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Innovation Learning Network 2006

Innovation Learning Network:


Insights and Lessons Learned
February 2007
Innovation Learning Network 2006

TABLE OF CONTENTS

1
Introduction

Origins and Initial Goals 2

First Meeting: April 2006 3


• Open Space 3
• Subcommittee on Diffusion and Spread 4

Building the Network 5


• Relationship Building 5
• Social Network Mapping 6
• Social Network Metrics 7
• EPIC Subcommittee 8
• Collaboration within Kaiser 8

Virtual Collaboration 9
• Virtual Fridays 9
• Virtual Infrastructure 10

Second Meeting: October 2006 12


• Panel Discussion 12
• Open Space and Collaborative Projects 13
• Follow Up 14

Lessons Learned 15

Going Forward 17

For more information about the Innovation Learning Network, contact:


• Chris McCarthy, Director, Innovation Learning Network, chris.mccarthy@kp.org
• Linda DeWolf, President, VHA Health Foundation, ldewolf@vha.com
• Steve DeMello, Director of Research and Forecasting, Health Technology Center, sdemello@healthtech.org
Innovation Learning Network 2006

INTRODUCTION

If ever there was an industry that was closed-minded and steeped in its own
importance and tradition, and resistant to major change…it’s health care. I’ve
never seen an industry that is so siloed and focused on itself without looking
outside of itself.

George Burgess, MD, Vice President of Technology and Innovation,


Franciscan Missionaries of Our Lady Health System

How do you institutionalize the practice of innovation? Isn’t regimented creativity an


oxymoron? How do you allow for creativity and risk-taking in health care? Doesn’t that
sound like a bad idea?

Ten nationally recognized health care organizations have been jointly pursuing the
answers to these and other questions associated with innovation. Breaking away from
Intentional, disciplined innovating – with methodologies and typical practices in health care, scores of senior managers agreed to let go of control
theories behind it – has been neglected, from local settings all so that something exciting could emerge. The results have been interesting,
the way up to the global arena. As a result, the need is so big surprising, and offer useful guidance to other health care organizations and leaders
and so pervasive it’s numbing… it’s been obvious for so long seeking to affect change earlier, more rapidly, and better than before. The network
and yet, where do we start? that emerged to answer these questions became an innovation itself.

Keith McCandless, Consultant, Social Invention Group This is the story of the Innovation Learning Network (ILN): what was done, what has
been successful, and what the future holds. The ILN hopes that this narrative will
serve as an example to other groups planning to build collaborative networks, and will
accomplish the following purposes:

To describe the development and activities of the ILN


To enumerate the specific tools and practices used by the ILN
To comment on the relative effectiveness of the activities

Groups wishing to replicate the tools and practices used by the ILN should consult the
associated “Resources and Tools” document.

Our thanks to all the members of ILN, project staff, consultants and the VHA Health
Foundation for taking risks, trying something different, and participating in the
adventure as it unfolds.

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Innovation Learning Network 2006

We made it really clear from the onset that this was going to ORIGINS AND INITIAL GOALS
be a member-led organization.
The ILN was conceived in the summer of 2005 as a joint venture between Kaiser
Chris McCarthy, Director, Innovation Learning Network Permanente and the VHA Health Foundation (VHAHF). VHAHF hoped to bring
together a network of organizations that could create innovations, then share and
I think we’ve done very well with… helping the ILN members prototype them throughout each of their respective systems. The initial ILN charter
to create a forum for them that works… soliciting what it is called for the group of organizations to “evaluate best practices related to the
that the members would need and having it drive. selection of innovation and technology, the implementation process, and the
outcomes of these endeavors.”
Marilyn Chow, RN, DNSc, FAAN - Vice President of
Nursing/Patient Care Services, Kaiser Permanente Everybody didn’t need to be working on technology to be part of an
innovators’ network – they could be working on anything. The more important
What organization What is the role thing would be the attitude they bring. Together they could come up with what
structures are being used of project work in were the most meaningful things to work on. The principles for innovation are
for innovation? innovation? the principles of innovation, and it doesn’t matter whether you’re working on
technology or communication strategy…there are things to share and learn.

Linda DeWolf, President, VHA Health Foundation

Structures Projects During the last months of 2005 and the early months of 2006, Kaiser and VHAHF
worked to recruit health care organizations and the sponsors and champions that
would serve as primary contacts for the network. The group agreed to participate in
two in-person meetings and monthly conference calls.

A fundamental premise of ILN organizers was that members should determine the
Diffusion process and content of the group. Project leaders focused on creating an environment
that was capable of identifying compelling interests and allowing participants to act on
What vehicles are being used those interests. The approach was primarily experimental, and not prescriptive.
among members for diffusion of
innovations? One need members recognized early was for all to learn about the practice of
innovation itself – the science and the methodology behind it. Three primary elements
emerged – diffusion (spread), structures, and projects – and formed the core of the
…science of innovation, the science of chaos, the science of ILN’s work and learning about innovation.
complexity. When I first heard about that in the late 80s, early
90s, and I thought, “what? That’s weird.” But in fact, quantum The fundamental purpose of the ILN has remained consistent throughout the group’s
mechanics has had some breakthroughs that Newtonian lifespan: the group would facilitate the spread of knowledge from one health care
physics just didn’t cut. It’s the same thing with our thinking. organization to another. Yet what resulted was even larger than what was originally
planned. In addition to finding great ideas within each organization’s existing
David Tew, Vice President and COO, Bergan Mercy Medical operations, the group found an effective infrastructure for innovation: the network that
Center they themselves had created.

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Innovation Learning Network 2006

FIRST MEETING: APRIL 2006

In April, the group met in person for the first time at CIMIT (Center for Integration of
Open
Medicine and Innovative Technology), an affiliate of Partners HealthCare in Boston.
Space
Structures Projects The meeting structure contained two essential components: the use of Open Space
Technology meeting design (Open Space), and an explicit focus on building
relationships among participants.

Open Space. Chris McCarthy, the Director of the ILN, Maggie Hentschel, Project
Diffusion
Analyst for the ILN, and Keith McCandless of Social Invention Group had chosen to
use Open Space for the group’s first session in order to facilitate the development of a
member-driven network. According to one expert, Open Space is “a self-organizing
Open Space increases responsibility and freedom for practice of individual discipline and collective activity that releases the inherent
1
participants. To be sure, what emerges is only a guess. And creativity and leadership in people.”
to even do it, you have to accept uncertainty and work with it
– trusting that people will organize themselves in a better way At the beginning of the day, all participants are invited to announce a topic of their
than you could have anticipated or controlled or planned. choice to discuss at some point during the day, and post that topic on the wall-size
agenda. Participants are free to join the discussions they find compelling, and to move
Keith McCandless in between discussions as they see fit – the only rule is to follow your passion. The
principles of Open Space are simple and direct:

Whoever comes are the right people


Whatever happens is the only thing that could have
When it starts, it starts
When it is over, it’s over

These principles are supported by the “Law of Two Feet”: participants must go to
where they are learning or contributing, and are responsible for ensuring that their
own needs are met.

At the end of each discussion, a designated Recorder enters a report-out into a


It also established, I think, by the methods used, that the website that all participants can later access. The day closes with an hour-long
organization itself was highly flexible and open to new discussion where participants can share highlights, “ahas,” and key learnings.
ideas… Maybe to all of us. We were kind of scratching our
heads saying, “what on earth are we doing here?” But by the
time it was finished, I knew I had a much better idea of what
we were doing and why.

George Burgess
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Anne Stadler, annestad@comcast.net

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Innovation Learning Network 2006

The initial ambiguity of the meeting structure


allowed all the participants to express their Lessons learned
passions and talk about the areas of interest that
really mattered to them. This facilitated both the Let the members choose
development of relationships between members the direction.
with common interests and a general awareness
building of the variety of issues that were now
open for exploration.

The ILN staff had hoped that the discussions held in April would lead to further
collaboration – that participants would utilize the website as a gathering place for
further conversation and eventually, collaborative project work. A handful of the topics
resulted in additional discussions, meetings or activities.

Notes from the diffusion surveys An Example: Subcommittee on Diffusion and Spread One of the discussions
during the April meeting focused on two topics: teaching styles that can accelerate the
“[One innovation] started to spread natural[ly] and then implementation of an innovation, and the process of diffusion. A smaller group of
leadership acknowledged it as a best practice and members continued to converse and explore the topics further over the summer. The
mandated it for everyone to do.” group had several conference calls, in which they discussed methods to capture
“Implementation can drive innovation which in turn lessons from ILN members on best practices of implementation and diffusion. They
accelerates implementation….as the ‘inventors’ are the eventually settled on a survey, in which members could interview another individual
users.” within their organization about an innovation success story.
“Implementation is the responsibility of those who created
the project and asked the question. The design team The group’s activities slowed a bit over the summer, but moved back into action as
considers implementation throughout the process by the second in-person meeting in October neared. After the meeting, in which
maintaining a primary focus on the human aspect of the members mentioned the work they had done so far and encouraged other ILN
desired/intended change.” participants to contribute to the survey, the group began to gather results.

The lessons learned through the survey will certainly apply to other ILN activities
going forward. Although there may be no further activity among this particular group,
the knowledge gained through their work will become part of the dataset held by the
network that will affect future projects.
Structures Diffusion Projects
survey Some of the other discussions that began in April never resumed; some re-emerged
at the meeting in October or in subsequent conference calls. By building a network
with many interpersonal and inter-organizational relationships, the ILN created for
themselves an ability to tap into the collective knowledge, interests and experiences of
Diffusion the group, at a time when it is right for each individual member’s particular situation.

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That’s why I think to some degree it is important to have the BUILDING THE NETWORK
in-person contact. You know, you can talk over the phone but
it’s so easy to then, once you get off that hour phone call, to The group soon learned that collaborating on innovations was not something that
get sucked back into your daily organization and life. And could happen in a productive manner immediately. Group members needed time to
when you see each other and you spend some time together, get to know each other and understand each other’s strengths and interests, so they
you actually say, “OK, what are we going to do to really make could determine who to collaborate with on what projects. Relationship building turned
this happen, really make this come together?” out to be the central principle of a successful collaborative network.

Donna Deckard, Vice President of Implementation/ Relationship Building. One of the difficulties of creating a successful network is a
Optimization - KP HealthConnect, Kaiser Permanente function of time – finding the time to create
personal connections outside of each member’s Lessons learned
existing duties and official job descriptions.
Developing meaningful connections between Work hard to build
organizations and individuals required a personal personal relationships.
investment on the part of the participants. Make it fun!
Additionally, participants needed to feel trust
before they were willing to collaborate.

The in-person meetings were thus designed with a trust-building component in order
to truly cement the relationships between the participants. In addition to the formal
piece of the meeting in April, the group also gathered for dinner, where participants
were able to get to know each other personally, as well as professionally.

In the April meeting we had this great dinner. And next thing you know,
everyone’s putting on these leopard robes and having this really great
moment together where they really bonded and were laughing and sharing.
That one moment carried them through to the October meeting.

Chris McCarthy

I thought the Boston hotel was fabulous. I’d never been in a The special nature of the meeting – the platform for members to be candid, the social
hotel with robes that were leopard-skinned, leopard colored. activities, and the lack of structured expectations – led the members to develop a
That really made that first meeting, that hotel, I think was different kind of bond with each other than they would at a typical conference or other
such a great contributor to that. I know that’s strange meeting. After the two days in Boston, members reported that they felt freer to contact
sounding. It broke what would be an ordinary meeting into an each other with questions about each other’s projects and work on collaborative
innovative meeting that was not the same as every other one. efforts. Chris and Maggie worked to connect ILN members with common interests and
challenges, and made sure to include social activities in the October meeting, further
George Burgess, MD cementing the developing bonds. As those relationships developed, the network
became more distinct – a creative and adaptive organism of its own.

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Social Network Mapping. At the end of the April meeting, Keith McCandless had
asked the ILN members to put one hand on the shoulder of another ILN member with
whom they wanted to work in the coming year. The results were several different web-
like formations that allowed the ILN members to visually recognize the potential value
of the connections they had made.

After several months had passed and the network had further developed, the ILN staff
hoped to recapture this visualization in a more robust, quantifiable way. Keith brought
forward the concept of social network mapping – an emerging technology-based
method used for defining personal interactions and building relationships.

Keith introduced ILN project leadership to June Holley, an expert in building networks,
who educated the group on the concepts of social network mapping. June also
demonstrated a visual software tool that tracks the ties between members of a
network. ILN leadership agreed to pursue developing metrics about network
Before ILN composition and changes over time using the tools.

In September, the group participated in a survey that asked a series of questions


about the connections made within the network:

1. Prior to the start of the ILN, who did you work with or exchange information on
a project, topic or shared interest?
2. Since the ILN started, with whom have you shared ideas or worked on
projects that were catalyzed by your ILN interactions
3. Who has inspired you or given you new ideas since the ILN began?
4. Who would you like to work with over the coming year on an ILN-inspired
project or topic?

The results came in several network maps, which show the blossoming of the network
over time. The maps contain many individual stories of collaboration and connections
made. The process was repeated following the October meeting, and maps updated.

The group realized that the maps could prove a great tool to determine where
connections could be made both within and between organizations. As a service to
the member organizations, the ILN contracted with June Holley to learn about how to
Anytime you want to do something that has more impact, that create network maps for individual organizations and “weave the network” – a
usually means there’s more risk involved. technique used by community development organizations to make better connections
between organizations and individuals – using data from the maps.
June Holley, Smart Networks Weaver

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September 2006 Social Network Metrics. The network maps on pages 6 and 7 present obvious visual
differences – notice the increased size and density of each succeeding version. June
Holley also introduced some specific metrics that quantify the nature of three critical
dimensions of the network:

• Integration: Who are network leaders? How healthy is the network? Are we “in
the thick of things?”
• Awareness: How likely is it that you know what is going on far from the core?
• Connector: To what degree are the “clusters” (in this case, the institutional
groups) connected to each other

Measures of integration, awareness and connector were calculated for the pre-ILN,
September 2006 and 2007 time periods. In addition, a determination of “potential”
could be made – the likely maximum level that could be achieved with the existing
network. The results were very encouraging:
2007
Metric Pre-ILN Sept 2006 2007 Potential
Integration 184 492 761 810
Awareness 16 29 37 40
Connector 138 355 1099 1454

The level of integration – the fundamental index of network health – has nearly
quadrupled from pre- ILN levels. As importantly, the incumbents have even greater
upside -- the potential of the network is approximately 50 points higher. With
awareness, more significant growth occurred in the early months of the network, with
slower growth as members were added at the second group meeting. In contrast,
connector metrics – the measure of relationships between the member organizations
– grew dramatically after the second meeting, and shows significant potential for
continued growth.

The maps also reveal details about how well Lessons learned
the ILN has penetrated within each
participant organization. As each organization Sponsors and
is represented by a different color, it is champions need to play
immediately apparent which organizations active roles.
have been successful at inviting more
individuals to participate. In order to
successfully diffuse innovations further into organizations, individual sponsors and
champions will need to work to build connections between other ILN members and
staff within their own organizations.

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I wish you could solve for ways I could stay even better An Example: The EPIC Subcommittee. Woven into the network maps is the story of
connected. three organizations who shared experiences with implementing an electronic health
Marilyn Chow record. Evanston Northwestern Healthcare, the Cleveland Clinic and Kaiser
Permanente had all recently begun implementing the same information system. At the
first in-person meeting in April, Bobbi Schramek of Evanston, Mary Partin of the
Cleveland Clinic, and Donna Deckard of Kaiser connected about their experiences
with the implementation, and decided to stay in contact over the course of the year to
continue to share challenges and lessons learned.

