DH - Commissioning to make a bigger difference - 25 June 08
A guide for NHS and social care commissioners on promoting service innovation – 25 June 08
- Extract from : http://tinyurl.com/6rt3yq
Summary
The guide also provides commissioners with insights into making a bigger difference in service and marketplace development overall in their role of helping to create conditions in their health and social care economy that favour the generation of innovative ideas. The culture for innovation framework describes
seven factors that organisational studies show are linked to innovative output.
In each section, this guide provides detailed instructions, examples, and practical advice on application geared to the needs of worldclass commissioners. An appendix provides five additional case examples, summaries of tools, and a glossary of terms.
While incremental change remains highly desirable, at perhaps no other time in its history has the NHS and its partner public services needed innovation – step-changes in what we do and how we perform – more than now.
This guide, along with companion publications from the NHS Institute for Innovation and Improvement, is designed to stretch your thinking and get you started in your new role as an innovative world-class commissioner of health and social care.
Overview of the 5-step process for assessing an innovative idea
Step 1: How big a difference does it make? Assessing the impact on performance indicators.
A natural place to start in assessing an idea is to look at its actual or potential impact. The seven dimensions of performance tool presents a useful framework for thinking about measuring the impact of a service innovation idea. The output of this step is the before and after measurements, along with a judgment about whether these results represent a step-change in performance.
Step 2: To what are you comparing the idea? Defining the context.
Next, we need now to determine if the details of the idea itself represent a step-change in the way health and social care are delivered compared with what is usual. This requires that we select a comparison context – the health or social care setting or system against which one wishes to consider the innovativeness of a new idea.
The innovation claim framework presents a range of choices for this selection. The output of this step is a clear description of the main context for comparison, as well as a secondary context that we can use to further challenge our thinking.
Step 3: How big a process change is it really? Constructing a 4Ws table.
The 4Ws table provides a format for a side-byside comparison of a new idea to the typical approach regarding Who is primarily involved in delivering the care, Where and When it is delivered, and What people experience while receiving the care. Properly constructed, the 4Ws Table is a simple, clear, powerful tool for assessing whether a given change idea is an incremental or step-change in the way things are done.
Step 4: What might make an even bigger difference? Stimulating further service innovation.
One of the main reasons for assessing an idea is to stretch our thinking towards even higher levels of innovation – making a bigger difference. Reviewing the 4Ws Table, we ask such questions as: What did we really change in the system of care? What did we leave unchanged? What additional new possibilities and opportunities have we now created? Imagine the power of a system where every change naturally leads to thinking about the next innovation! The output of this step is a brainstormed list of more ideas that might make an even bigger difference for those we serve that we can consider for future testing.
Step 5: Overall, how would you characterise the idea? Summarising your thinking.
After the thorough analysis of the preceding steps we come to the ultimate question – Is this idea a service innovation in the sense of being a step-change in both performance and process? The fi nal output of this step is a short, descriptive summary of your assessment of the innovativeness of your idea relative to typical practice in the comparison context.
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