The Most Important Innovation Skill

The new whiteboards in our ICU patient rooms didn't just appear one day.

The new whiteboards in our ICU patient rooms didn't just appear one day.

By Frankie Abralind

We’re building a culture of innovation at Sibley Memorial Hospital. It’s not always easy.

Back in the summer of 2016, a passionate nurse manager from the ICU (Intensive Care Unit) walked downstairs to the Innovation Hub with what seemed to be a simple problem: the whiteboards in the patient rooms were terrible. They weren’t the useful patient communication tools they could be. They didn’t have the right spaces for information, they looked ragged, and she felt Sibley could do better.  After a brief conversation to understand the scope of the project, I scheduled a prototyping session with her and her team for the next week.

A few days later, I gathered a couple handfuls of colored markers and a stack of 11x17 printer paper and walked up to the second floor. The nurse manager saw me coming. “Everyone in the break room!” she said with excitement to anyone in earshot. “We’re doing a design project!” A group of nurses and clinical assistants (CAs) assembled, curious and eager to see how they could participate. I made everyone go around and introduce themselves, then settled us in to the task at hand: reinventing this communication tool they use every day.

My role as a design coach in the Innovation Hub is to make innovators look good. It’s risky to put yourself out there with a new way to do things, and most people are (understandably) afraid failure will be hard to recover from.

The staff here are natural problem solvers. Sometimes, however, the pressures of a big institution can undermine the most well-intended nurse, CA, doctor or housekeeping staff. That’s why design coaches are so important to a fledgling innovation program that champions frontline staff. We provide training, support and facilitation, but our ultimate goal is empowerment.

I studied design at Cornell University and got my MBA at the University of Maryland’s Robert H. Smith School of Business. Expediter duty, though, may be the most important work that I do here. That simple, thankless, low-creativity work of shepherding a design project past barriers and through roadblocks is what makes or breaks it.

Armed with prototypes and notes from the conversation in the ICU break room, I went back to my desk in the Innovation Hub and drew up an aggregate prototype, still marker-on-paper, that summarized the different ideas. I walked back up to the floor to show this to the team and harvest some early feedback. “Oh, this box should move over here,” said one nurse. “Yeah, the sizing of this ought to be more like this,” said another. “Can you add a visual for this part?” asked a CA.  

Several rounds of testing produced more items for modification. Even though getting this far had taken many weeks, energy still pulsed through the team from being able to create actual mockups of something they had dreamt up themselves.  A new draft version went up. Another round of feedback came back. We were close, and the ICU team was excited. After a final round of revisions, we stood back, crossed our arms, and smiled at the result. Everyone was ready to see these whiteboards in action.

Alas, a number of barriers stood in the way. I discovered a big one many weeks after the nurse manager reported that she had placed the order with the custom whiteboard company. They hadn’t ever shown up. Feeling protective of the ICU staff and wanting them to have a smooth innovation experience, I took on the followup myself and called the vendor’s customer service person.

“You need to pay for them,” she said.

“I think we have paid for them,” I said, happy to be sharing my good news.

“Our system says no,” she said.

“Huh,” I replied. “I’m looking at the SAP (the purchasing system Sibley uses) notes and it shows everything is in order.”

“We don’t use SAP.”

“Oh! Well, you’re registered in the system as a vendor. Perhaps you have some money waiting for you somewhere that you don’t know about?” I’m nothing if not optimistic. This went back and forth for a few minutes before it became clear that we hadn’t actually paid anyone anything.

Ultimately, with other minor snafus and competing priorities, it was more than nine months from the time of the first design session in the break room to the time the boards were installed in patient rooms. Would the ICU have new whiteboards now without my involvement? Sure. They’d be the same old off-the-shelf versions with a one-size-fits-all layout. Inadequacies would slowly grate on the staff, decreasing job satisfaction and reinforcing that demoralizing “Why didn’t anyone ask us how we use it?” internal monologue.

Sibley, however, is committed to being “the role model for innovation in healthcare,” and that means not settling for the way things always have been. There’s a portrait of Clara Barton, who founded the American Red Cross in 1881, over my desk. She once said, “It irritates me to be told how things have always been done. I defy the tyranny of precedent.”

Heck yeah. We design coaches are here to support staff who take risks and defy the tyranny of precedent at Sibley. That's how we're helping create a brighter healthcare future. To provide that support, I’ve found an ounce of persistence is worth a pound of design training.

But a pound of persistence is best.