Although the group initially had difficulty finding time to connect, they have since held
two conference calls to discuss areas of common interest, including some challenges
all three had encountered. They hope to help each other wade through the thorny
issues of configuring the applications, avoiding common pitfalls, and sharing best
practices. The group has also discussed possible engagement in conversation with
the vendor, utilizing their combined market share to pressure the vendor to make
necessary changes.

People are writing a list of questions that they’re sending to Bobbi, that whole
Structures Social Projects team is going to be on the phone, the implementation managers are going to
Network be on the phone. I think it’s going to be really rich, what’s going to come of it.
Mapping
Donna Deckard
Diffusion
An Example: Collaboration within Kaiser. The maps also capture increasing
integration that occurred within individual organizations. Several of the ILN member
organizations are very large entities with hundreds or thousands of employees, many
of whom may never meet or collaborate. The forums for information sharing that the
ILN promoted brought many of these individuals together for the first time. Jing Wang
of Kaiser reports that she connected with Sean Chai and Scott Heisler, two Kaiser
employees in different areas, for the first time to work on mobile sensors. Jing writes
that she found “effective knowledge sharing through [the] social network.”

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People were actually really excited to share their projects. It VIRTUAL COLLABORATION
seemed like people were proud to be able to report out on the
different types of things they were doing. Maintaining connections between ILN meetings became a high priority of the project
team. They developed two primary vehicles: Virtual Fridays and a Virtual
Maggie Hentschel, Project Analyst, Innovation Learning Infrastructure for collaboration.
Network
Virtual Fridays. In April, after the conclusion of the Open Space portion of the in-
person meeting, CIMIT staff had given ILN members a tour of the Center along with
several presentations about the group’s current initiatives. These presentations
piqued the interest of many ILN members, who requested a forum for learning about
innovations at other organizations. The ILN staff thus came up with a web-based
solution.
Virtual Projects
Structures
Fridays Chris had come up with this idea that we have people present out on Fridays
for a quick forty-five minutes the specific projects they are working on. It’s not
mandatory to attend. These would be recorded and posted, and so people in
the network could access the presentations at a later time.
Diffusion
Maggie Hentschel, Project Analyst, Innovation Learning Network

The presentations became known as “Virtual Fridays” – conference calls that included
Some of the connections resulting from Virtual Fridays: a web-based component for presenters to share PowerPoint presentations and other
interactive components. The Virtual Fridays rapidly showcase a specific topic in detail
• Guy Chicoine (Kaiser) connected Anna-Lisa Silvestre in a way that keeps the audience interested and engaged, maintaining a personal feel.
(Kaiser) to Ginger Price (Veterans Affairs) on the use of These interactions helped the members to maintain the relationships they had begun
online services to develop in April.
• Ann Hendrich (Ascension Health) and Jeff Norton (CHI)
connected with Chris McCarthy (Kaiser) about Nurse The Virtual Fridays also proved an easy way to
Knowledge Exchange introduce the group to the variety of innovations Lessons learned
• Jim Noga (Partners) and Christi Zuber (Kaiser) connected at each organization and float many ideas and
about green facility design interests to the surface. By fostering the Create an idea pipeline.
• Eric Cleveland (Mayo Clinic) connected with Andrea development of trust and professional credibility
Werner (Bellin Health, a non-ILN participant) on throughout the network, the Virtual Fridays
prioritization models resulted in many connections and
• Oyweda Moorer (Veterans Affairs) connected with collaborations between individual ILN members
Marilyn Chow (Kaiser) and Ann Hendrich (Ascension and their organizations.
Health) about nurses’ work environments
The Virtual Friday archive also allows organizations to access helpful information at
the right time. After Chris McCarthy presented the first Virtual Friday on Nurse

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We need to allow us to sample and to look at the menu, Knowledge Exchange, an innovative process to improve nurses’ exchange of
rather than having to order the entrée to taste it. information during shift changes, Ann Hendrich from Ascension Health contacted
Chris immediately to find out more. Individuals at the Mayo Clinic and CIMIT also
David Tew expressed interest in the topic, but at a much later time; Chris was able to direct those
individuals to the archive for the complete presentation. The archive thus enables the
ILN members to access information when a particular issue has an immediate need,
and does not require every innovation to be applicable at the very moment in order to
diffuse from one organization to another.

Wiki Projects
Virtual Fridays were the most successful collaborative tool used over the course of the
Structures
Website ILN; some members have expressed interest in hosting Virtual Fridays for their own
List-serve organizations’ staff.

Virtual Infrastructure. A number of ILN members have emphasized the importance


Diffusion of having an active virtual infrastructure to allow not only for connecting with other
members, but also as a host space for joint project management. The ILN staff tested
several different virtual collaborative spaces as a means of keeping the network
connected, including: an email list-serve, a conventional website, and a wiki – a
collaborative website that allows all members to post and edit content.

The wiki has certainly been used by the members Lessons learned
on a far more regular basis than the previous
website, yet still has not taken hold as a consistent Have an active virtual
tool for members. This reflects both the relative infrastructure.
inexperience of members with this form of
collaboration, and the early stage of most of the
group’s collaborative projects.

The list-serve has been utilized relatively frequently, and presents the advantage of
allowing members to push information out as well as pull information in from the other
members. ILN staff expect that traffic will increase significantly as the network grows.

The ILN is changing from a network based on disjointed, one-time encounters to a


group that engages in a continuous stream of contact. Over the next year, the ILN
faces the challenge of finding or creating a virtual collaboration tool that will facilitate
both relationship-building and content generation, without excessive contact.

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SECOND MEETING: OCTOBER 2006

In October, the group met in person for a second time, at the Sidney H. Garfield
Health Care Innovation Center, Kaiser Permanente’s recently opened innovation
laboratory in San Leandro, California. Three elements drove the meeting: the opening
of the session with a panel discussion; the continuation of Open Space; and a
sharpened focus on collaborative projects.

Panel Discussion. Activities began with a panel discussion of innovators from


industries outside health care. The idea for this panel had initially emerged in the April
meeting during a group discussion on “Human-Centered Design.” Members of this
craigslist group recognized that there were many lessons to be learned from other industries,
and hoped to enlist innovative leaders from other fields to learn specifically about their
practices of engaging with their customers.
ILN asked the panelists: what should health care work on?
The discussion featured five panelists:
Robin: My mom has a variety of illnesses and I took her through
the hospital. Whenever I had a question, my mom felt it wasn’t • Robin Boyar, Senior Director of Research, Electronic Arts
our place to ask. I would like her doctors to help her to be a more • Jim Buckmaster, CEO, Craigslist
informed consumer. Be more interactive, want your patients to • Joy Mountford, Distinguished Scientist and Senior Director in User and
ask questions. Experience and Design – Yahoo! Communications, Communities and Front
Joy: When I was in the hospital, I wanted to know what was Doors business areas
happening and when and why – what is the task flow? I want to • Sarah Snudden, Consumer Packaged Goods, Clorox
make sure I’m on track and okay. I want unbiased advice but • Ron Volpe, Customer Vice President – Supply Chain, Kraft Foods
don’t ask me to be intelligent while I’m in the hospital because I’m
not feeling well. Make it simple for me to understand, with The panel discussed how each of their organizations view and practice innovation,
pictures. along with how they have handled the barriers that prevent innovation. The group also
Ron: My kids are 20, 16, 3 and 1. I want an opportunity for them spoke at length about how they incorporated customer feedback and opinions into the
to get information they can use throughout their lives – an design of new products and processes. Joy Mountford of Yahoo! emphasized the
educational process that’s built into experience of going to the importance of storytelling when bringing innovations to life, a subject that members
doctor. often reiterated throughout the two days of discussions.
Jim: Push the needle from curative to preventive. Open the
system up to user reviews. The American medical system is Several other themes discussed during the panel would emerge throughout the next
screwed up in terms of incentives - why can’t we talk about two days. By exposing the ILN members to perspectives from outside their industry,
national health care? We can lean on IT trends to push the panel helped the group to think outside of healthcare’s usual norms, kicking off
improvement. two days of creativity and excitement.
Sarah: Reduce my barriers to entry. I can’t overemphasize the
need for accessibility. I’d also like to be able to give feedback to
my dad’s doctor from far away. Balance optimism with reality.

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Open Space and Collaborative Projects. Attendance at the October meeting


included large cohorts of returning and new members, requiring a balance of
consolidating the group and advancing specific agendas. The members perceived
themselves as more focused – many came to the meeting with the question in their
mind: “What are we going to do this time that will lead to some specific action?” The
content that had started to emerge in April and had developed through the Virtual
Fridays began to coalesce into common areas of interest with specific related
projects.

The first day resembled the April meeting very closely in set-up: after an initial tour of
the Garfield Center, participants were asked to choose topics that they wanted to
discuss. The second day, however, had a more distinct action-oriented component.
Keith McCandless, who facilitated the meeting, asked the group to select a few topics
that had enough momentum during the discussions to move forward and become
group projects.
Lessons learned
Four groups emerged. Using a template
provided by Keith, they created concrete game The real value will come
plans for next steps, with goals, timelines and from collaborative
leaders. These included: projects.

• Personal Health Records - a group led by David Tew of Alegent Health Care
that aims to make personal, portable, electronic health records nationally
available within two years

• Virtual Simulations - a group led by Christi Zuber of Kaiser Permanente that


seeks to use virtual simulations to support collaboration and innovation
between and among providers and patients

• Innovation Labs - a group led by Jennifer Ruzek of Kaiser Permanente that


plans to share the resources of their innovation laboratories and workshops

• ILN 2007 - a group led by Chris McCarthy that began planning the work of the
ILN over the next year

It is living… really is a living network.

Marilyn Chow

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Follow Up. Since the meeting in October, each of the projects has progressed. With
the term of the VHAHF grant coming to a close, the ILN members have taken steps to
Virtual keep the network financial sustainable. By November, eight of the ten original
Simulations organizations had committed to supporting the ILN for the next year, a testament to
Structures Innovation Projects
both the potential that participants saw in the collaborative work and the value that
Labs they had already received from having access to each other.
Personal
Health Records The personal health record group has continued to hold regular conference calls. After
Diffusion an initial investigation revealed a wealth of existing available products, the group
decided to compile a review of the current major offerings. The group assembled a list
of available products, and created a tool to evaluate these according to the standards
Personal Health Records survey they had developed during the October meeting. In a Virtual Friday, the group
updated the ILN on their progress and enlisted members’ help to evaluate products.
The group hopes to publish these results soon, and leverage their findings to engage
in discussions with other stakeholders, such as employer groups, to make Personal
Health Records more widely available.

The virtual simulations group agreed to evaluate the Second Life website as a
potential platform for development. Since the October meeting, the group has held
two virtual meetings within the Second Life platform to begin investigating the
potential applications of this avatar-based environment. One of the committee
members has instigated discussions with an executive of Second Life; the group
hopes to learn from her how other health care organizations have used Second Life.

The innovation labs group hopes to utilize each other’s facilities to discover innovative
Second Life screenshot solutions regarding medication reconciliation. The group is still coalescing and has yet
to determine how that plan will unfold; first steps have included meetings between
CIMIT and Garfield Center staff in Boston.

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This is about diffusion, and the water will seek its own level LESSONS LEARNED
on the one hand. On the other hand, a rising tide does not lift
all boats. The boats that it lifts are the boats that are Innovation does not need to occur within a network – it can occur within a single
seaworthy. organization. Yet the ILN members found an immense diversity and richness of ideas
that they could tap into by being hooked into this network, facilitating the innovative
David Tew process.

I think that innovation is really a science of quality. It’s a Innovation is a dynamic interplay of structures, projects and diffusion – the ILN
process in which rich discovery and self-discovery and all became a successful innovation because it grew to exhibit all of these. The set
sorts of spin-off innovations are occurring as you’re trying to structures included Open Space meeting design and Virtual Fridays, from which
get to this deliverable. And most of that is an invisible thing to collaborative projects grew; these subsequently diffused into organizations via the
the senior leaders that hold the purse strings or whoever Virtual Fridays and the members’ relationships – the network itself.
originally started this thing.
Several ideas have emerged about how to build a successful network.
Keith McCandless
1. Requiring the members to decide on the direction and activities of the network
themselves will result in a more engaged, participatory group than might arise
Open Space Personal Health Records from a group that has been given a predetermined agenda. The ILN’s initially
Network Maps Virtual Simulations vague agenda fostered creativity and energy among the members, who used
Email & Web Tools Innovation Labs the open space forum to surface the issues they most wanted to address,
then expressed an extraordinary willingness to tackle these issues.
Participants cannot be given freedom without bounds, however; they must
also have responsibility for ensuring the success of their homegrown network.

2. Relationship building is the central principle of a successful network. In order


for the members to truly collaborate, they needed to feel like they could trust
Structures Projects
each other. That perhaps may be why most of the discussion topics that
arose at the April meeting failed to take off – the network was not yet mature
enough. Many members wished that the second in-person meeting had been
held sooner after the initial meeting, in order to reinforce those initial
Diffusion connections made.

3. Make it fun! Every single member of the network had a full workload before
Virtual Fridays they began participating in any of the ILN’s activities. To find time to devote to
Diffusion Survey the ILN, members must truly enjoy the work. From the very first meeting, the
ILN staff set a tone that was playful and energetic, and the members
responded in kind.

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4. Each organization’s sponsors and champions need to actively push


information out within their own organization and pull in new people to
participate. The social network maps demonstrate how well connections, and
subsequently information, spread throughout individual organizations. As the
next year of work begins, the ILN will need to clearly define the roles and
expectations for sponsors and champions, to ensure that value reaches many
areas of each organization. Greater diffusion into the member organizations
will also help to make a more compelling case for continuing the ILN’s
activities and funding.

5. The discovery of common interests will come from surfacing many initial
ideas. Through both the open space meeting discussions and the Virtual
Fridays, members were able to learn about the projects being completed at
each other’s organizations, along with the challenges that each organization
faced. The life of the ILN can be viewed as a narrowing pipeline that
highlighted those projects that could develop momentum.

6. In order to build on the momentum around projects, the network needs an


active virtual infrastructure to serve both as a means of maintaining
relationships and as a tool for managing projects. The wiki and the list-serve
have served as a foundation for collaborative activities. In order to maintain
engagement, the network will need tools that push information out and serve
as consistent reminders of the wealth of content available through the
members of the network.

7. The true value of the network will come from collaborative projects. In order to
thrive and continue, the ILN will need to significantly and tangibly impact the
member organizations. There has been significant small-scale collaboration
(groups of two or three members) that has been hard to document; the ILN
hopes to further utilize the social networking surveys and maps to capture that
work and demonstrate value. The major projects that took root during the
October meeting demonstrate promise, and may serve as a litmus test for the
organization’s viability moving forward.

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Well, it gives me hope, and I need it. GOING FORWARD

Keith McCandless The activities of the ILN thus far establish a pattern for a continuing two-phase cycle:
face-to-face meetings with deep dives into particular topics, followed by longer periods
I’m looking forward to seeing what continues to come out of of collaborative projects and network building. In 2007, the ILN has plans to initiate
this. new activities such as group consultations and a “borrow an expert” inter-
organizational exchange program; the in-person meetings will become larger, longer,
Chris McCarthy and more frequent. While the ILN is still building capacity and momentum, it has
proven an exemplary model of a rapidly developed network with an enormous amount
I think it’s got extreme potential. of potential.

Donna Deckard As 2007 progresses, the ILN will be the group to watch.

It gives me as a health care consumer a lot of hope.

Maggie Hentschel

That’s why innovation is so important and why I’m really


excited about the ILN.

