For decades, the pace of creativity—generation of novel and useful ideas—in health care delivery organizations (for example, hospitals and medical groups) has been slow. Additionally, despite the industry bringing us innovative ideas such as precision medicine and big-data analytics, many promising ideas within health care delivery organizations have stalled amid resistance to change and organizational constraints.

Then came the COVID-19 pandemic: As organizations, their leaders, and their staff heroically stepped up to care for patients in unprecedented circumstances, creativity overflowed. Creative innovations and implementation strategies related to care delivery, operations and supply chain management, vaccine distribution, and other areas have saved lives, improved delivery and financing of care, and addressed critical challenges related to capacity, equipment, workforce, and vaccine shortages. Health care became an exemplar creative industry quickly.

Lessons Learned

We highlight four key lessons to be remembered as the industry moves forward. We also identify organizational actions and policy levers that are needed to support ongoing, post-pandemic creativity to address the formidable challenges that existed before Covid-19 and persist now, such as low-value care and inequity.

Lesson 1: The Health Care Workforce Is A Ready Source Of Creative Ideas

During the pandemic, the common image of a creator as entrepreneur or artist was expanded to include professionals on the front lines of the COVID-19 response. We saw critical care doctors and nurses creatively re-purpose split-respirators, baby monitors, snorkels, and hairdryer hoods for COVID-19 care; supply chain supervisors contact laundromats and hardware stores to help maintain personal protective equipment; and environmental services managers experiment with sanitizer placement and clever signage. As vaccine distribution faced challenges, public health workers turned closed Sears stores into vaccine centers.

The creativity on display across the spectrum of health care delivery revealed the readiness of health care and public health workers to generate, share, and implement creative ideas for improvement in routine work in response to large-scale crises—as they frequently do in the regular course of work without recognition. In both situations, their ideas can be highly effective. Health care and public health workers have deep knowledge of how their fields work; their expertise positions them to understand the sources of problems and often see creative opportunities to address and effectively implement solutions. Research shows that the more problematic or frustrating the situation, the more creative front-line workers become, with clear benefits for the patient experience.

Lesson 2: Creativity And Standardization Are Complements, Not Antagonists

Prior to COVID-19, creativity was often described as contradictory to health systems’ goal of evidence-based standardized care on the theory that creativity introduces variance whereas standardization seeks to reduce variance. COVID-19 showed, however, that these “contradictory” processes can be complementary and thus managed jointly. Creativity supports the identification of innovations worth standardizing. Clear surgical masks to facilitate lip-reading and family inclusion in palliative care virtual discussions have become standard practice in some organizations, for example.

Symbiotically, standardization enables creativity by providing a baseline for focus and revision. An example occurred when COVID-19 challenged delivery of the evidence-based ICU Liberation “A to F” bundle, for reducing pain and delirium. Hospitals maintained best practices in interprofessional teamwork and pain assessment yet creatively adapted the bundle by integrating virtual round participation, reimagining in-room presence to two-person teams, and adding just-in-time training for redeployed clinicians.

COVID-19 showed that administrative systems that support flexibility via parallel and intersecting processes are essential and possible for dual management of standardization and creativity. At the Mayo Clinic, they achieve this through committee design. There, a large committee of leaders convenes to review standardized safety protocols for routine matters, a slow, reflective, and consensus-focused process. A subset convenes to brainstorm and enact solutions to emergent crises in 15-minute daily calls. The full committee and the subset come together and apart as needed, an approach likely possible for other organizations.

Lesson 3: Implementation Of Creative Ideas Can Be Fast And Effective

It is reported that evidence-based medical practices, which often start as creative ideas, take 17 years to be incorporated into routine practice. Telemedicine—a creative, evidence-based practice of electronic and telecommunications technologies used to provide care at a distance—appeared to be on this path until COVID-19. After a decade of slow uptake, virtual visits rose 150 percent in a month during the pandemic, with organizations such as Emory Healthcare scaling their programs within eight weeks. Similar rapid implementation occurred for other creative ideas that had been marginalized, such as integration of behavioral health services into primary care, which have streamlined previously siloed care delivery processes.

