Health Innovation School: 2018 and Beyond by Zayna Khayat https://padlet.com/khayat_zayna/vsxd9yzynft9 Feedback and direction for the next cohort(s) of Health Innovation School en-us 2017-11-19 13:24:38 UTC 2017-12-11 13:04:05 UTC hello@padlet.com I. COMPOSITION OF THE COHORT - mix of participants? Optimal size? Selection process? khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208466969 Who was missing? 
  • Policymakers / national government. 
  • local government - municipal, provincial (X5)
  • more patients /family members - including those who can have an overview beyond their own condition
  • 'normal' patients with more simple health issues managed in primary care; including mental health+medical comorbid
  • health professionals from primary care; 
  • more nurses X2
  • students, younger people ... health professional trainees; innovation students; technical physicians.  students are actively making their own patient-centered curriculum. intrinsic motivation, mindset already there  X2
    • MBO/(HBO)  [applied/technical colleages]
  • teachers too!
  • welfare / vulnerable population service providers
  • More companies.  X4
    •  MKB/FME  [SMEs]
  • ICT-afdelingen [departments]/EPD [Electronic Patient Dossier]/Privacy compliance
  • Wetenschap [science]/ZonMw
  • Beroepsverenigingen [professional associations]
  • Koepels/belangenverenigingen [umbrella/interest groups]
  • Top sector
  • “Bestuurders” aanhaken/Fin vormen  [boards /directors on boards/CFOs]
  • RvT (raad van toezicht) [Supervisory board members]

Risk if you broaden it -- might not have enough core.
  • students/teachers could be observers if there is not enough space
  • policy makers different role - observers/advisors

What to change? Who else to bring in next year?
  • Many of the trainers are change agents but spoke more about methods or achievements; could we get more Helen Bevans and Jesscia Tangelders. 
  • eg: Hów to change on the spot where it should take place: in the workplace.  There are some brilliant and very inspiring change management guru’s in Holland - Leon Caluwe, Thijs Homan, Leike van Os/Jaap van ’t Hek, Marco de Witte,  Paul Kloosterboer
  • Go-no/go to stay in cohort, verwachting cons. [if unable to meet expectations]

Application process: 
  • commitment -- really important. some people were really not willing to put in any effort  - how to screen those out? erodes the experience. screen this further.
  • wanted to say more through an interview. perhaps add this as an option of people want it.
  • apply as a team?
  • ask what the person is going to contribute as an alumni
  • submit a video pitch of themselves (option)

How should we select the next 50?
IDEA: pick people who have connection with the first 50 to build more momentum - starts to create  X4
  • If colleagues of cohort 1 are allowed to apply, ask them in the registration how they want to continue innovation with the alumni, within their organisation or regionally ...
  • regional spread: some regions are more ahead than others in innovation. build on existing regional participation 
]]> 2017-11-19 13:26:25 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208466969 II. CONTENT (5 MODULES) - in person and virtual (e-learning) sessions. What should we keep - stop - add? Faculty/trainers? Learning model? khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467025 KEEP
  • Appreciated international speakers - good balance
  • Keep the inspiring talks.
  • Human Centered Design         
  • Informeler & open momenten  [informal/open moments]
  • International speakers:
    • Helen Bevan
    • Melvin Samsom                       
  • Local speakers with practical, honest experiences, including failure:
    • Peter Bennemeer
    • Erik Gerritsen
    • Van Houdenoven & Remco + Bezoek  [site visit]
  • Roast method
  • Jessica Tangelder: verschillende werkvormen [different work forms]

Add more days  [DONE - we added 1 day]
  • keep it inspirational
  • allow more team time
  • allow more time to reflect with each other eg Helen day was mind-shaking, but did not have time to reflect

Value of leaders with lived experience sharing their story
  • every trainer should have practical experience with what they are teaching (instead of just classroom based instruction)
  • Inspirational to have examples of how to organize healthcare in different way eg Bernhoven, Maxima MediMore primary care
  • See more of the biggest failures - this is where there is maximal learning
  • Include more examples - eg Maastricht Blue Healthcare
  • got a lot of energy from the great stories of the speakers. From the innovation process to the examples from practice. That has given me a huge boost and confidence. Innovation is difficult and requires perseverance, but I still take this energy and the trust that it is good to work every day (where I especially want to inspire others and get supporters)