David Tew

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Innovation Learning Network:


Resources and Tools
February 2007
Innovation Learning Network 2006

RESOURCES AND TOOLS

First Meeting/Open Space A


• Principles and Set Up A-1
• Meeting Agenda A-3
• Summary of Discussion Groups A-4
• Diffusion Survey Results
o Summary A-6
o Surveys A-7
o Elements of Successful Spread A-15

Social Network Mapping B


• Survey B-1
• Summary of Results B-2
• Presentation of Findings B-6
• Article: Building Smart Communities through Network Weaving B-7

Virtual Fridays C
• Process Guide C-1
• Topics and Abstracts C-2

Online Collaboration D
• Site Map – ILN Website D-1
• Site Map – ILN WIKI D-2
• Screen Shots D-3

Second Meeting E
• Panel Discussion
o Participants E-1
o Summary E-3
• Meeting Agenda E-5
• Summary of Discussion Groups E-6
• Project Game Plans E-9
o Game Plan Template E-13

Going Forward F
• Summary of ILN 2007 F-1
• RFP for Social Network Mapping and Weaving F-2

Resources G
• ILN 2006 Members G-1
• Other Resources G-2
Innovation Learning Network 2006

Section A: First Meeting/Open Space


Principles and Setup of Open Space

What is Open Space?

It is a self-organizing practice of individual discipline and collective activity that releases the
inherent creativity and leadership in people. By inviting people to take responsibility for what they
care about, Open Space establishes a marketplace of inquiry, reflection and learning, bringing out
the best in both individuals and the whole. It has been used successfully all over the world in
many organizations and communities.

When to Use It

• Where the situation is complex


• Where there is a high degree of diversity
• Where there is an urgent need to make speedy decisions
• Where many stakeholders are needed for good decisions to be made
• Where there are few preconceived notions of what the outcomes should be

Probable Outcomes

• Builds energy, commitment and shared leadership


• Participants accept responsibility for what does or doesn't happen
• Action plans and recommendations emerge from conversations
• You create a record of the entire proceedings as you go
• All of the issues that are MOST important to the participants will be raised
• All of the issues raised will be addressed by those participants most qualified and
capable of getting something done on each of them
• In two days, all of the most important ideas, discussion, data, recommendations,
conclusions, questions for further study, and plans for immediate action will be
documented in one comprehensive report -- finished, printed and in the hands of
participants when they leave
• After an event, all of these results can be made available to an entire organization within
minutes of the event, so the conversation can invite every stakeholder into
implementation -- right now

How It Works

The Law of Two Feet means you take responsibility for what you care about -- standing up for
that and using your own two feet to move to whatever place you can best contribute and/or learn.

Four principles apply to how you navigate in Open Space:

• Whoever comes is the right people


Whoever is attracted to the same conversation or challenge are the people who can
contribute most to that conversation—because they care. So they are exactly the ones -- for
the whole group -- who are capable of initiating action.
• Whatever happens is the only thing that could have
We are all limited by our own pasts and expectations. This principle acknowledges we'll all
do our best to focus on NOW -- the present time and place-- and not get bogged down in
what could've or should've happened.

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• When it starts is the right time


Creativity cannot be forced or scheduled. Our task is to make our best contribution and enter
the flow of creativity when it starts.
• When it's over, it's over
Creativity has its own rhythm. So do groups. Just a reminder to pay attention to the flow of
creativity, not the clock. When you think it is over, ask: Is it over? And if it is, go on to the
next thing you have passion for. If it’s not, make plans for continuing the conversation.

How Open Space Works When There Is Conflict

The Law of Two Feet gives participants freedom to move at any time to a discussion they care
about. Caring creates common ground, and helps to remind participants of higher purpose.

The Steps of Open Space in Brief

1. Select a focusing statement or question for your gathering. It should frame the higher
purpose and widest context for your discussion in a positive way.
2. Invite the circle of people: all stakeholders or all the people you'd like to have in the room.
Include the theme, date, place and time of gathering in the invitation.
3. Create the circle: Set up chairs in a circle or in concentric circles, leaving space in the
center. Choose a blank wall for the Agenda Wall and label it AGENDA: AM, PM across the
top. Set up a table for computers near a wall you label NEWS. Put blank sheets of paper
(about quarter size of a flip chart page) and colored felt pens in the center of the circle. Near
the Agenda Wall and the News Wall put masking tape for people to post papers on the walls.
4. To begin the gathering: Facilitator explains: the theme, the simple process the group will
follow to organize and create a record, where to put things up and find out what is
happening, the Law of Two Feet, and the Principles of Open Space. Then, facilitator invites
people to silently reflect on what is important for each of them in responding to this
challenge.
5. Opening the marketplace: the Facilitator invites anyone who cares about an issue or
challenge to step into the middle of the circle and write the topic, their name, a time and
place for meeting, announce it and post the offering on the Agenda Wall -- one sheet per
topic—as many topics as he/she wants. They will be conveners who have responsibility for
leading their session(s) and seeing to it that a report is made and shared on the News Wall.
A recorder in each room will assist each leader.
6. When ALL offerings are concluded, the Facilitator invites people to sign up for what they are
interested in and take responsibility for their schedules, using the Law of Two Feet.
7. People participate in discussions. The Facilitator takes care of the space. Recorders enter
discussion reports in the computers and printouts are posted on the News Wall.
8. Evening News & Closing Circle: all reconvene an hour before closing to share highlights,
"ahas" and key learning in a dialogue format: simply listening to whatever people have to
offer without discussion.
9. Mail out, simulcast, or post the record that is created. Share the Gameplans and include
more people in the efforts underway.

Adapted from Anne Stadler, annestad@comcast.net.

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ILN In-Person Meeting #1


April 26-27, 2006
Agenda

Day 1
Start Finish Duration Task Notes
8:00 8:30 0:30:00 Welcome/Settle In/Rapid Re-Intro
8:30 8:45 0:15:00 ILN Story
8:45 9:00 0:15:00 Open Space Technology Setup
9:00 9:30 0:30:00 Open Space Agenda Creation
9:30 15:30 6:00:00 Open Space Each topic leader should have
documented the flow of
discussion, major points, and next
steps
15:30 16:00 0:30:00 Discussion Closedown/Break
16:00 17:00 1:00:00 CIMIT Simulation
17:00 18:30 1:30:00 (back to hotel)
18:30 19:00 0:30:00 Cocktails (hotel)
19:00 21:00 2:00:00 Dinner (hotel)

Day 2
Start Finish Duration Task Notes
7:30 7:45 0:15:00 Welcome Back
7:45 8:15 0:30:00 CIMIT Presentation 1 OR of the Future
8:15 8:45 0:30:00 CIMIT Presentation 2 Medical Device Interoperability
Plug-n-Play
8:45 9:00 0:15:00 Break
9:00 9:30 0:30:00 CIMIT Presentation 3 Ambulatory Practice of the Future
9:30 10:00 0:30:00 CIMIT Presentation 4 Connected Health Initiative
10:00 10:15 0:15:00 Break
10:15 11:30 1:15:00 Closure/Connections
11:30 11:45 0:15:00 Delta/Plus

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Discussion groups

Accelerating Education and Implementation of Innovation - Capturing Best Practices and


Diffusion
CIMIT/Partners HealthCare - Beverly Brown (bbrown9@partners.org)
HealthTech - Joanne Asercion (jasercion@healthtech.org)
This group explored different processes that their organizations were using to diffuse innovations
internally. The group how to create a safe environment that allows for risk taking, and concluded
that a key indicator for successful innovation is being replicable on a larger scale. The group
brainstormed elements of successful diffusion, including: enlistment of opinion leaders, executive
sponsors, and good facilitators; celebrating small successes as part of a larger strategic plan;
sharing failures as part of the learning experience; and managing expectations. This group
continued their conversation over the summer and disseminated a survey about diffusion. For the
results of that survey, please see Appendix 1-6.

Innovative Work Environments and Innovation Labs


CIMIT – Janice Crosby (jecrosby@partners.org)
This group discussed several projects underway at their organizations relating to work
environment, including a multicenter study of where and how nurses spend their time, and
innovation “laboratories” for both ambulatory and inpatient care. The group emphasized the need
for a mechanism to share ideas, trials, successes, failures, and lessons learned.

Patient Experience
Alegent Health – Ann Jones (ajones@alegent.org)
The group discussed how to learn more about the patient experience, and what tools could be
used. Tools discussed include interviewing patients, following them, and observing behaviors.
The group noted that patients’ vulnerability makes the industrial model less applicable in the
healthcare arena, as the intensity of emotions and the complexity of the processes are clear
differentiating elements. This group continued to work over the summer; the ultimate result of
their collaboration was a panel discussion that opened the second in-person meeting. For a
summary of that meeting, please see Appendix 5-1.

Open Innovation
Alegent Health – Ted Schwab (tschwab@alegent.org)
This group asked the question, “How do we continue to include outside sources of information
and keep the innovation open as we begin to implement?” The group discussed major projects
within their organizations that could use innovative thinking, lessons learned about how
innovation works, and major challenges to open innovation.

Virtual Collaboration Processes and Tools


Massachusetts General Hospital/Partners HealthCare – Jim Noga (jnoga@partners.org)
The group discussed what works and doesn't work in virtual space. Preferences included a basic
list serve that any member of the group can use to quickly post a question to the entire group.
The group also preferred an approach to information sharing that allowed members to choose
their areas of interest, and then sent out relevant email updates with a link back to a central site;
the group also hoped for wiki capability. The group chose four areas of interest: Ambulatory
Practice of the Future, Facilities Design, Medication Administration, and Changing Corporate
Culture to Support Innovation.

Positive Deviance and Other Liberating Structures: A Tale of Two Innovators


Social Invention Group – Keith McCandless (keithmccandless@earthlink.net)
Liberating Structures are the processes, rules and infrastructure that make it easy for people to
be creative, adaptable, build on each other ideas, and get results. This group shared innovation
stories and the approaches taken. A few themes emerged:

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• The importance of including multiple stakeholders in the selection, research, and design
effort not separating the design and spread activities.
• The importance of "air cover" tone that encourages risk taking -- from leaders.
• The need to create space and time for an innovation culture to bloom.
• Diminishing fear of job loss ("if my role or work process changes, I may lose my job").
• While healthcare innovates fabulously in medical devices, innovation in other key aspects
is lacking.

Making Meaningful Changes in Organizations


Mayo Clinic – Alan Duncan (duncan.alan@mayo.edu)
The group began the discussion by talking about the ways in which incorporation of innovations in
a systemic fashion in organizations requires the organization to structure itself differently. The
role of senior leadership was emphasized repeatedly. Risk acceptance and tolerance, in
particular, were seen as the groundwork for a culture of innovation. The group talked about the
ways in which innovation organized through "projects" can lead innovators astray because of the
pressure for timelines, immediate deliverables, and the like. The group discussed how metrics
could either foster or stifle innovation, and about constraints and enablers. Finally, the group
discussed simple rules that can help innovators and organizational leadership to accomplish the
goals of increasing both autonomy and integration.

Healthcare Reform Based on Quality


Franciscan Missionaries of Our Lady – George Burgess (gburgess@fmolhs.org)
This group discussed current attempts to change how health care is delivered, and the barriers
and opportunities present. The group discussed what assumptions and requirements would lead
to the realization of the Institute of Medicine’s six goals. The group discussed starting a planning
improvement process to develop options for improved model(s) for healthcare, along with
potential next steps. George Burgess continued to build on the ideas arisen within this group, and
presented the results of his work during a Virtual Friday.

The Link Between Accelerating Change and the Use of Incentives


Catholic Health Initiatives – John Anderson (johnanderson@catholichealth.net)
This group asked the question, "What impedes the unleashing of the talent pool of creativity
within health care?" The group discussed different ways in which incentives could be used to
encourage innovation at the core of health care, and cited the difficulty of merging incentives of
clinicians with those of other healthcare professionals. The group also addressed the importance
of maintaining personal and emotional connections to the well being of individual patients even
the system begins to innovate and explore.

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Diffusion Survey Results – Summary

Implementation is influenced significantly by the scope of desired implementation and ability to


marshal a multi-disciplinary team to drive implementation across entities.

Implementation success factors

- The innovation team needs a respected, inspirational leader. A physician leader can help
produce buy-in.
- Successful spread can come two-fold. First, an innovation starts to spread naturally; then
leadership acknowledges it as a best practice and mandates it for everyone.
- Let the end user customize the innovation to reduce the need for training.
o Get manufacturers to participate in the training of their devices.
- Implementation requires a robust social network that allows change agents to use
relationships to navigate through committees.

Barriers to successful implementation

- Lack of high-level sponsorship.


- Unclear scope and definition of problem.
- Inability to prioritize problems to be solved.
- An organization committed to putting out “point fires” and not seeking a comprehensive
solution to improving patient safety.
- Organizational culture that makes it hard to convince people to embrace changes instead
of being afraid of them.
- Challenge of maintaining the integrity of an innovation when handing off from the
designers to those implementing the innovation. One group’s solution:
o Implementation is the responsibility of those who created the project and asked
the question. The design team considers implementation throughout the process
by maintaining a primary focus on the human aspect of the desired/intended
change.

Notes from Partners HealthCare

- “Translating innovation into eventual implementation takes a ‘village.’ At Partners, the


Corporate Sponsored Research program and CIMIT can provide such a village
environment to help technologies traverse the rocky shoals of development,
commercialization and implementation.”
- “At the highest levels, Partners is seeking to do the right thing first and figure out how to
get reimbursed later. “

Notes from Kaiser Permanente

- Kaiser has an innovation team that can support operations throughout the organization.
The team has two major approaches for assisting groups:
o The team conducted a seminar for a region on rapid cycle change, then invited
others to submit ideas to implement. They started with nine teams, and cut down
to two teams. Met every other month for a year and half.
o The team held an application process for groups to receive their support. The
team helped applications to fill out the application, especially defining the
problem to solve, metrics, etc. Questions included:
How does this strategically align with organization?
How will this idea improve affordability?
What kind of support are you seeking from the innovation team?

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Survey #1: Regional Kaiser Permanente Innovator

1) Where does innovation occur? Innovation happens all over our organization, from the top
to bottom. How do you define innovation in your organization? Innovation is trying
something new to address a problem. In your organization, where are technologies,
workflow improvements and IT upgrades either developed internally or identified
externally? Technologies and workflow improvements come out of clinical areas based
on needs and desires, and working with our regional Strategic Management Consulting,
Innovation Team or the Clinical Research Unit. I am not sure how this happen in the IT
side of our organization.
a. If a separate group exists, how large is it, how is it funded and what is their
charter? The Innovation Team is made up of twelve people (five are MDs, four
directors of departments, union representatives and two project managers) and
the group is led by Bill Marsh. The Innovation Team is part of the operating
budget for the region, and its mission is to promote a spirit of innovation and risk
taking throughout the organization in order to improve affordability. How does its
work get implemented and by whom? There are two main ways groups can tap
into the Innovation Team’s resources: first, we conduct seminars on rapid cycle
change and often invite folks to submit ideas to implement. An example is that
we had nine teams thinking about new ideas. We shaved that down to two, and
then met every other month for development. Second, there is an application
process that we can assist folks with, especially with defining the problem to
solve and metrics development. Part of the process is answering the questions:
“how does this strategically align with organization?”, “how will this idea improve
affordability?” and “what kind of support do you want from the Innovation Team?”

2) Specific Example of Success: Across your entire organization what is a good example of
a recent successful implementation of a new technology or a significant process
improvement across a large percentage of your organization (an example might be
EMR)? Be prepared to talk in some detail about how the implementation was planned
and staged as well as the results. An example of success is with our Practice
Management initiative (in Colorado) where the Primary Care MD manages their whole
panel of patients. It was well spread because there was a regional mandate to do so.
Originally it started to spread naturally. However because of the great results, and
determination that it was a best practice, leadership mandated as a standard. The
implementation started about two years ago.

3) Specific Example of Failure: Across your entire organization what is a good example of a
recent failed implementation of a new technology or a significant process improvement
that was attempted across a large percentage of your organization? Be prepared to talk
in some detail about how the implementation was planned and staged as well as the
results. Were you able to understand why it failed? Please give the details. I can’t think
of one at the moment.