Through these examples and others, COVID-19 demonstrated that implementation of creative ideas can be swift and improve the efficiency and effectiveness of care. This lesson is embodied in programs such as Stanford Health Care’s “52 and 52,” in which staff execute improvement ideas in two to eight weeks. Such programs and the overall response to COVID-19 showed that organizations and staff will mobilize when a compelling case is made, to the benefit of patients, workers, and organizations.

Lesson 4: Creativity Benefits From Collaborations With Diverse Stakeholders

During the pandemic, creativity was frequently used to build supportive networks and systems to care for vulnerable communities, enhancing commitment and effort to address local needs. Public-private partnerships among community health workers, organizers, and governments fueled the success of pop-up events and mobile vans to deliver COVID-19 testing and vaccine services to Black, Latinx, and underrepresented populations. Likewise, such partnerships facilitated home health services through mobile vans, sometimes with novel features such as rapid responders such as EMTs or paramedics to assist older adults with telehealth visits at home. In most industries, creativity powers the development of commercial outcomes such as new products and is a means to competitive advantage. During COVID-19, creative partnerships were used to effectively care for communities instead, addressing a combination of physical and social determinants of health.

Operationalizing Lessons Through Policy And Management

Together, these four lessons indicate the potential and feasibility of leveraging creativity for improvements. Doing so requires actions by organizations and policy makers. Organizations must take at least four steps.

Invite Creativity

First, organizations should invite the creativity of front-line workers by soliciting their participation and emphasizing their creative potential. Existing routines, such as daily huddles or rounds, may be enhanced or repurposed to integrate creativity. Intermountain Healthcare, for example, uses daily tiered escalation huddles as a process to carry forward improvement ideas from the front lines of care to senior leadership. Critical patient care information, including new ideas and suggestions, are escalated from initial front-line discussions to senior leadership in a series of time-staggered huddles. Routinizing idea generation in daily work processes normalizes creativity at work and increases the steady flow of staff-generated insights and knowledge to decision makers.

Special events to source creative ideas from the workforce as a collective can also energize organizations with the knowledge and motivation to make change. University of Pennsylvania Healthcare, for example, has used innovation tournaments to identify new programs to improve patient care experiences and care coordination. Inviting the workforce to participate in creative problem-solving can enrich senior leader-led decision making with new ideas that yield better long-term performance.

Support Creativity By Providing Resources

Providing support for creativity and use of elicitation tactics such as team brainstorming and reflection promotes a climate that encourages learning from success and failure. Cleveland Clinic, for example, provides resources to aid the adoption and spread of promising creative ideas through tools such as the “Invention Disclosure Form,” which staff can use to submit ideas to Cleveland Clinic Innovations, its commercialization arm. Creative ideas that emerged in response to the pandemic, such as new mask prototypes or ways to make public transit safer, had a chance to rapidly scale to provide protection to the workforce, patients, and community members.

Leaders should consider resources and tactics that signal to those in the organization that staff-led ideas are valued and have a pathway to being implemented and scaled. Research conducted on creativity in community health centers has found that brainstorming for creative ideas at the start of each improvement team meeting, coupled with reflecting on team functioning at the end of each meeting, is associated with staff generating more creative ideas. These processes are resources for creativity, and notably they are not expensive.

Creativity And Standardization

Organizations should design systems that allow iteration and complementarity between creativity and standardization. Structured process improvement strategies such as plan-do-study-act cycles and Lean management can be used to identify creative practices worth standardizing. They can also be used to invite and manage creativity by structuring the integration of creativity within standardized systems. Although these approaches are often narrowly viewed as a means of reducing waste and embedding standardization, they also involve gaining an understanding of emergent problems and providing real-time solutions, which benefit from and often require creativity.

Kaizen, or continuous improvement, lies at the core of Lean. Tools such as Kaizen boards enable employees to propose and iterate on ideas for improvement as part of a structured change process. The boards provide a reliable infrastructure for creative ideas to journey from idea generation to evaluation to implementation and can be designed to allow for alternating processes of experimentation and routinization. Paradoxically, these mechanisms that promote efficiency can also foster more flexible and adaptive processes by identifying and cultivating ideas worth spreading as innovations.

