Innovating Innovations in Healthcare

Yesterday, I had the pleasure of visiting the Centre for Innovation in Complex Care. It is an interprofessional, trans-institutional organization, housed at the University Health Network in downtown Toronto that is

dedicated to studying how to improve the entire process of care for patients with multiple problems. Its purpose is to engage our patients and clinicians to identify problems with current healthcare practices and develop solutions for addressing them. Innovative research and evaluation in a real clinical environment will allow our clinicians to utilize the latest technology to improve patient care.

It is also, much to my delight, a UCaPP organization, and it is its UCaPP nature that is its key to success in achieving true innovation throughout every aspect of the healthcare system.

The Centre has active projects that range from improving clinical communications via new Blackberry applications, to methods that are focused on improving the in-patient experience, to completely rethinking and redesigning the systems and processes associated with treating atrial fibrillation, currently the most frequently encountered arrhythmia for which patients are admitted to hospital (not to mention being “challenging, costly, and resource intensive”).

So what makes the CICC innovative in its approach and organizational design – that is, what makes it UCaPP – and how does this influence its success? Fundamental to all UCaPP organizations is the idea that change happens where it happens, and the impetus for change can come from literally anywhere in an organization, or in this case, anywhere throughout the healthcare system. CICC members include physicians and nurses, pharmacists and nutritionists, engineers and designers, researchers and patients. It includes members from all the teaching hospitals in Toronto, and institutions elsewhere in Ontario. To become a member, one “only” needs to initiate a project (more on that in a moment), and find collaborators, which precisely echoes the process I’ve observed in other UCaPP organizations. Their “rounds” – medical jargon for socializing knowledge – are generally open to any interested party, and those who are interested in innovations in healthcare that address systemic or global issues are welcome to initiate a project conversation that is consistent with the Centre’s vision and values. As its Medical Director, Dr. Dante Morra, said to me, “if you’re interested in addressing a handwashing issue on 13E, we’re not so interested. If you’re interested in addressing a handwashing issue throughout the entire system, come talk to us.” Project participation is largely through self-nomination, which means that there is an emergent and organic vetting and review process that occurs throughout its life. There are lots of opportunities to share information, through weekly operational rounds, monthly deep-dive reviews of active projects in which all members from among multiple areas of expertise have an opportunity to contribute, and innovation rounds that look at new opportunities coming into the Centre.

The Centre strikes me as non-hierarchical, with any individual being able to take relative leadership roles, depending on the nature of what type of leadership needed at any particular time for any given project. Most important, however, is that the collaborative leadership creates a tremendous sense of camaraderie, with individual autonomy among the members, collective responsibility for the success of each project, and mutual accountability for the Centre’s overall success. It’s through innovations like this one that healthcare will become sustainable, especially in the face of increasing challenges and demands.