4) Training (how, who and what worked and didn’t): Is the training included in the
implementation plan? Who owns the training and how much of the total effort (time and
budget) is devoted to training? What are the tools that you have used successfully and
unsuccessfully? Please detail why some worked and others did not. Training is not a
significant part of what we do with implementation, and is done ad hoc. We encourage
folks to connect with each other by phone and site visits, and also hold innovation fairs
where they can connect. Specific training we do is around the rapid cycle change
process.

5) What are your metrics for success? For the innovation team it is to improve affordability
(for example: decreased ALOS). We use a value equation and quality indicators to

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determine if we are on the right track; however we have not seen improvements in cost
just yet.

6) What are some of the key barriers to successful implementation and how did you
overcome them? One key barrier is the lack of sponsorship. We identify and bring in
sponsors early on in the project, and have them co-developing measures of success to
help remedy this. Another barrier is a lack of clarity regarding what the problem is. Our
insights have helped us to more clearly define the problem to be tackled with our
sponsors, before beginning a project.

7) Is there anything that is really unique to your organization that makes implementation
either easier or harder than elsewhere? Please provide details. In our part of the
organization its fairly easy: we have an innovation team that is sanctioned by the medical
group and health plan leaders, and is led by Bill Marsh, one of the most respected
physician leaders. Are you able to provide incentives to early and easy adoption? We try
really hard to recognize people who are trying new things: monetary rewards, email
commendations to their supervisors to name a few. And the Innovation Team helps to
make it easier for teams to adopt things early. What are some of the motivations that
have worked for you? Bill Marsh is certainly motivating; he is an inspirational leader. Also
finding and working with people around the organization that are kindred spirits—those
willing to put themselves out there to take risks.

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Survey #2: Nat Sims, Partners Health Care


Smart Infusion Pump Learning Lab

Smart Pump: Device IT convergence through multidisciplinary cycles of innovation and


implementation
Nov. 21, 2006

This is a great story to highlight as the underlying technologies are “mature,” in the market place,
and implemented across the country. The story is a long one, spanning 20 years, and it
embodies success and failure of this critical life saving integration of a dumb device with a
knowledge database of drugs and institutional guidelines within the context of a clinical diagnosis
to minimize drug errors in acute care settings. Implementation can drive innovation which in term
accelerates implementation….as the “inventors” are the users. The story highlights the fact that
in ideal projects, innovation is best done with implementation in mind.

1) Where does innovation occur? It occurs all over an organization, in all corners of the
clinical environment. Basically, health care providers see unmet needs, come close to or
make critical mistakes in caring for patients. This drives them to seek to correct the
systems that contributed to the errors. “Years ago, an anesthesia resident was caring for
a newborn baby with congenital heart disease who needed a precise intravenous infusion
of a powerful drug to dilate the blood vessels prior to surgery. After the infusion was
started, the baby remained inadequately oxygenated. Eventually the clinicians
discovered that an error in the complex dose calculations had led to a serious
underdosing of the critical drug. This sentinel experience resulted in a personal resolve
by the anesthesiologist to devote significant energy to addressing patient safety.” Out of
that vision, a multifunctional team was formed at MGH to study the problem. They
concluded that there were two deficiencies:
1)There were inadequate systems to disseminate intravenous drug knowledge to
physicians and nurses at the exact moment of need and
2)We had inadequate systems to ensure that the right drug and the right drug dosing at
the time of bedside administration.
The team concluded that both problems could be substantially resolved with a single
technological solution, along with associated care-process changes. This insight led to
the conception and implementation of “smart” infusion pumps with “onboard drug
libraries.”
Translating innovation into eventual implementation takes a “village”. At Partners, the
Corporate Sponsored Research program and CIMIT can provide such a village
environment to help technologies traverse the rocky shoals of development,
commercialization and implementation.

2) Specific examples of success:


1)Develop close working relationships with the local technology transfer and industries
who will fund development and commercialize the eventual product – this is critical.
2)Grant non-exclusive licenses of the basic technologies so many companies can
innovate, compete and accelerate the implementation.
3)Seek to engage the front line in customization of the product. This helps overcome
company liability as it moves it into the “practice of medicine” at the local level and
confers ownership to those who are customizing it. It automatically meets the customers’
needs as they are in control of the final product. This provides context aware information
at the right time that follows the institutions’ guidelines.
4)Keep the inventor at arm’s length for conflict of interest issues relating to purchasing
but engage them on strategic discussions of future products. This is somewhat
neutralized if many vendors have licensed the technology and are selling products.

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3) Specific examples of failure:


1)We granted exclusive license to an early industrial sponsor (for a very small amount of
money) resulting in the company sitting on the technology for 5-8 years as they did not
want to cannibalize their current products and there was no competitive pressure to
launch - the innovation was so far ahead of the competition. Initially, research hospitals
thought that they could make large revenue on medical devices through exclusive
licenses. Over time, they came to realize that devices are not drugs and wide spread
access brings more revenue in the long run.
2)Companies who first commercialized it ran into huge resistance by dictating to
institutions how they practice medicine, how drugs are formulated and how physicians
make decisions. With this approach, the companies took ownership for the liability as
well. In acute care settings, “every way we use drugs in the hospital is off-label”. When
the companies gave control of the workflow back to the customer (hospital), guidance
rules and programming belonged to the clinicians. This immediately shifted the liability to
the hospitals and the companies started selling units.

4) Training (how, who and what worked and didn’t):


1)When the customer does the customization, they have automatically reduced the need
for training. New medication rules, workflow and guidelines are not required. All that is
needed is the actual use of the device itself. The “customizer” becomes the trainer as
well.
2)Manufacturers participate in the training of their devices that are standardized across
the industry.

5) What are the metrics of success? There are really milestones to success with this
project. First came the vision of solving the bedside drug errors. Then came the
invention of the smart pump with a drug calculator and guidance by user defined “guard
rails” to reduce or eliminate the dose errors. Next came coupling automated drug
recognition (through RFID or barcode) to prevent harm. Finally, the holy grail will be to
incorporate the vital signs of the patient with the EMR and other data systems to provide
an end to end solution. Success is in sight but not achieved yet.

6) What are some of the key barriers to implementation?


1) No top level commitment to implementation
2) No centralized IT or vision of IT for the organization,
3) Not enough wireless expertise to make smart pumps reliable in a “noisy environment
and
4)An organization committed to putting out “point fires” and not seeking a comprehensive
solution to improving patient safety.

7) Is there something unique to your organization that makes implementation easier than
elsewhere? Yes, at the highest levels, Partners is seeking to do the right thing first and
figure out how to get reimbursed later. As a top strategic direction, Partners has set it’s
vision on High Performance Medicine. Through the promise of improving the quality of
healthcare delivery, it will make safety a profit center at some point in the future. This
requires the lofty but comprehensive vision of integration of all of the safety initiatives
such as Smart Pumps, CPOE, eMAR, Auto ID, IT across all affiliates and information
systems into one focus. Funding will ultimately come from the revenues conserved by
reducing patient errors.

The ILN is in a unique position to advance the thinking and sharing so that many healthcare
systems can accelerate their thinking to comprehensive solutions. The Smart Pump story is an
excellent case study with considerable information available to all who request it.

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Survey #3: National Kaiser Permanente Innovator

1) Where does innovation occur? Innovation is sprinkled throughout Kaiser Permanente


(KP) from our technology sector to direct patient-care delivery to population care. We
have teams at the unit level all the way to the national (corporate) level that tackle
pressing challenges. On the macro level, we have intentional efforts to collaboratively
design solutions such as Nurse Knowledge Exchange and the Perinatal Journey Home
Boards. On the micro level, or unit level, we’ve embedded the skills for innovation in the
individual so that innovation can happen spontaneously. The formalized innovation
structures include the Sidney R Garfield Center for Health Care Innovation (Garfield
Center) and the Innovation Consultancy. We even have regional innovation teams such
as in the Colorado Region. How do you define innovation in your organization? We’ve
never formally defined innovation, and it remains elusive. However it seems most KP
folks are comfortable with the following definition: “any concept that is newly introduced
that generates value.” In your organization, where are technologies, workflow
improvements and IT upgrades either developed internally or identified externally? That
depends on the scale of the design challenge. It could be on the fly for a particular unit or
at the regional or national level, such as at the Garfield Center.

a. If a separate group exists, how large is it, how is it funded and what is their
charter?
i. Garfield Center – 2 FTE funded jointly by IT, Facilities and Patient Care
Services
ii. Innovation consultancy – 3 FTE funded by Health Plan and Operations
iii. Regional and Medical Center groups – varied
How does its work get implemented and by whom? That is very good question.
Handing off evidence-based innovation to a team that can implement is an area
that KP (and many other organizations) is struggling with. The current model
seems to be that teams that innovate also implement. Organizationally, we know
that it’s not ideal, however the plus side of this is that there is consistency in
terms of who is “running” the project. One model that KP is experimenting with is
having a “transition team”, where members of an implementation team would join
the Innovation Team during the last round of testing so that they become
embedded with the content and can easily move into implementation. We say
“experiment” because we will test this model in 2007.

2) Specific Example of Success: Across your entire organization what is a good example of
a recent successful implementation of a new technology or a significant process
improvement across a large percentage of your organization (an example might be
EMR)? Be prepared to talk in some detail about how the implementation was planned
and staged as well as the results. A good example is definitely Nurse Knowledge
Exchange (NKE). It was planned using the IHI Rapid Scale-up methodology, being
staged geographically and by time. We let each hospital region decide their approach,
and asked them to plan not more than three waves to complete the hospitals that joined
the collaborative. We will be implemented in twenty-one hospitals by 12/2006 and the
remaining ten in 2007 (See Virtual Friday presentation on KP NKE).

3) Specific Example of Failure: Across your entire organization what is a good example of a
recent failed implementation of a new technology or a significant process improvement
that was attempted across a large percentage of your organization? Be prepared to talk
in some detail about how the implementation was planned and staged as well as the
results. Were you able to understand why it failed? Please give the details. I’ll approach
this question from a different perspective. NKE is made up of four components, one
being Bedside Rounds. During the first wave of implementation we noticed that the
Bedside Rounds were not being done across the system, and the other three

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components were. We were puzzled. As we began getting data from the twenty-one
hospitals and antidotal evidence, it became clear that we had two major barriers to
overcome. The first being HIPAA. Many nurses were confused about what they could
say at bedside in front of the family or another patient. The second issue was that many
nurses had “stage fright”; being uncomfortable talking in front of the patient with another
nurse. With these two issues, we saw failure of this component across the system.

However our process metrics triggered us to look deeper, and by uncovering the
“barriers” we were able to target KP-wide interventions to push this initial failure into
success. One of the major infrastructure insights from this experience was learning how
to tap into the awesome resources at the local level. Nurse educators became our “best
friends” for simulating Bedside Rounds with the nurses. This is something that we never
considered in the innovation phase of the work, but was integral for a rapid scale-up.

4) Training (how, who and what worked and didn’t): Is the training included in the
implementation plan? Who owns the training and how much of the total effort (time and
budget) is devoted to training? What are the tools that you have used successfully and
unsuccessfully? Please detail why some worked and others did not. For NKE, we
developed a change package that included customizable training materials. Actual
training was done by and at the local medical centers. To deliver content to a broad
audience (all twenty-one hospitals) we used webcasting as our main mechanism.

5) What are your metrics for success? This varies project to project, however the dream
metric and also the most difficult is ROI. We’d love to able to standardize ROI, and I can
see that this may be a goal for 2007. Currently we rely on process metrics to at least
help us know we are going in the “right direction”. The process metrics are chosen by
doing a chain analysis from the outcomes we are trying to achieve. What are the criteria
that are used to select what technologies to implement and how to measure success?
Again, this varies by project. For example, for NKE, the prototype metrics indicated a
major improvement, and therefore we received the green light to move forward.

6) What are some of the key barriers to successful implementation and how did you
overcome them? For NKE, it was getting leadership to clearly understand its role in
implementation. Some leaders are much more hands on, and the typical result of this
approach was success. The hands-off leadership was a more difficult challenge. I’m not
sure we overcame that one, however we attempted to by creating a communication time
line that leaders could use to guide their actions across time. We’ve had some mild
success with this approach.

7) Is there anything that is really unique to your organization that makes implementation
either easier or harder than elsewhere? Please provide details. Implementation at Kaiser
Permanente is much harder. We have an extremely distributed power structure with the
local facilities being nearly as or stronger than the region and the region as strong as or
stronger than national operations. We have a tri-leadership with the health plan,
physician group and labor groups equally having a say in how to do work. Therefore it’s
imperative to have strong agreement across these entities. But there is a huge benefit in
this structure as well, mainly that when you get agreement it is very powerful. Are you
able to provide incentives to early and easy adoption? Formally, no; however, we’ve
always paid special attention to early adopters by highlighting their work. For example in
NKE, we always “storytell” that Baldwin Park, Moanalua, and South Sacramento were
early innovators and adopters. Additionally its beneficial for our early adopters as they get
more say in the design of solutions. What are some of the motivations that have worked
for you? The motivations that have worked best for me is knowing that we are on the
cutting edge of design, and being recognized for it. Having the Institute for Healthcare
Improvement and Wall Street Journal recognize your work is very, very motivating!

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Survey #4: Anonymous Respondent

1) Where does Innovation occur?


- Innovation Centers within our Organization
- Several grass-roots/local initiatives that are connected with innovation are taking place
within our institution

Within the Institution at this time, a variety of efforts are underway to stimulate and foster
innovation. Groups working in this arena tend to be housed in local business units thus
funding comes from operational budgets. A unifying institutional infrastructure is being
developed to aid these current efforts and drive diffusion. Innovation efforts are guided
by the common notion of creating new value for patients.

To date, there is no easy way to answer the question of implementation. Implementation


is influenced significantly by the scope of the project and the ability to marshal a multi-
disciplinary team to drive implementation across entities. Regardless, implementation
tends to require people being able to add this activity to an already full to-do list and a
robust social network that allows change agent to use relationships to navigate through
committees.

2) Specific Example of Success: The project in question focused on improving the summary
visit process, which in simple terms is the concluding experience for patients as they
prepare to return to their home environment. Nine insights/recommendations were
derived primarily from ethnographic research and rapid prototyping in real time patient
care episodes and these findings were formally presented to departmental project
sponsors.

As of this writing, a guiding document that contains six elements culled from the
aforementioned design process is close to becoming a reality. The MD sponsor of the
project has been pursuing approvals for the past four months, which is a rather quick
period of time in our environment. Based on feedback and observation during the design
phase, it is believed that virtually no training for users will be required.

In this case, implementation is the responsibility of those who created the project and
asked the question. The design team considers implementation throughout the process
by maintaining a primary focus on the human aspect of the desired/intended change and
design principles and criteria at the conclusion of the project in essence provides a
blueprint for a solution(s) and the required change process to the sponsor. The sponsor
then must engage in the process of making change happen through our committee based
environment.

3) Specific Example of Failure: Due to the new and unique manner by which her team
works, the individual I interviewed chooses to see lack of implementation as a joint
inability to share and apply micro-learning to larger systems.

This individual indicates that as their program and methodology have grown and matured
it is becoming easier to engage the larger system in the necessary conversations for both
re-imagining a complex system and developing the capacity to act on both short and long
term projects that will flow from that disciplined human research oriented process.

4) Training (how, who and what worked and didn’t): With respect to the project being
focused on in this case study, no training was needed. The research and rapid
prototyping process led to the creation of a tool that worked effectively for patients and
clinicians. The tool in essence is an enabler of an existing work task so adoption and use

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Innovation Learning Network 2006

by practitioners was high and intuitiveness of tool led to no needed training.

