Generating Solutions Pt. 2
From: M. D. Anderson Department of Performance Improvement
Date: January 15, 2008

Jyme Arthur: But I said I wanted to come back to step three, generating alternatives and the brainstorming function. Here you are going to be looking at types of solutions and we talked about quick solutions versus somethings that's gonna take awhile and longer solutions are ok, it depends upon your presenting problem.

We want you to look for conventional versus unconventional and perhaps you'll come up with a nice combination of both. And of course they need to be workable. What I wanted to talk about briefly is what creativity is not, it is not a zap out of the blue, it isn't magic, it isn't silliness and certainly it is not something that only other people have. And I mention this because I believe that in healthcare we are very, very serious people and sometimes we think about creativity and I'll back up here a second, as being silly and gosh I can't engage in that, and I discovered this book by Paul Plsek and you see Paul's name on this slide and he wrote this book Creativity Innovation and Quality and I loved it because Paul is an engineer and he felt for a long time that he was part of that category four where everybody else is creative but me, and so he decided well maybe I don't know enough about creativity so he decided to study it and of course the book is the outcome. And he came up with a term called directed creativity which I love because it appeals to me as the analytical sort that I am and you see the definition there, the deliberate mental action needed to produce novel ideas in targeted areas.

Somehow for me that looks at creativity in a more measured way, a measured determined way which appeals to me. And back to the whole notion of, hey healthcare is serious business. Absolutely it is and I think that what we see in healthcare are people who are drawn to the business of healthcare because number one they love people, and secondly they love the science and as such, they are serious analytical people. And what we're doing here is asking us serious folks to look outside the box as the cliché suggests and Paul ran a seminar entitled 'Creative Thinking for Serious People' which I thought resonated with me and I hope it does for you.

Encouraging you to consider creativity as part of a solution generating process that you can embrace, what Paul Plsek suggests is that think about creative thinking in combination with analytical thinking and that's what makes it work. If you think of PDCA cycle which we've presented to you as just an extension of a scientific method and I'm calling it the PDCA stew, and add that spice of creativity to it and then it all comes together, and it makes it work. Paul sites an example of a med error team that was operating at a hospital; they had done everything that they were supposed to do in the analytical framework.

They had identified the problem, it was medication errors, they had scoped it out, they had examined the baseline data, they knew what type of med errors they were looking at and they had solutions for problems one and two, they had parodied it, problem three was they were stuck and that's what he called stuck thinking. And so they asked for his help and he said 'sure I'm gonna help you with this one' and he shared with them the five mental actions in directed creativity and what they were able to do was clarify that focus as step number one says that required new thinking. And they said 'ok we need a new way to remind busy people' oh I should back up a sec, their solution for that third med error approach was, and the third med error was delivering medications on time. In that facility if you were 30 minutes late it was a med error and they had tried posting the times of the medication distribution in the nurse's station and that didn't work at all. So it backed up and they said alright, let's clarify that focus. They needed a new way to remind busy people when a certain time had come, ok?

The second point, recognize the current facts. Well the current facts was they had tried this time log and it wasn't working, the third one, list alternatives for a new approach. Well, they had tried a visual reminder and let's think about all the other senses. There's hearing, touching, feeling, smelling, what else could they use? And the mental association was how could you remind a busy person about time through hearing rather than sight? And the solution was an alarm clock, we went ok, that's not very practical however, alarm clocks? And so step five was developing ideas into practical realities, it couldn't cost too much, it had to be flexible, portable, easy to associate with individual patients they came up with the little sticky digital clocks that they could stick to, and I think at that time they had patient charts, they set them to alarm for the patient times of medication administration and it worked like a charm.

And Paul mentions, he says this wasn't rocket science but it worked beautifully because they were able to apply these five steps and it got them unstuck so in terms of solutions we encourage you to express it, develop it, try it out, and see what happens. Now let's go back to Duke and Tina.

Narrator: Thank you Jyme that was a very good presentation. Well we're back live in the studios now and we're open to take your questions so I asked our back office to see if we have any questions coming in. You can call 39651, we may place you on hold for a few moments, please turn down your volume on your computer or TV as you call in. Lets see if we have anything going. [ ringing ] We do. Hello?

To Narrator: Duke, we do have a question.

Narrator: Alright. (The) question is, when you have a lot of possible solutions how do you pick the right or most meaningful steps of solutions?

Jyme Arthur: Oh very good, ok well that's an interesting question. The team can be very good as far generating lots of solutions and there's several things you want to take into account when you're doing that. One is make sure that as you're creating these go ahead and make, if you can imagine a flip chart. Put a line down the center on one side has to do with the effectiveness of the, what benefit can you get from the solution itself and you have people just brainstorming. What impact will this have on again making an impact on our aim statement and then on the other side is look at the effort of implementation, could this require resources. Does it take a lot of training, education, so what are the different aspects that are needed to put this thing in place and maintain it all the time, so as you're looking at (it), you'll see what you'll want to do, is if you can cover eighty percent of the impact of affecting your aim statement and use it for up to twenty percent of the solutions will fall in that category. If you can focus on those, then you'll know that you'll target on those and then usually you'll come out winning.

You see as a system of solution so you're trying to pick and choose those that make the biggest benefit, the other thing to make sure as you're doing this is go ahead and utilize your stand, in other words as a team we're trying to think of these possible solutions, what do you think? And they actually are buying in by giving you input and of course always check in with management to get their reading and that kind of stuff because they know exactly what, could know some things about resources that you do not know.

Narrator: Right. So it's very good there. Other than that do we have any other questions on the line? Ok, very good.