aren't
the big messy wicked problems design is famous for handling.
In fact, we love the smallness and
the non-wickedness of what ignite encourages employees to tackle.
For a closer look,
let's visit the experience of one participant in Idea,
Marliza Rivera from Arizona's Fort Apache Indian Reservation.
Through Ignite, Marliza, in charge of
performance improvement at White River Indian hospital,
realize the value of testing and retesting your assumptions in innovation projects.
White River faced a serious situation,
due to long wait times,
about one fifth of emergency department visitors were leaving without being seen.
Like many rural hospitals,
people were using the emergency room for just about
all issues, even prescription refills.
But White River's problem was magnified with
the emergency leave rate being twenty times the national average.
The patients leaving were rarely in crisis,
but treatable minor and semi urgent complaints were soon turning major and expensive.
Two thirds of emergency room visitors weren't seeking
crisis treatment and those non-emergency patients consistently got delayed,
as staff address true emergencies,
sometimes waiting as long as six hours.
When potential patients left emergency, mid-level problems worsened,
and when those problems became true emergencies,
patients often needed to be helicoptered off the reservation at White River's expense.
Nationally, about one in three patients who leave emergency without being seen,
require crisis treatment within two days.
Discovering HHS's Idea Lab and sensing an opportunity,
Marliza pulled together a team of
White River employees and sought ideas for utilizing Ignite.
One idea, an electronic kiosk to improve
the emergency room process and reduce wait times was selected as an Ignite finalist.
White Rivers' innovators had discovered
the kiosk benefits at John Hopkins Hospital in Baltimore.
There, a patient electronically signs in upon arrival and
the electronic system immediately informs other issue related hospital departments,
the pharmacy, specific physicians, testing laboratories.
Besides saving administrative time,
the kiosk also speeds the process of
identifying the best medical approach for any particular patient.
Ignite leadership of course,
is aware of the risk of starting with solutions at hand, like Marliza's kiosk.
It in effect, minimizes the what is question,
and the ease of re-framing any challenge.
Often, what innovation teams see is the problem,
much less its solution,
might not address the actual stakeholder needs.
It's the cart before the horse,
but Ignite has to win all these hundreds of applications somehow.
Hence, the White River team had an initial aha moment,
almost the instant they arrived at Ignite's three day boot camp.
The boot camp opened by challenging participants to re-examine their definitions,
of whatever problems, by questioning any and
all assumptions on which their winning solution was based.
Marliza and Elisa Cardona,
who had arrived in Washington,
were confident they were on the right track.
They knew the wait time problem was significant,
and they knew the kiosk idea best addressed it.
Here are Marliza's words.
We were there thinking we knew what we were going to do,
and nobody was going to change our minds,
that this kiosk is what we needed.
We knew these great places were doing it and it's the best thing ever.
One of the first things Idea Lab taught us was,
challenge your assumptions, challenge them over and over again.
And we learned to not be stuck in one place thinking this is the end-all, be-all answer.
If you question everything,
you're going to probably end up in a better place,
and with something that is more fitted for what you really need.
You've got to be willing to give up the ego and
give up the idea that was set in stone and work through it.
You've got to ask the hard questions.
Ideas that fail can often be traced to
some supposition we made about the world that later proved false.
Paying careful attention to what we are assuming is true,
and looking for ways to test those theories,
is the surest method of reducing the risk of new ideas.
We'll learn how the White River team reassessed its assumptions.
But as Marliza said,
you got to ask and address the hard questions.
It's always difficult but crucial.