5) Metrics for Success: The primary measure of success here is the ability to set a big
picture vision for how a system or experience could be re-designed/re-imagined. The
value of the meta-vision is the creation of concepts that can then become the focus of/for
further ideation, development and implementation. The vision would be composed of
design principles and criteria, which ought to strongly inform implementation.

6) What are some of the key barriers to successful implementation and how did you
overcome them? First is an inability to prioritize which systems and experiences need to
be redesigned. Secondly, implementation and the rigorous activity of navigating through
the committee structure is a secondary duty for MD’s.

7) Is there anything that is really unique to your organization that makes implementation
either easier or harder than elsewhere? The operating principles of our robust and time-
consuming decision-making process generally results in highly effective and rapid
implementation of solutions. A decision to implement means that critical mass has been
achieved in a way that guarantees resources and leadership for implementation to be
successful.

Another critical variable that cannot be overlooked is our patient centered approach to all
things. This focus allows for solutions to be implemented that usually create value for
them first which eases acceptance and adoption by staff.

Implementation is made more difficult primarily due to strong emphasis on shared


services, an intimate engagement in the project by numerous committees, and a risk-
aversive environment that makes it easy to delay and/or reject outright innovative
solutions. Due to the integrated nature of our delivery system, the scope of projects can
rapidly expand beyond the local unit of study adding complexity and efforts required to
involve ancillary units into the overall change process. Obviously, this presents
significant challenges for those driving for change and implementation.

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Innovation Learning Network 2006

Elements of Successful Spread

Taken from Kaiser’s Virtual Friday presentation on the Diffusion of the Nurse Knowledge
Exchange (NKE) practice.

Project Attributes
1. Trialability
• Use of rapid cycle PDSA (Plan-Do-Study-Act) is empowering and allows for
learning through trial and error
• Can test and implement in any order
• Adaptable to any unit
2. Complexity
Although the NKE change package was simple in description…
• Language was difficult
• Front line staff don’t use tools
• “NiKE: Just Do It”

Social System
• Project lead is socially networked and respected
• Nurse champions spread to other nurses
• Communication plan
• Executive sponsor works closely with project lead

Leadership
• Engaged facilitative executive sponsor
• Project lead attributes:
– Passion
– Excellent communicator
– Organized
– Able to access flex resources
– Use measurement to tell the story

Organizational System
• NKE is aligned with organizational goals
• Structure “mirrors” the National collaborative structure
• Use networks and champions to spread
• Provides formal education and freedom to “test” implementation and share
success

Collaborative Structure
• Face to face sharing and networking
• Project lead calls
• Coaching for project lead and hospital teams
• Process metrics
• Extranet to post tools

Spread model
• Know where you will spread to
• Multiplicative spread
• Use of pilot units

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Innovation Learning Network 2006

Section B: Social Network Mapping


Surveys – September 2006 and January 2007

Dear Participant:

We invite you to participate in creating a Smart Network Map. The map is a visual representation of the social network that is emerging from
Innovation Learning Network (ILN) interactions. Everyone that has participated or touched the ILN, however briefly, has been invited to participate.
We will be collecting data to form these maps via an online survey. Your input to this survey is critical to successful map creation.

We will use the maps to deepen our understanding of how innovations spread through social networks and to strengthen relationships among ILN
members with an eye toward spreading innovations among ILN members.

Together, we plan to use and interpret the maps on our September monthly member web-call 9-28-06 and during our Design-For-Diffusion
meeting in California.

Please follow the link below to complete the survey - It should take no more than 10 minutes to complete. Please respond no later than September
15th so we have time to prepare the network maps.

Smart Network Survey Link

In advance, thank you for participating.

Sincerely,
Chris McCarthy & Maggie Hentschel

Questions:

1. Prior to the start of the ILN, who did you work with or exchange information on a project, topic or shared interest?
2. Since the ILN started, with whom have you shared ideas or worked on projects that were catalyzed by your ILN interactions?
3. Who has inspired you or given you new ideas since the ILN began?
4. Who would you like to work with over the coming year on an ILN-inspired project or topic?

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Innovation Learning Network 2006

Summary of Results
Smart Network Map 1

Prior to the start of the ILN, who did you work with or exchange information on a project, topic or shared interest?
Before March 2006

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Innovation Learning Network 2006

Smart Network Map 2

Since the ILN started, with whom have you shared ideas or worked on projects that were catalyzed by your ILN interactions?
As of September 2006

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Innovation Learning Network 2006

Smart Network Map 3

Since the ILN started, with whom have you shared ideas or worked on projects that were catalyzed by your ILN interactions?
As of 2007

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Innovation Learning Network 2006

Smart Network Map 4

Who would you like to work with over the coming year on an ILN-inspired project or topic?

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Innovation Learning Network 2006

Presentation of Findings:
Notes from Social Network Maps discussions, October 19-20 Meeting (based on September 2006 Maps)

Four Smart Network maps for the ILN were reviewed and discussed in detail.

There are numerous ways to look at the graphs:


• Different categories of people: boundary spanners, core connectors, periphery,
• Overall patterns
• Changes from before to after

Three layers of meaning or story were explored: individual, organizational and cross-organizational. Metrics of network dynamics include:
• Awareness (how likely is it that you know what is going on around the network... 2 or 3 degrees out)
• Connectors (how connected are you to others that are connected)
• Influence (who goes to whom for expertise or inspiration)
• Integration (in the thick of things)
• Resilience (what happens when people leave the network)

The progression toward a "smart" network -- a tight or dense core with a loose or diverse periphery -- was noted by group members.

Conversation centered around actions -- informed by the mapping -- than can help spread innovation. Practices included:
• Closing triangles (introducing people that are currently not connected but should be)
• Connect or try to influence the influencers
• Engage the community in connecting to more of itself via building awareness or collective mindfulness
• Bring people from the periphery into the specific innovation efforts
• Focus mapping activities on strategic initiatives (e.g., diabetes care), using them to build generative relationships within and across
local/regional communities of practice

Group members were considering applications to many activities including ILN projects.

Note from a participant: Each graph is in response to one question so if you are doing this in your organization, getting the question(s) right is key.

Risks to creating maps:


• People may game it when they see how the maps will appear. They may not want to show a connection or may want to show a connection
that is not real.
• Bosses might get ticked off if they don't show up as the right connection.

Page B-6
Building Smart Communities through Network Weaving
by Valdis Krebs and June Holley

Communities are built on connections. Better connections usually


provide better opportunities. But, what are better connections, and how do
they lead to more effective and productive communities? How do we build
connected communities that create, and take advantage of, opportunities
in their region or marketplace? How does success emerge from the
complex interactions within communities?

This paper investigates building sustainable communities through improving


their connectivity – internally and externally – using network ties to create
economic opportunities. Improved connectivity is created through an
iterative process of knowing the network and knitting the network.

Know the Net

Improved connectivity starts with a map – knowing the complex human system you are

embedded in. The Appalachian Center for Economic Networks [ACEnet], a regional economic

development organization in Athens, Ohio has long followed the connectivity mantra – create

effective networks for individual, group and regional growth and vitality. Recently ACEnet has

begun to map and measure the social and economic connections it helped create in the grassroots

food industry in Southeast Ohio.

ACEnet, founded in 1985, provides a wide range of assistance to food, wood and technology
entrepreneurs in 29 counties of Appalachian Ohio. This region has some of the highest poverty and
unemployment rates in the country, and ACEnet works with communities throughout the region who
want to improve their support for entrepreneurs as a means to provide more local ownership and higher
quality jobs.
Network maps provide a revealing snapshot of a business ecosystem at a particular point in time.

These maps can help answer many key questions in the community building process.

• Are the right connections in place? Are any key connections missing?

• Who are playing leadership roles in the community? Who is not, but should be?

• Who are the experts in process, planning and practice?

• Who are the mentors that others seek out for advice?

• Who are the innovators? Are ideas shared and acted upon?

• Are collaborative alliances forming between local businesses?

• Which businesses will provide a better return on investment – both for themselves and

the community they are embedded in?

These are all important questions that ACEnet wants to answer so that they can help build a more

vibrant economy in Appalachian Ohio.

Before you can improve your network you need to know where you are currently – the ‘as is’

picture. A network map shows the nodes and links in the network. Nodes can be people, groups

or organizations. Links can show relationships, flows, or transactions. A link can be directional.

A network map is an excellent tool for visually tracking your ties and designing strategies to

create new connections. A network map is an excellent tool for visually tracking your ties and

designing strategies to create new connections. Network maps are also excellent ‘talking

documents’ – visual representations that support conversations about possibilities.

Transformation that leads to healthy communities is the result of many collaborations among

network members. Scientists describe this phenomenon – where local interactions lead to global

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-8
patterns – as emergence. We can guide emergence by understanding, and catalyzing,

connections. For example, knowing where the connections are, and are not, allows a community

development organization to influence local interactions. This is particularly important in policy

networks where key nodes play an important role in what flows throughout the network.

Influencing a small number of well-connected nodes often results in better outcomes than trying

to access the top person or calling on random players in the policy network. If you know the

network, you can focus your influence.

Recently ACEnet Food Ventures staff asked area entrepreneurs and organizations, “From whom do you
get new ideas that benefit your work?” “From whom do you access expertise that improves your
operations?” and “With whom do you collaborate?” The answers to these questions were mapped using
Valdis Krebs’ InFLOW™ social network mapping software into an Innovation Network, an Expertise
Network, and a Collaboration Network. Analyzing these networks led the team to realize that there were
several entrepreneurs who played a critical role in the food sector, but with whom they had little
relationship. The team developed a strategy for more explicitly working with these entrepreneurs, by
asking them to conduct workshops for other entrepreneurs and finding out their needs for business
assistance.

What does a vibrant, effective community network look like? Research has been done to

discover the qualities of vibrant networks. Sociologists, physicists, mathematicians, and

management consultants have all discovered similar answers about effective networks. The

amazing discovery is that people in organizations, routers on the internet, cells in a nervous

system, molecules in protein interactions, animals in an ecosystem, and pages on the WWW are

all organized in efficient network structures that have similar properties.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-9
Five general patterns are observed in all effective networks:

1. Birds of a feather flock together: nodes link together because of common attributes, goals
or governance.
2. At the same time diversity is important. Though clusters form around common attributes
and goals, vibrant networks maintain connections to diverse nodes and clusters. A
diversity of connections is required to maximize innovation in the network.
3. Robust networks have several paths between any two nodes. If several nodes or links are
damaged or removed, other pathways exist for uninterrupted information flow between the
remaining nodes.
4. Some nodes are more prominent than others – they are either hubs1, brokers2, or boundary
spanners3. They are critical to network health.
5. Most nodes in the network are connected by an indirect link in the network. A-B-C-D
shows a direct link between A and B, but indirect links between A and C and A and D.
Yet, the average path length in the network tends to be short. There are very few long
paths in the network that lead to delay and distortion of information flow and knowledge
exchange.

Even though we know several keys to building effective networks, this knowledge is rarely put

to use. Networks, whether social or business, are usually left to grow without a plan. When left

unmanaged, networks follow two simple, yet powerful driving forces:

1. Birds of a feather flock together.


2. Those close by, form a tie.

This results in many small and dense clusters with little or no diversity. Everyone in the cluster

knows what everyone else knows and no one knows what is going on in other clusters. The lack

of outside information, and dense cohesion within the network, removes all possibility for new

ideas and innovations. We see this in isolated rural communities that are resistant to change, or

1
Nodes with many direct connections that quickly disperse information.
2
Nodes that connect otherwise disconnected parts of the network – they act as liaisons.
3
Nodes that connect two or more clusters – they act as bridges between groups.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-10
in a classic “old boy network”. Yet, the dense connections, and high degree of commonality

forms good work groups – clusters of people who can work together smoothly.

Instead of allowing networks to evolve without direction, successful individuals, groups and

organizations have found that it pays to actively manage your network. Using the latest research

we can now knit networks to create productive individuals and smart communities.

Knit the Net

A vibrant community network is generally built in 4 phases, each with it’s own distinct topology.

Each phase builds a more adaptive and resilient network structure than the prior phase. Network

mapping can be used to track your progress through these four stages.

1) Scattered Fragments
2) Single Hub-and-Spoke
3) Multi-Hub Small-World Network
4) Core/Periphery

Experience shows that most communities start as small emergent clusters organized around

common interests or goals. Usually these clusters are isolated from each other. They are very

small groups of 1-5 people or organizations that have connected out of necessity, see Figure 1. If

these fragments do not organize further, the community structure remains weak and under-

producing.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-11
Figure 1 – Scattered Fragments

Without active leaders who takes responsibility for building a network, spontaneous connections

between groups emerge very slowly, or not at all. We call this active leader a network weaver.

Instead of allowing these fragments to drift in the hope of making a lucky connection, network

weavers actively create new interactions between them.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-12
Network weavers4 begin with a hub and spoke network, with the weaver as the hub. The weaver

has the vision, the energy, and the social skills to connect to diverse individuals and groups and

start information flowing to and from them. The weavers usually have external links outside of

the community to bring in information and ideas. This is a critical phase for community building

because everything depends on a weaver who is the hub in the network. However, if multiple

weavers are working in the same community, we may get multiple hub and spoke networks, with

some overlap between them. Figure 2 shows a weaver connecting the previously scattered

clusters.

Figure 2 – Hub-and-Spoke Network

4
While the Athens food network focused on one network weaving organization – ACEnet, there were actually several individual
network weavers within ACEnet. Each network weaver within ACEnet had a particular focus. They all worked together from a
common vision. If several network weavers are present and willing to collaborate, increased progress is possible.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-13
Initially a network weaver forms relationships with each of the small clusters. During this phase

a weaver is learning about each individual or small cluster – discovering what they know and

what they need. However, the hub-and-spoke model is only a temporary step in community

growth. It should not be utilized for long because it concentrates both power and vulnerability in

one node – the hub. If the weaver fails or leaves then we are back to a fragmented community.

In healthy networks, the spokes of the hub do not remain separated for long. The weaver begins

connecting those individuals and clusters who can collaborate or assist one another in some way.

Concurrently the weaver begins encouraging others to begin weaving the network as well. Even

though it is a temporary structure, the hub-and-spoke model is usually the best topology to bring

together the scattered clusters seen in most immature communities.

An organization with a vision, and contacts to external ideas and resources, can play the role of

the hub. This is the role ACEnet took up when it saw that SE Ohio was home to many small,

uncoordinated food clusters. There was the Farmer’s Market crowd, the natural bakery, a

worker-owned Mexican restaurant and a few other entrepreneurs creating unique food products.

ACEnet brought all of these unconnected groups together around a kitchen incubator – a state of

the art facility for preparing and packaging a large variety of food items.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-14
When ACEnet decided to build a Kitchen Incubator—a licensed processing facility where
entrepreneurs could rent the use of ovens, stoves and a processing line to produce their
products—they used the need to design the incubator as an opportunity to link small clusters.
For example, for one design session they brought people from the town’s restaurants together
with small farmers who wanted to turn their produce into value-added products. Farmers were
able to learn about food production safety from the restaurateurs who explained how these
procedures could be incorporated into the incubator. Some of the farmers also used the
opportunity to sell their produce to the restaurants, who were always on the lookout for unique
raw materials. And, an unexpected bonus was that the restaurants realized that they could use
the Kitchen Incubator’s storage warehouse for large orders they made from their suppliers, and
as a result became an important part of the network.

As the weaver connects to many groups, information is soon flowing into the weaver about each

group’s skills, goals, successes and failures. An astute weaver can now start to introduce clusters

that have common goals/interests or complementary skills/experiences to each other. As clusters

connect, their spokes to the hub can weaken, freeing up the weaver to attach to new groups.

Although the spoke links weaken, they never disappear – they remain weaker, dormant ties, able

to be re-activated whenever necessary. In order to accommodate new connections, the weaver

must teach others how to weave their own network. Training in network building is important at

this juncture. Network mapping reveals the progress and identifies emerging network weavers.