Reward Creativity

Organizations should reward creativity with recognition and evidence of impact. Managerial research has found that even dissatisfied clinicians and staff willingly generate creative ideas, given opportunity and support. The impacts of rewards and recognition on engagement, especially during times of increased stressors and burnout, are increasingly recognized. Cleveland Clinic’s Caregiver Celebrations explicitly recognize behavior that “welcomes change, encourages invention, and continually seeks better, more efficient ways to achieve goals.”

Rewarding creativity ensures that it is valued. Rewards can be both monetary or non-monetary, as long as the program and award recipients themselves are highly publicized.

Policy makers must support creativity as well. We offer four ways they can do this.

Promoting Creativity Through Incentive Programs

First, incentive programs such as value-based purchasing must continue; these programs encourage organizational creativity to achieve performance-reimbursement goals. For example, the Centers for Medicare and Medicaid Services’ (CMS’s) Merit-based Incentive Payment System (MIPS) rewards clinicians and groups with a 15 percent payment for improvement activities. These activities, such as process improvements for care transitions and responses to patient experience data, frequently spur innovation through the creative efforts of clinicians and their teams as they push the boundaries of health care and require new types of expertise and work patterns.

Future reforms of MIPS and other pay-for-performance programs (for example, accountable care organizations) should be explicit about the organizational support required for creativity; they should include support for more resources and time devoted to staff-led improvement activities that involve new ideas. This support would be particularly impactful for underresourced practices that serve complex and underserved patients who require more customized, patient-centered care, as these practices need creativity to “do more with less.”

Updating Regulations

Second, local- and state-level regulations must be periodically reviewed and updated to ensure they do not stifle creativity. For example, a key facilitator of telehealth’s rapid implementation was changes to laws that removed delivery and reimbursement barriers to adoption. CMS’s changes to its Physician Fee Schedule to expand telehealth and other telecommunications technologies allow the demonstrated positive impact of the telehealth innovation to continue. Existing funding programs and regulations should also be updated to ensure they can integrate the most promising creative ideas such as mobile clinic programs, which could fit into existing case management models proposed in the national COVID-19 surveillance system but will also require federal reimbursement models to be enhanced to cover necessary community-based resources.

Continuing Challenge Grants

Third, rapid-response and grand challenge-style funding that operated during peak COVID-19 emergency periods should be retained for another purpose: to reimagine health care systems. Rapid-response grants from federal agencies such as the Agency For Healthcare Research and Quality and the CMS Innovation Center stimulated timely, creative, and cutting-edge research to address gaps in care delivery revealed by the pandemic. The infrastructure of such award mechanisms, including reducing the need for pilot data and shortening review cycles, facilitated pioneering research that may not have survived traditional award procedures. Countries such as Canada also introduced special awards to support research focused on solving especially difficult “big questions” facing societies, thereby nurturing important creative ideas that typical funding outlets may miss. These sorts of challenge grants should be continued so that the creativity they unleash can continue to improve health care systems.

Cross-Industry Collaboration

Finally, the health care and public health must collaborate with the other industries. Evidence suggests that meeting community health needs requires creative networks and partnerships, within and across industries. For example, the Clorox Alliance provided disinfecting products and used public health best practices from the Centers for Disease Control and Prevention Foundation to guide United Airlines, Uber, and AMC Theatres in bringing back their services safely; the Alliance also provided grants to hospitals to support research on safety and cleaning best practices for COVID-19 patient care. Non-health care organizations are eager and well-positioned to provide insight and resources: Furloughed airline workers used their customer service skills to provide lounges for exhausted health care workers; Hewlett Packard donated 3-D printers to create personal protective equipment; and Formula 1 and London Hospital partnered to develop a respiratory device design for mass production, to cite just a few examples.

Self-reliance is unlikely to generate the creative ideas and implementation required to address the big, remaining issues in health care. While COVID-19 brought much devastation, it also showed the power of creativity and creative potential of the industry to address serious problems. That lesson is something that should not be lost.

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Originally Appeared Here