The Ergonomics of Innovation: Our McKinsey Quarterly Article on the 100,000 Lives Campaign

My colleague Huggy Rao and I just published an article in the McKinsey Quarterly called "The Ergonomics of Innovation."  We analyze an astounding effort by a small non-profit in Boston called The Institute for Healthcare Improvement (IHI) to lead a campaign to reduce medical errors in U.S. hospitals.  Their goal was to stop over 100,000 preventable deaths in hospitals over a one year period. And, although there is some controversy about the campaign's effects, it appears that they ultimately involved hospitals that included over 75% of the beds in the U.S. and exceed their goal by about 20,000 lives.

 You can get the article here at the McKinsey website (it is free, you just have to register) or here is the pdf:

Download the_ergonomics_of_innovation.pdf

Even if you get the pdf here, I suggest poking around the McKinsey site as they have lots of great free stuff.

We call this article "the ergonomics of innovation" because the IHI staff did such a brilliant job of designing the campaign so that it reduced the cognitive and emotional load on their tiny staff (about 100 people) and, especially, on the thousands of hospital staff members who participated in the campaign.  For example, IHI focused everyone's efforts on six relatively simple behaviors that had been shown to be big causes of preventable deaths in prior research.  They developed very concrete guidelines that hospitals could use to stop these causes -- which reduced load on everyone because, although the list could have contained hundreds of evidence-based practices, instead, it helped people focus their efforts and also made it more efficient for hospitals to share what they had learned because they were working on a limited numbers of problems.  IHI also created all sorts of efficient ways for people to learn and share, including a weekly "call-in" radio show that as many 4000 people a week participated in and they made it very easy for hospitals to sign-up for the campaign: all it required was a one page fax signed by hospital administrators in which they agreed to try at least one of the six practices and to provide mortality data from their hospital after the campaign was over.

This is an inspiring case because so many lives were apparently saved in a system that is often seen as both broken and impossible to change.  It gave me great hope that change is possible even when seems things seem bleak, which is something that all of us need right now given the state of the economy.  The specific long-term interest for Huggy and me is that the case taught us that -- although efficiency and innovation are two words that often seem at odds -- there do seem to be ways and times when ideas can be developed, spread, and implemented in efficient ways.  We use the term "ergonomics" because we spotted so many ways -- like ergonomically sound tools -- that were found to reduce the cognitive and emotional burden on everyone involved.  

I would love to hear any comments you have on the article, and even better, other examples and practices that combine "innovation" and "efficiency" in ways that lead to and spread better ideas, and at the same time, bolster rather than damage the human spirit.

Comments

[Nils Davis]

"Although efficiency and innovation are two words that often seem at odds -- there do seem to be ways and times when ideas can be developed, spread, and implemented in efficient ways."

Let's hope this counter-intuitive concept *does* apply to getting us out of the economic mess we're in. My particular area of interest (see my blog) is energy independence and green energy. Most analysis says that it's cost-effective (actually profitable) and the IPCC says we have to do it. Conclusion: the investment will be good for the economy, and is low risk.

But it's perceived as costly, unnecessary, and in particular, time-consuming. Just like fixing the medical system. I'm hoping for a visionary group like IHI to come along to drive this.

[Jim Waller]

Bob,

I really enjoyed the article, thanks for sharing it with us. I think it really illustrates how innovation based on a small framework can have a HUGE impact. I think that in addition to the "ergonomics" of the implementation, there was certainly an "ergonomics of emotion" that helped the implementation and success of the project, because the goal was to save lives.
Clearly, a factor of innovation is the emotional investment of the participants, which is why making the suggested processes easy to understand and easy to implement led to more participation.

I found the article very interesting. Thanks.

Jim Waller

[Mary Pat Whaley]

In 2006, I was VP of a rural hospital and was privileged to be a very small part of the 100,000 lives campaign. In that same year I was admitted to the hospital and my life was saved by a rapid response team when I stopped breathing. I agree that the IHI project demonstrates the ergonomics of innovation, although I didn't realize it until I read your article. It is often difficult to feel positive while working in the US healthcare system, but there are amazing things being done daily across the country by people who care deeply about the welfare of others.
Great job!
Mary Pat Whaley
www.managemypractice.com