This happened with ACEnet as several of the businesses and small non-profits began to

build their own local connected clusters. As the overall network grows, the role of the weaver

changes from being the central weaver, to being a facilitator of network weaving in the

community – coordinating with, and mentoring of other network weavers.

There are two parts to network weaving. One is relationship building, particularly across

traditional divides, so that people have access to innovation and important information. The

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-15
second is learning how to facilitate collaborations for mutual benefit. Collaborations can vary

from simple and short term—entrepreneurs purchasing supplies together—to complex and long-

term—such as a major policy initiative or creation of a venture fund. This culture of

collaboration creates a state of emergence, where the outcome—a healthy community—is more

than the sum of the many collaborations. The local interactions create a global outcome that no

one could accomplish alone.

Network weaving is not just “networking”, nor schmoozing. Weaving brings people together for

projects, initially small, so they can learn to collaborate. Through that collaboration they

strengthen the community and increase the knowledge available in it. After working with the

authors, Jack Ricchiuto, a Cleveland-based management consultant and author, created a

pyramid of network weaving involvement. Level 1 is a “networking” type interaction, while

levels 6 and 7 are highly involved commitments to building community. A majority of

ACEnet’s larger successes fall under the two top levels [6 & 7] of Ricchiuto’s Pyramid5.

Level Activity
7 Introducing A to B in person and offering a collaboration opportunity to get A
and B off to a successful partnership
6 Introducing A to B in person and following up with A and B to nurture
connection
5 Introducing A to B in person
4 Introducing A to B in a conference call
3 Introducing A to B in an email
2 Suggesting A talk to B and calling B to look for a contact
1 Suggesting to A that A should talk to B

5
http://www.jackzen.com/archives/2006/01/the_7_circles_o.html

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-16
This transition from network weaver to network facilitator is critical. The weaver is identifying

and mentoring new weavers who will eventually take over much of the network building and

maintenance. If the change is not made then the community network remains dependent on the

central weaver and his/her organization. At the transition point the weaver changes from being a

direct leader to an indirect leader, influencing new emergent leaders appearing throughout the

community. This transition is necessary for the network to increase its scale, impact and reach.

Moving from a single hub/weaver network to a multiple hub/weaver network has many

advantages. The first advantage of a multi-hub topology is elimination of a single point of

failure. ACEnet is still a dominant hub in SE Ohio, and its failure would affect the region greatly

– but not as significantly as five years ago when the network was sparser and more dependent on

ACEnet. Now ACEnet has the luxury of spending time in new pursuits such as teaching others

to knit their nets and expanding the network to other areas inside and outside of Appalachia.

As the weaver connects various individuals, organizations and clusters, these entities connect to

each other loosely. A new dynamic is revealed here – the strength of ‘weak ties’6. Weak ties are

connections that are not as frequent, intense, as strong network ties that form the backbone of a

network. Strong ties are usually found within a network cluster, while weak ties are found

between clusters. As clusters begin to connect to each other, the first bridging links are usually

weak ties. Over time weak ties may retain their structure by bridging separate clusters or they

may grow in to become strong ties binding previously separate groups into a new larger cluster.

6
Mark Granovetter

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-17
Bridging ties between clusters are also important in innovation. New ideas are often discovered

outside the local domain. To get transformative ideas you often have go outside of your group.

A successful formula for creating ties for innovation is to find other groups that are both similar

and different than your own. Similarity helps build trust, while diversity introduces new ideas

and perspectives. Connect on your similarity, and profit from your diversity.

To bring in new ideas from outside the region, ACEnet has developed several “innovation
learning clusters” that bring together leading edge organizations from around the country who
share their innovations with each other. ACEnet staff who participate then bring information
about those innovations back to the region and adapt them to the local environment. For
example, Larry Fisher, one of ACEnet Directors, participates in a rural entrepreneurship policy
cluster where he learned the basics of building a policy network from organizations with many
years’ experience. He is now leading ACEnet’s efforts to change the policy of local counties so
that it is more supportive of entrepreneurship, but he can move forward with a more sure hand
since he is building on the experience of others—and can contact them when he has questions.

Now that other hubs [network weavers] are emerging in the network, the various weavers begin

to connect to each other, creating a multi-hub community. Not only is this network topology less

fragile, it is also the best design to minimize the average path length throughout the network –

remember, the shorter the hops the better for work flow, information exchange and knowledge

sharing! Information percolates most quickly through a network where the best connected nodes

are all connected to each other.

Figure 3 shows a multi-hub small-world network. Here four clusters [designated by the thick red

links] have created many weak ties [gray links] to each other. The weak ties may, or may not,

strengthen to create one tightly coupled larger cluster. The multiple hubs can be small

businesses or other community development organizations.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-18
Initially, the ACEnet Kitchen Incubator was a major gathering place, a physical network hub,
where people ran into each other, hung around to talk, and often cooked up some kind of deal:
joint orders of jars so they could get a cheaper price, an arrangement to jointly market their
products, or an agreement to trade labor on a project.

However, after a few years, many other network hubs popped up. For example, the Athens
Farmers’ Market hosted more than 90 farmers and local food vendors who networked with each
other and their avid customers. Several years ago, 4 local organizations set up a Farmers’
Market Café that provides tables and chairs under tents so that people could hang around longer
and network with more neighbors.
Casa Nueva, a worker-owned Mexican restaurant, is not only a networking hub, but has played a
major role in organizing most of the locally owned restaurants into the Athens Independent
Restaurant Association which donates money each month to community non-profits and is
increasing the amount of area restaurants purchase from local farm families.
Six miles outside town, more than 200 people flock on Saturdays to enjoy fresh baked focaccia,
pastries and hearth bread on the outdoor terrace outside the Big Chimney Bakery. The
proprietor is a major network hub himself, who helps new entrepreneurs develop their recipes
and learn strategy from a pro.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-19
Figure 3 – Multi-Hub Small World Network

The next step is to strengthen the appropriate loose ties in the network so they become strong

ties. This happens after turf issues have been handled. A multi-hub network may be difficult to

achieve if political and ‘turf’ issues are raging through the network. If two or more community

development organizations start battling over turf and control of the community then the result

may be two or more competing, single hub networks that ignore the larger community needs and

just focus on survival of their own network.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-20
The end-goal for vibrant, sustainable community networks is the core/periphery model.

This topology emerges after many years of network weaving by multiple hubs. It is a stable

structure that can link to other well-developed networks in other regions. The network core in

this model contains the key community members, including many who are network weavers, and

have developed strong ties between themselves. The periphery of this network contains three

groups of nodes that are usually tied to the core through looser ties:

1) Those new to the community and working to get to the core

2) Bridges to diverse communities elsewhere

3) Unique resources that operate outside of the community, and may span many communities

The economic landscape is full of imperfectly shared ideas and information. The periphery allows

us to reach ideas and information not currently prevalent in our network. The core allows us to act

on those ideas and information. The periphery is the open, porous boundary of the community

network. It is where new members/ideas come and go. The periphery monitors the environment,

while the core implements what is discovered and deemed useful7.

ACEnet has helped form the Appalachian Ohio Regional Investment Coalition (AORIC) which
includes another community organization, a regional foundation, the Ohio Arts Council, and an
Ohio University based institute. AORIC is now mobilizing a large network of organizations
interested in supporting entrepreneurs as a way to create a healthier regional economy. This
network is reaching deep into communities to identify barriers entrepreneurs face, and then
collaborating on projects that will develop new supportive infrastructure to increase their
success.

7
Influenced by the research and analysis of Ronald S. Burt.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-21
Figure 4 – Core/Periphery Network

Figure 4 shows a well developed core/periphery structure. The blue nodes are the core, while the

green nodes reside in the periphery. This network core is very dense8 -- not all cores will have as

high a concentration of connections as this one. Too much density can lead to rigidity and and

8
Network density is calculated by the number of existing connections as a percentage of the total possible. Any density greater
than 50% is very high.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-22
overload of activity. Monitoring your network using social network analysis can help you see

where your network needs to shift connections to match the current environment.

At this point the network weavers’ initial task are mostly completed. Now, attention turns

toward network maintenance and building bridges to other networks. The network weavers can

begin to form inter-regional alliances to create new products, services and markets—or to shape

and influence policy that will strengthen the community or region. This happens by connecting

network cores to each other utilizing their peripheries. The network weaver maximizes the reach

of the periphery into new areas, while keeping the core strong. The weavers now focuses on

multi-core projects of large substance that will have major impact on the community.

Conclusion

As we have seen weaving a network requires two iterative and continuous steps:

1. Know the network – take regular x-rays of your network and evaluate your progress.

2. Knit the network – follow the four (4) phase network knitting process.

All throughout this process network maps guide the way – they reveal what we know about the

network and they uncover possible next steps for the weaver.

Starting with a disconnected community, network builders can start weaving together the

necessary skills and resources to build simple single hub networks. This will be followed by a

more robust multi-hub network, concluding with a resilient core/periphery structure – maximized

for learning and implementation.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-23
Valdis Krebs is a organizational consultant and the developer of InFLOW software.
www.orgnet.com
valdis@orgnet.com

June Holley is founder and President/CEO of the Appalachian Center for Economic Networks.
www.acenetworks.org
juneh@acenetworks.org

June and Valdis and Jack have created a training seminar for Network
Weavers, please contact either one of them for further information.

Building Smart Communities through Network Weaving © 2002-2006 Valdis Krebs and June Holley Page B-24
Innovation Learning Network 2006

Section C: Virtual Fridays


Process Guide

The ILN utilizes web conferencing to enable members at a variety of locations to interact and
collaborate in real-time. Virtual Fridays are web conferences where members view and share
presentations, documents, or web pages on their computer while simultaneously dialing in to a
teleconference over the phone. There are various technologies available to conduct web-based
teleconferences, including: WebEx, Qwest, Raindance, MeetingOne, and many others. These
vary significantly in price and available features.

Suggested Roles:

• Coordinator: Coordinates web-meeting, schedules and communicates meeting details to


participants, collects presentation from presenter in electronic format, uploads
presentation to web conferencing site, and trains presenter on use of web conferencing
technology. Generally facilitates Virtual Friday discussion.
• Presenter: Prepares and gives presentation.
• Participant: Logs into web meeting and teleconference, listens, and participates in Q&A.

Process:

Step 1: Group identifies topics; coordinator sets schedule.

Step 2: Coordinator communicates event details to participants. (i.e. date, time, dial-in number,
web conference address, login and password or meeting number…how to join will vary
depending on what web-conferencing technology is used).

Step 3: Prior to meeting date, coordinator and presenter perform a “test run” of logging into web
conferencing to ensure their computers are set up and to avoid any technical difficulties prior to
web meeting.

Step 4: Coordinator sends out a reminder to participants (a few days in advance of event date),
including an Adobe PDF version of the presentation for those that will not be able to join the web
portion of the call. Reminder should also provide tips or recommendations for joining meeting.

Tip: Coordinator should encourage presenter and participants to join web conference ten
minutes prior to start time. This ensures participants are able to fix any technical
difficulties they might encounter prior to start of presentation, and generally ensures the
web-conference can begin on time.

Step 5: If technology requires, coordinator or presenter uploads presentation to web conferencing


site.

Step 6: Coordinator should start meeting at least 20 minutes in advance to allow ample time for
presenter and participants to join.

Step 7: Coordinator starts recording and presentation begins!

Step 8: Coordinator makes presentation recording available online for those members who were
unavailable during the call.

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Topics and Abstracts

Nurse Knowledge Exchange


Kaiser Permanente - Chris McCarthy (chris.mccarthy@kp.org)
The Nurse Knowledge Exchange (NKE) was a set of protocols implemented to improve the
process of shift change. This Virtual Friday describes the initial problems that Kaiser faced, the
process of creating the NKE program, goals, planning, prototyping, implementation, and plans for
rapid scale-up.

The SPARC (See, Plan, Act, Refine, Communicate) Innovation Program


Mayo Clinic - Alan Duncan (duncan.alan@mayo.edu)
The SPARC Innovation Program at the Mayo Clinic is an “innovation lab” used to rethink the
delivery of ambulatory care. This Virtual Friday describes the development of the concept,
including origins, planning and goals, along with lessons learned and examples of use.

Bar Code Expansion Project


Department of Veterans Affairs - Jon Zeller (jon.zeller@va.gov) and Ruth Jara (ruth.jara@va.gov)
The VA has used barcoding for several years for lab specimens and blood product delivery. This
Virtual Friday describes the expansion of this technology’s applications, including medication
administration and the collection of data such as vital signs to support documentation compliance.

Integrating Healthcare and Retail Services


Alegent Health - Joan Neuhaus (jneuhaus@alegent.org)
Alegent has investigated the retail service industry for parallels that might be applicable to health
care delivery. This Virtual Friday describes the initial goals of the investigation, their findings,
some potential methods of implementation, and barriers they have forseen.

My HealtheVet
Department of Veterans Affairs - Ginger Price (ginger.price@va.gov)
My HealtheVet is an electronically based personal health record that the VA is currently piloting
testing. This Virtual Friday describes the creation of My HealtheVet, including the technology the
VA used, the patient base served, regulatory barriers they faced, and how they built the
technology to serve both providers and patients.

Oncology Human Experience


Alegent Health - Myra Ricceri (MRicceri@alegent.org)
Alegent undertook an ethnography project to follow eight cancer patients throughout their entire
treatment process, in order to improve the patient experience. This Virtual Friday describes the
project process and next steps for adopting the lessons learned.

Human-Centered Design
IDEO - Ilya Prokopoff (iprokopoff@ideo.com)
IDEO is a company that provides consulting services to help organizations rethink attitudes about
innovation and prioritize the experience of end-users in order to create value. In this Virtual
Friday, IDEO presents their philosophy of innovation. This also marked the first Virtual Friday
presented by a non-ILN member organization.
st
21 Century Care
Kaiser Permanente - Hannah King (hannah.king@kp.org) and Ruth Brentari
(ruth.brentari@kp.org)
Kaiser’s 21st Century Care project was designed to re-envision the function of primary care
teams. This Virtual Friday describes the goals of the 21st Century Care project, the four major
changes envisioned, and some of the emerging results.

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Introduction to the ILN Wiki


Kaiser Permanente - Maggie Hentschel (maggie.hentschel@kp.org)
In September, Maggie Hentschel created an ILN wiki - a collaborative website that can be
modified by all ILN members. In this Virtual Friday, Maggie gives a tour of the wiki and its various
features.

Louisiana: An Opportunity for Innovation


Franciscan Missionaries of Our Lady - George Burgess (gburgess@fmolhs.org)
In the wake of Hurricane Katrina, the Franciscan Missionaries of Our Lady have emerged as the
sole health care provider in the St. Bernard parish. This Virtual Friday describes the efforts at
recovery that the Franciscans have undertaken to provide a completely rebuilt model that
provides access to all.

Time and Motion Study


Kaiser Permanente - Marilyn Chow (Marilyn.P.Chow@kp.org)
Ascension Health - Ann Hendrich (ahendrich@ascensionhealth.org)
Kaiser and Ascension have undertaken a joint, multi-site study, funded by the Robert Wood
Johnson Foundation and the Gordon and Betty Moore Foundation, to learn about the workflow of
medical-surgical nurses with the ultimate goal of improving patient safety. This Virtual Friday
describes the components of the study, its goals, initial results, and next steps. This Virtual Friday
was the first joint presentation from two participant organizations.

EHR Tools for Pneumococcal & Influenza Vaccine Compliance


Evanston Northwestern Healthcare – Bobbi Schramek (bschramek@enh.org)
Evanston Northwestern currently uses EPIC’s electronic medical record software, and recently
undertook an effort to use EPIC’s reminder tools to help increase the number of patients who
received two vaccines. This Virtual Friday describes the process of creating and implementing
these tools.

Personal Health Records Committee


Alegent Health - David Tew (dtew@alegent.org)
During the open space meeting in October, a committee of ILN members interested in developing
nationally available portable, personal electronic health records came together to exchange ideas
and set goals. During this Virtual Friday, the committee presents their progress to date and asks
other ILN members for assistance.

Diffusion
Kaiser Permanente – Kristene Cristobal (kristene.cristobal@kp.org) and Lisa Schilling
(Lisa.schilling@kp.org)
This Virtual Friday revisits Kaiser’s Nurse Knowledge Exchange program to examine the rapid
scale-up process in greater depth. The presenters describe their process of spread and some of
the lessons learned.

IS Innovation Program
Partners HealthCare/Massachusetts General Hospital – Jim Noga (jnoga@partners.org)
Partners HealthCare runs an Innovation Program, in which selected employees spend half of
their time working in teams to come up with an innovative solution to an organizational problem.
This Virtual Friday describes the selection criteria used, initial results, and program logistics.

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Section D: Online Collaboration


Site map – ILN website

• ILN Overview
o Participating Organizations
• Virtual Friday Archives (link to wiki)
• Resources
o Articles and Recommended Reading
o ILN member survey results
o April ILN Cambridge, MA Meeting 2006
Presentations:
Overview of CIMIT: Clinical Innovation Labs
OR of the Future Part 1 - Warren Sandberg MD, PhD
OR of the Future Part 2 - Warren Sandberg MD, PhD
Medical Device Interoperability Plug-n-Play - Julian Goldman MD
Ambulatory Practice of the Future - Susan Edgman-Levitan
Connected Health Initiative - Penny Ford Carleton RN
• Member Directory
• Event Calendar
o Event list
• Message Board
o ILN April Open Space Discussions
Accelerating Education and Implementation of Innovation - Capturing
Best Practices and Diffusion
Innovative work environments and innovation labs
Patient Experience
Open Innovation
Virtual Collaboration Processes and Tools
Liberating Structures
Making meaningful changes in organizations
Healthcare Reform based on Quality
The Link Between Accelerating Change and the Use of Incentives
o Innovation Articles and Case Studies
o Website Feedback

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Site map – ILN wiki

• Front Page
• Monthly ILN Archives
• Virtual Friday Archives
• Building Smart Networks
o Social Networking Tools
• Design For Diffusion Conference
o Design For Diffusion Games Plans
Collaboration and Utilization of Innovation Labs Within ILN
ILN 2007 Information
• ILN 2007 Member Organization Status
Personal Health Records Game Plan
• Personal Portable Health Records
• Personal Health Records Resources
• Personal Health Records survey
Virtual Simulations plan
• Second Life
o Design For Diffusion Report Outs
Allowing Space for Play in Innovation and Relaxing Control
Creating Internal Structures of Diffusion and Learning
Creative Communication - Of Large Scale Plans
Culture Change for Innovation
Effective Collaborative Design
Effective Engagement of Customers in the Design-Innovation Process
Enabler - How to Drive An Innovation into Action
External Diffusion
Funding Strategies for Innovation
Healthcare Beyond the Institutional Walls
ILN 2007
Patient Driven Care Design
Personal Electronic Health Records
Physician in Change Process
Report on Innovation
ROI on Innovation
Social Network Mapping #1
Social Network Mapping #2
Staff as Customer and Engaging Staff
Virtual Simulations
o Design For Diffusion Conference Pre-Reading
o Design For Diffusion Panel Bios

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Innovation Learning Network 2006

Screen Shots

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Innovation Learning Network 2006

Section E: Second Meeting/Collaborative Projects


ILN In-Person Meeting #2
October 19-20, 2006
Panel Discussion – Participants

Robin Boyar – Electronic Arts

Robin Boyar is the Senior Director of Research at Electronic Arts, the world’s largest videogame
publisher. In her role, she leads consumer research supporting EA’s PC, console, handheld,
online, and mobile games. She and her team support the development of these products from pre
concept to post launch and use a wide range of methodologies ranging from standard focus
groups and surveys to more in depth ethnographic and lifestyle approaches.

Robin has over ten years research experience. She began her career as a researcher
specializing in education and technology, working for such companies as McGraw-Hill, PBS, and
various educational software companies. Previous to her role at Electronic Arts, she was
Manager of Consumer Insights at InsWeb.com, an online insurance company.

Jim Buckmaster – craigslist

Since 2000 Jim has led craigslist to be the most used classifieds service in any medium, with
over 10 million new ads submitted each month, and one of world's most popular websites, with
over 5 billion page views per month, while maintaining its renowned public service mission,
unorthodox business philosophy, non-corporate vibe, and staff of twenty.

Jim formerly served as craigslist's lead programmer and CTO, contributing the site's multi-city
architecture, search engine, discussion forums, flagging system, self-posting process, homepage
design, personals categories, and best-of-craigslist.

Before joining craigslist, Jim directed web development for Creditland (defunct) and Quantum. In
1994-95, Jim built what may have been the world's largest website at the time, a terabyte-scale
database-driven public website for the Interuniversity Consortium for Political and Social
Research at the University of Michigan.

Jim graduated summa cum laude from Virginia Tech with a bachelors in biochemistry, and
studied medicine and classics at the University of Michigan.

Jim has been the subject of feature stories in New York Times, Wall Street Journal, Fortune,
Business Week, Telegraph, SF Chronicle, and many other publications. He has been interviewed
for dozens of television and radio programs, and is possibly the only American CEO ever
accused in major business periodicals of being anti-establishment, a communist, a socialist, and
an anarchist.

Joy Mountford – Yahoo!

S. Joy Mountford has been designing interfaces for over twenty-five years, ranging from
applications on aircraft to personal computers to consumer devices. She has become an
internationally recognized leader in user-centered interaction design. She has led design efforts
creating interfaces to audio and visual devices, interfaces between the electronic world and
printed materials, and toys, as well as for interactive music creation and generation systems.

Joy most notably headed the Human Interface Group at Apple Computer for eight years and then
moved to Interval Research for five years. At Interval she led a series of innovative and influential
consumer music creation and jamming software and hardware devices for various consumer

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products. After Interval she formed her own interaction design firm, idbias, working for a range of
clients to design, redesign, prototype, and evaluate interfaces to help people be more effective
with technology. Past clients encompassed a broad range of businesses, from banks, libraries
and music publishers, to the toy companies Lego and Mattel. In 1990 Joy pioneered forming the
Interface Design Project which sponsors interdisciplinary design at universities around the world,
continued to lead this effort for various sponsor companies and now has brought this to Yahoo!
which held their first successful Design Expo in Aug 2006.

Joy joined Yahoo! Research in Sept 2005, as a Distinguished Scientist and Senior Director in
User Experience and Design for products in the Communications, Communities and Front Doors
business areas. She has recently expanded her charter to start a design innovation studio for
Yahoo!. Her project interests center around building extensible and creative spaces such as
hotels using technology, and in creating wearable technology-aware ensembles. Joy is most
intrigued about how best to bring artists and scientists together to create usable and appealing
new 'tools'. She believes that this merger of disciplines working side by side is the best way to
encourage real innovations for consumers.

Sarah Snudden – Clorox

Sarah Snudden has worked on a variety of innovation, advertising and market research projects
in the Consumer Packaged Goods sector. Her projects include the Clorox Bleach Pen, Clorox
ToiletWand, Glad ForceFlex and Children's Instant Oatmeal. She has worked at Ecolab,
Pillsbury, Quaker and, for the past 5 years, Clorox. She has also worked in social marketing and
health advocacy on projects such as smoking cessation and drinking and driving.

Throughout all her ventures, Sarah essentially considers herself an "anthropologist and
sociological super-sleuth." In her spare time, Sarah works on documentary film projects and
enjoys cooking, entertaining and fixing up her old craftsman home.

Ron Volpe – Kraft Foods

Ron is Customer Vice President – Supply Chain for Kraft Foods, and leads Kraft’s Global Center
of Excellence for Supply Chain Innovation. Labeled ‘The Collaborator’ in the book The Ten Faces
of Innovation by IDEO General Manager Tom Kelley, in 2005 Ron was awarded the inaugural
Global Supply Chain Excellence Award by Kraft Foods for his work around customer
collaboration and innovation. In 2004, Ron’s led a Kraft project designed to bring product design
and innovation techniques to the Supply Chain process arena. This partnership project with
Safeway was the inaugural winner of the Grocery Manufacturers of America AMC CPG Award,
which honors innovation through creativity, product innovation, and industry collaboration.
Presently, Ron is involved in expanding Kraft’s use of the IDEO process to Kraft customers in
both the EU and Asia Pacific.

Ron is a graduate of the University of Massachusetts, and resides in Danville, California with his
wife Sue and four children.

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Panel Discussion – Summary

How is innovation viewed at your organization?


• Clorox: We developed structures to foster innovations.
o We worked with a competitor to create a product.
• EA: We’ve realized we need to seek new audiences.

Do problems arise out of operations or outside ideas?


• Kraft: All about operational issues – tend to depend on history.

How to encourage innovation internally, especially on front line?


• Yahoo: It’s hard when you have a legacy, so we buy companies. Let the brand deviate.
o Design is the key to innovation.
• Craigslist: It’s not our technology that’s innovative; it’s the business model.

Why did people start using Craigslist?


• Craigslist: We only do what users want.

It’s hard to innovate in health care because everyone asks what the ROI is. How do you
balance that with the need to explore?
• Yahoo: There’s no easy answer; it’s very difficult. Experience and faith.
o Be a better storyteller about design’s value. Speak your executives’ language.
• Kraft: Customer feedback gives you working capital. Make the customer your co-
designer.
• Clorox: Figure out how to make things speak to people.
• EA: You need to present your idea as sexy. Figure out what the story is, and then brand
it.
o Remember: we are not our user base!

We’re known as an industry that is local and based of problem-solvers – how to break
free?
• EA: Understand what makes your user group different, then adapt to that – cultural
relevance.
• Clorox: Figure out what delights your audience, and keep those ideas throughout your
day.

We’re starting to partner with out patients. How do you do that?


• Yahoo: Talk to users at the very beginning. The rougher the draft, the more interesting
the ideas.
o Use dyads instead of individual interviews – they talk differently, they’re more
honest.
• Clorox: Drive articulateness of the consumer up. Get to know long-term, develop real
relationship.
• Craigslist: We took opposite approach - leave it to users to find problems and propose
solutions.
o We come up with fastest solution possible, and see if people like it.

Our basic tools for marketing are surveys, focus groups – any other means of
engagement?
• EA: Greatest innovation: surveys that are online, multimedia.
• Yahoo: Ethnography/participatory design helps people participate.
• Clorox: Look at emotional reactions – very telling.
o Look at workarounds and processes because people won’t always tell you what
they want.

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How do you get people excited?


• Clorox: Know your target and how to reach them. Think about point of entry into system.

It takes curiosity to both nourish innovation and relax control –how to allow that to
happen?
• EA: Failure. It’s a wake-up call.

You seem to have a lot of autonomy. How do you keep that?


• Yahoo: A manager has to protect people and let them do their jobs.
o Can’t always try for a slam-dunk right away.
• Kraft: It’s a cumulative process – use preliminary success to drive future projects.
• Clorox: Knowing how to argue for right time frame for a win – it’s part of the art of
storytelling.

People are trying to bring consumers into health care decision processes more, but we
believe that people can’t understand it. How can we reach them?
• Yahoo: Different age groups use different types of media. How do we make more out of
that?

What should health care work on?


• EA: My mom has a variety of illnesses and I took her through the hospital. Whenever I
had a question, my mom said it wasn’t her place to ask. I would like her doctors to help
her to be a more informed consumer. Be more interactive, want your patients to ask
questions.
• Yahoo: When I was in the hospital, I wanted to know what was happening and when and
why. Explain to me what the task flow is. I want to make sure I’m on track and okay. I
want unbiased advice but don’t ask me to be intelligent while I’m in the hospital because
I’m not feeling well. Make it simple, with pictures. Use university students to help.
• Kraft: My kids are 20, 16, 3 and 1. I want an opportunity for them to get information they
can use throughout their lives – what can my daughter pick up when she is at the doctor’s
office? I want an educational process that’s built into experience.
• Craigslist: Push the needle from curative to preventive. Open up to user reviews – the
American medical system is screwed up in terms of incentives. Why can’t we talk about
national health care?
o There are several IT trends we can lean on for improvement.
• Clorox: Reduce my barriers to entry. I don’t know how to articulate the need for
accessibility. I’d like to be able to feed back to my dad’s doctor from far away. How to
balance optimism with reality.

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ILN In-Person Meeting #2


October 19-20, 2006
Agenda

Day 1
Start Finish Duration Task Notes
15:00 16:00 1:00:00 Tour of Garfield Center for
panelists
16:00 18:00 2:00:00 Non-Health Care Industry Panel
on Innovation and Human
Experience
18:00 19:00 1:00:00 Reception

Day 2
Start Finish Duration Task Notes
8:00 8:20 0:20:00 Breakfast
8:20 8:30 0:10:00 Welcome
8:30 9:30 1:00:00 Tour of Garfield Center
9:30 9:45 0:15:00 Break
9:45 10:15 0:30:00 Open Space Technology Setup Activity: share stories of
successful diffusion
10:15 10:30 0:15:00 Open Space Agenda Creation
10:30 15:45 4:15:00 Open Space
15:45 16:30 0:45:00 Discussion Closedown Activity: Mad Tea Party
16:30 18:45 2:15:00 (travel to hotel, travel to harbor)
18:45 21:00 2:15:00 Dinner Cruise

Day 3
Start Finish Duration Task Notes
8:00 8:45 0:45:00 Breakfast and Morning
Announcements
8:45 12:00 3:15:00 Open Space (continued)
12:00 13:00 1:00:00 Lunch
13:00 13:15 0:15:00 Selection of Gameplan Groups
13:15 14:45 1:30:00 Action Planning with Gameplans
14:45 15:30 0:45:00 Review of Gameplans Activity: flocking exercise
15:30 16:00 0:30:00 Closing Session

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Innovation Learning Network 2006

Discussion groups

Allowing Space for Play in Innovation and Relaxing Control


Kaiser Permanente - Adrienne Smith (adrienne.c.smith@kp.org)
This group offers the following advice to someone wanting to encourage innovative play in an
organization, even the one that might be resistant to it:
• Remember: It's okay to play within a healthcare organization. Play fosters creativity.
• Try it in small steps. Find people who are willing to play and engage them.
• Take ownership of your own playful spirit and be PROUD of it.
• Have a conversation with leaders about how playfulness benefits the organization.
• Stop doing the boring stuff, like PowerPoint presentations.
• Use an arts exercise or incorporate physical activity or enactments.
• Bring in an improvisationalist to work through challenges.
• Find a spot to play and play anyway. It's infectious.
At the end of the first day of Open Space, this group offered a delightful dramatic performance on
how not to incorporate fun and play into innovation work.

Creating Internal Structures of Diffusion and Learning


Kaiser Permanente - Chris McCarthy (chris.mccarthy@kp.org)
Members of this group discussed current structures that their organizations use to share
information and diffuse innovations. The group brainstormed opportunities to share ideas,
including: innovation fairs, conference calls, and small group discussions, in which groups rotate
to other groups to learn, share and evaluate. The group discussed the role of the ILN and the
importance of internal networks for diffusion.

Creative Communication of Large Scale Plans


Catholic Health Initiatives - Jeff Norton (jeffnorton@catholichealth.net)
This group brainstormed ideas for better communicating internal projects and activities. Key
takeaways included:
• Recognize bandwidth limitations – prioritize messages and make them fast.
• Find alternative channels for communication, particularly multimedia.
• Make it FUN!
• Use social network mapping as a tool to figure out who can help you get a message out.

Effective Collaborative Design


Cleveland Clinic - Mary Partin (partinm@ccf.org)
This group debated whether change can occur organically, or whether there needs to be a
structure to design standards for implementation. The group also asked what decisions need to
be made at a high level, and what can be decided collaboratively at the grassroots level. The
group then discussed how to design an effective collaborative, including how to choose the right
participants, what work is necessary before design begins, and how to ensure that the end
product matches the initial problem set before the collaborative.

Effective Engagement of Customers in the Design-Innovation Process


Kaiser Permanente - Jan Ground (janis.t.ground@kp.org)
This group discussed the power of using stories to get attention onto a problem, and talked about
the need to pay attention to behaviors to learn about people’s needs. The group emphasized the
need to make it easy for people to participate, and the value of using prototypes to get immediate
feedback and improve the design process.

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Innovation Learning Network 2006

Enabler - How to Drive An Innovation into Action


Partners Healthcare/Massachusetts General Hospital - Jim Noga (jnoga@partners.org)
This group discussed ways to ensure that innovations take roots. Ideas included using incentives
that "make it easy to do the right thing," and identifying social and informal networks to drive
change. The group emphasized the importance of changing an organization’s value system.

External Diffusion
VHA Foundation - Linda DeWolf (ldewolf@vha.com)
This group discussed strategies for diffusing innovations to other organizations. The group
discussed the difference between creating a common enemy vs. a common vision to galvanize a
group, and suggested that using public transparency and even embarrassment were effective at
pushing organizational change. The group also talked about communication strategies.

Funding Strategies for Innovation


CIMIT - Beverly Brown (bbrown9@partners.org)
This group acknowledged that currently, multiple sources fund innovation, but expressed concern
for future sustaining funding. The group suggested a number of future models of funding,
depending on the structure of innovation within the organization. The group also discussed
engaging philanthropists and using the innovation centers to build a case for support.

Healthcare Beyond the Institutional Walls


Kaiser Permanente - Naomi Fried (naomi.fried@kp.org)
This group discussed the future of community-based healthcare, with the home as the nexus of
care. The group addressed existing challenges, from technology interoperability and user-
friendliness to alignment of financial and business models. The group also talked about trends in
health care that will make care delivery in the community more feasible, including consumer
awareness and the integration of health care with retail service.

ILN 2007
Kaiser Permanente - Chris McCarthy (chris.mccarthy@kp.org)
This group brainstormed ideas for the structure and activities of the ILN in 2007. The group
decided that the ILN would have two tiers of work: the first to explore the science of innovation
and diffusion for the advancement of healthcare, and the second to help members find practical
applications through collaborative projects. This group continued their discussion with the
development of a Gameplan. For further information, please see Appendices 5-12 and 6-1.

Patient Driven Care Design


Partners HealthCare - David Judge (djudge@partners.org)
This group discussed patients’ current role in health care, and brainstormed ideas to increase
patient involvement in the design of the care delivery process. The group highlighted the
importance of sensitivity to variation among cultural groups, and of understanding the unique
patient population’s needs. The group also discussed potential ramifications of greater patient
involvement on health care delivery systems.

Personal Electronic Health Records


Alegent Health - David Tew (dtew@alegent.org)
Department of Veterans Affairs - Tim Cromwell (Tim.Cromwell@va.gov)
In a highly animated discussion, this group debated what the ideal personal electronic health
record should be. The group agreed that the personal health record is a collaborative approach
that creates a complementary care model for enhancing the patient-provider relationship. The
group hoped to build momentum among the ILN to push forward the adoption of this technology,
and continued their discussion with the development of a Gameplan. For further information,
please see Appendix 5-10.

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Innovation Learning Network 2006

Physician in Change Process


Catholic Health Initiatives - David Swieskowski (DSwieskowski@mercydesmoines.org)
The group discussed how to maintain physicians’ autonomy while working towards improvement
in health care. The group brainstormed ideas for communication tactics that work with physicians,
including the use of peer physicians to relay ideas, and demonstrating that a change can make
physicians’ lives easier.

Report on Innovation
Kaiser Permanente - Christi Zuber (christi.zuber@kp.org)
In this discussion, Linda DeWolf walked the participants through the VHA's "Report on
Innovation." In summary, healthcare was viewed as an extremely "traditional" industry with very
little activity considered "innovative."

ROI on Innovation
Alegent Health - Joan Neuhaus (jneuhaus@alegent.org)
This group discussed their need to demonstrate value from innovation in order to maintain a
stream of funding for innovation-related activities. The group came up with a set of guidelines,
including sponsorship from senior leadership, the facilitation of a pipeline for projects to eliminate
failures early on, the development of a balanced scorecard to measure progress, self-promotion,
and alignment with organizational priorities. The group also talked about principles of exerting
influence within an organization.

Social Network Mapping (two sessions)


Social Invention Group - Keith McCandless (keithmccandless@earthlink.net)
Keith McCandless convened two working sessions to review the results of the social network
mapping surveys. For further information, please see Appendix 2.

Staff as Customer and Engaging Staff


Evanston Northwestern Healthcare - Bobbi Schramek (bschramek@enh.org)
This group discussed ideas for better engaging staff, including using technology tools to solicit
feedback, changing the role of middle managers, developing mentoring relationships, building an
infrastructure to facilitate group interaction, and ensuring that all staff feel empowered to make a
difference in patients’ lives.

Virtual Simulations
Kaiser Permanente - Christi Zuber (christi.zuber@kp.org)
The group had a lot of energy around the topic of "virtual simulations." This group discussed the
need to continue to expand methods of supporting collaboration and innovation between and
among clinicians and patients, and saw simulated environments in the "virtual" 3D world as a
potential tool to help support this collaboration and innovation. The two particular "products"
discussed in the most detail were Second Life and Forterra. The group continued their discussion
with the development of a Gameplan. For further information, please see Appendix 5-9.

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Innovation Learning Network 2006

Project Game Plans


Innovation Laboratories

Today (Now) Days Weeks Months Years


JR to send MP have Determine 1) Scan of Cross
welcome email assistant topics/sub-topics landscape region/organization
coordinate of medication (leverage off of consultancy of
Pick deep-dive calendars for administration Nurse Work *** organizations that
target date May-ish monthly call Summit) can/able/makes
with team Identify internal sense
Pick topic – organization’s 2) Hold deep
medication “key players” dive on Cross utilization of
administration medication available “lab
JR puts together administration space” capabilities
“let’s get
together” email of
plan

Page E-9
Innovation Learning Network 2006

Personal Electronic Health Records

Today (Now) Next Week(s) Months Years Goal


Query members for Survey patients Working Nationwide Commercially
rd
willingness to (get 3 party prototype for availability available portable
participate at with $$) demonstration (3- electronic
organizational AND 6 months) personal health
personal level Get record managed
involvement Testing (3 by me/ trusted
Create a skeleton from industry months) family member
survey of patients (Google, etc.) within 2 years or
Engagement with political less
One-page overview of Get a patient players and medical record
the project for (or two) vendors 10/20/08
distribution 2:25 PM
Develop
Contact companies: scenarios for use
- Google: Marty with patients and
- Yahoo: David J vendors (1-3
- Intuit: David T months)
- Facebook: Laura
VA to share
Jim writes up RFT “build demo” from
- Tim will give system Health University
requirements to Jim (VetHU) – to be
shared with
Adrienne: research Steering Group
HIPAA

Page E-10
Innovation Learning Network 2006

Virtual Simulations

Now In Weeks In Months In Years Goal


CA to email 2nd Rick to set up Try it with some Interaction of Understand how
Life and Forterra MS Live stakeholders patients, health virtual
to group meeting for care providers, simulations can
group to “try” SL If momentum, spaces, be useful within
Group – sign up together buy an “island” processes in healthcare and
for SL account together (have a some sort of the people we
Bobbi to virtual presence) virtual world… serve
CZ send status schedule
update to group meeting for A forum for Try it, try it, try it
(try to web group (within 3 innovation…
conference weeks) try by Engage with our
training program) Nov. 7-16 stakeholders who
like to interact in
CZ send Email Rick if virtual worlds
summit/Forterra you cannot set
sim up an account
measurements

Page E-11
Innovation Learning Network 2006

ILN 2007

Now Weeks Months Goal


Confirm membership Smart networks – Implement new tier LIFE!!!
demonstrate value structure
Find new members
Grant Jan 07 teleconference
Determine price - Bev/CIMIT ILN to vet Tier 2
- Duffy/HRET projects
Does KP coordinate
and participate – Write new purpose
2007?
Formal agreement on
services

Explore potential Tier


2 topics (list serve)

Page E-12
G A M E P L A N T E M P L A T E
Purpose:

TEAM/
RESOURCES
/ ACT IONS
• Leader: TASKS
Next Week Next Q Next Year
• Members:
Today
• Task
• GOALS
• Task
• Task •

• Action 1. …
• Action • 2. …


• •


• Member: • •


• •
• … •

• Resource •
MEASURES Measure 2

• …
• … Measure 1

SUCCESS • Success • • •
FACTORS Factor

CHALLENGES LINKS TO OTHER ISSUES/PEOPLE


• Challenge • …
• … • … • Link • …
• … • …
Innovation Learning Network 2006

Section F: Going Forward

ILN 2007

The purpose of the Innovation Learning Network is to foster discussion on the methods and
application of innovation/diffusion, ignite the transfer of ideas, and provide opportunities for inter-
organizational collaboration.

There are two tiers of work the ILN engages in:

• Tier 1: High-level, open discussion on innovation and diffusion, often with senior
leadership and champions of innovation within each organization
o Example: Open Space
• Tier 2: Focused exploration and collaboration on a specific topic. The group could
include Tier 1 participants, plus the content experts in each organization.
o Example: a deep dive into medication administration

Activities and Service of the ILN 2007

• Quarterly web conferences: These web conferences are for ILN sponsors and champions
to conduct the business of the ILN, to share, to learn, and to network
• In-person meetings: two-three per year with each held at a different ILN members'
campus. The purpose is for intensive, in-depth learning, sharing and networking
• Virtual Fridays: Short, topic-focused web conferences (up to two per month). Content on
a topic is presented by a member organization for thirty minutes, followed by fifteen
minutes of questions and answers. Virtual Fridays are archived into a virtual gallery which
any ILN member can visit at any time
• ILN website: ILNOnline.org is our portal into the ILN. It contains a:
o Searchable membership directory
o Discussion board
o Calendar of events
o Archives
• ILN list-serve: The ILN list-serve is one email address that allows members to email all
ILN members for quick and easy communications
• ILN wiki: The ILN wiki (accessed through the website) is a place that allows members to
collaborate and create content on the fly, including uploading files. Any ILN member can
edit and create.
• Group consultation: Any member organization that is facing a gnarly challenge can
request a group consultation either via a monthly web conference or at in-person
meetings. The group consult brings together the experience and creativity of the ILN
members to help provide breakthrough.
• Loan an executive/expert: Any member organization may borrow an expert/executive for
an on-site, focused experience. The ILN will help set up the trade/swap.

Page F-1
Network Mapping
!
& Training page 1 of 2

Proposal

June Holley, Network Weaver


8 Lincoln St., Athens OH 45701
june@networkweaving.com
740-591-4705

Dear Maggie and Chris,

I am delighted to offer you this proposal for training in Network Mapping and Network Weaving. This is just a sug-
gestion. I would be glad to modify it to better fit your needs. The proposal includes use of the Smart Network
Software by all of the participating groups at no cost, as it is still in beta testing (see attached agreement form
which must be signed by an authorized individual from each organization). The only requirement for the use of the
software is that the group provide information on any difficulties you find with the software and make other sug-
gestions, as requested, about its revision.

The goal of the training will be to provide provide a joint training with individuals from 3-4 ILN member organiza-
tions as well as ILN staff so that they are able to use the software in innovation projects in their organizations.

Part 1. Training in Network Mapping

Outcomes:
Each participant will have the skills necessary to:
• generate survey questions,
• implement a number of data collection methods,
• enter data into the data collection sheets,
• implement all steps necessary to generate a set of maps and measures, and
• interpret the maps.
Activities:
Dec 18-31: Participants will have an initial call (1 hour) to identify projects for mapping, engage in a
short session on Smart Networks and their role in innovation. We will go over projects
for feedback, then get feedback on questions if some groups have them ready.
Dec 18-31: Individual calls as needed to clarify who will be surveyed, how, and what survey ques-
tions will include. Instruction on how to enter data into spreadsheets.
Early Jan: Training on the use of the software is provided, using the data from each organization’s
projects. This will include 2 joint phone calls and some one-on-one time as needed. I
will help them clean their data. Maps and metrics will be generated with guidance over
the phone from me.
Mid Jan: Group teleconference training will be provided in analyzing the maps; we will go over
maps with the group to deepen analytic skills.
Later: Each group will determine when follow-up survey will take place and will conduct with
assistance as needed. Group will analyze the new maps and metrics and will be trained in
how to display the changes over time.

©2006 June Holley, Network Weaver


Network Mapping
!
& Training page 2 of 2

Proposal

Part 2. Training in Network Weaving: Enhancing the Network

Outcomes:
• Individuals from participant organizations will use maps and metrics to develop Network Weaving
strategies that will enhance their networks and lead to effective self-organizing.
• Individuals from participant organizations will form a learning cluster for peer support in their NEt-
work Weaving activities.
Activities:
Dec: Phone training in Smart Networks for background; discussion on how Smart Networks relate to their
innovation/Network Mapping projects
Jan: Introduction to Network Weaving. Network Weaving Self-Assessment to identify strengths and growth
areas.
Jan: Once participants have mapped and measured networks, session to understand stories in the maps and
metrics, what they mean, “what ifs”; how the networks can be enhanced through closing triangles, increasing
periphery, etc; basic Network Weaving strategies appropriate to their project. Set targets for metrics. We iden-
tify network leaders of various types using the metrics and discuss how to support their leadership activities.
February: Face-to-face training session at gathering. 5 Dynamics that increase the effectiveness of networks.
Network Weavers analyze the network maps and discuss how they could be enhanced using “what ifs” to see
the impact of additional connections. Lead Network Weaver and I debrief session and discuss your follow-up
role and tasks.
February-June: Additional training & peer learning. Monthly or bi-monthly phone training, mentoring,
and peer exchange session to the Network Weavers each month. Part of the time will be going over spe-
cific feedback on their Network Weaving activities, and part will be training in advanced techniques.

Please let me know if this meets your needs.

All the best,

June Holley

Network Weaver

©2006 June Holley, Network Weaver


Innovation Learning Network 2006

Section G: Resources

ILN 2006 Members

Alegent Health
http://www.alegent.org/

Ascension Health
http://www.ascensionhealth.org/

Catholic Health Initiatives


http://www.catholichealthinit.org/

CIMIT (Center for Integration of Medicine & Innovative Technology)


http://www.cimit.org/

Cleveland Clinic
http://www.clevelandclinic.org/

Evanston Northwestern Healthcare


http://www.enh.org/

Franciscan Missionaries of Our Lady Health System


http://www.fmolhs.org/

Kaiser Permanente
http://www.kaiserpermanente.org/

Mayo Clinic
http://www.mayoclinic.org/

United States Department of Veterans Affairs


http://www.va.gov/

Health Technology Center (HealthTech)


http://www.healthtech.org/

VHA Health Foundation


http://www.vhahealthfoundation.org/vhahf/

Page G-1
Innovation Learning Network 2006

Other Resources

Clorox
http://www.thecloroxcompany.com/

Craigslist
http://www.craigslist.org/about/

Electronic Arts
http://www.info.ea.com/

IDEO
http://www.ideo.com/

Kraft
http://www.kraft.com/default.aspx

Networkweaving
http://www.networkweaving.com/

Second Life
http://secondlife.com/

Yahoo!
http://info.yahoo.com/

Page G-2

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