How to profit more from ' whole system in the room'
  • Used too little now. Expected more exchange of interests across the points of view 
  • discussing key themes / common themes or experiences.
  • and learn more about each other ... set up visits, experience their job, drop the boundaries.
  • IDEA: Open Space
  • roasting session was a start, but hard to do virtually
  • More stories from other participants' experiences, instead of always outside speakers

START:
Go deeper into System Implementation
  • Internal implications
  • Financing
  • System change
  • Linked to Human Centered Design

  • De vraag over de waarde [The question about the value]
  • Open Space
  • Black mirror over tech
  • Meer voorbeelden uit andere sectoren [More examples from other sectors]
  • Vooraf meer literatuur [Advanced literature]
  • Meer varianten feedback  [more variety/frequent feedback]
  • Reflecties verzamelen en delen [collect/share reflections] 

Content missing?
  • sometimes felt overwhelmed by the techno optimism (tech as the answer for everything) during the courses. 
  • perhaps next year add a more critical focus too (example - open surgery initiative)
  • Introduce a section on: dark side of technology.
  • the (great!) frame that we don't need more solutions and technology didn't always match the choice of speakers or action projects. perhaps in the beginning spend more time with the challenge that we have and the solutions already offered (but not effective)
  • How to get the knowledge and experience out of the participants in the room, instead of only the guest trainers
  • Innovation has multiple aspects: changemanagement/implementation, cultural aspects about the relationship patient/caregiver, innovationtheory (what brings change in normal markets, innovationtheory Rogers,  disruptive theory, the chief idea killer, Value proposition, business model canvas), inspiration en vision, examples in practice, the innovation process/design thinking. Maybe it would help if we would emphasize what aspect a presentation is about (whith a colourscheme) and in the aftertalk evaluating what you heard: because a lot off presentations cover more than one aspect.
  • more information about the way you can get finance for an innovation. There are multiple things we could do: we could ask Zorginstituut en Nederlandsezorgautoriteit to present the cycle for new innovations before it is part of ‘het verzekerd pakket’ (care you are insured for). Maybe in one of the ‘side-sessions’ we could do a specific session about the financial rules. Or there could be sessions were someone who knows the system helps groups with their businessmodel canvas.
  • - input on the financial side lacked, is also a big hurdle in many innovation cases. social impact bonds are an interesting initiative, also the initiatives on introducing digital local currencies for more sustainable (local) economies
  • more focus on personal development and interpersonal skills:  how do you function in groups/ situations, what can you change to improve, besides the more 'technical skills' that certainly are very useful but only really work if the (inter)personal side is taken care of; personal innovation

STOP:
  • Langdurige online sprekers (behalve Helen)  [longterm online speakers, except Helen]

IDEAS: 
  • Include visit to others' workplace as an optional "experience tour"
  • Share the presentations/videos with your colleagues [will all be posted on website shortly]
     
    Other considerations about trainers:
  • Explicit knowledge is available online - learn this at home; focus the doing/practicing/exchanging during in person sessions. *video recordings of 2017 discussions will help with this
  • Not always necessary for the trainer to interact with the audience - depends on the trainer and content
     
]]> 2017-11-19 13:26:56 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467025 IV. ALUMNI. How should we keep you engaged, involved and supported? khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467073 Network of the alumni - keep it going for:
  •  sharing experiences and new ideas
  • update each other on process of innovations
  • share successes, and pains
  • Also good to share experiences or requests for help with each other via slack / linkedin.
  • follow up of the projects, as some teams will continue on their projects
  • put out a query or question to the cohort.
  • keep some kind of inventory of what expertise the people can offer - since not everyone knows everyone.  X2  example: per person briefly his / her attention / work area and expertise. It helps enormously if you can immediately engage with someone who also has the will to change the market and who can serve as an 'input' for other organizations. 

IDEA: Organise return days twice a year minimal - in person contact is key

Tools to keep network engaged:
Invite alumni to come back and be part of delivering the program:
  • to teach
  • to participate / observe during in-person sessions or virtual - they can contribute and share experiences
  • Option to work on another team's project (from first cohort), if there is interest
  • Help the new action projects (for cohort 2) as an expert advisor or coach
  • IDEA: form alumni advisory board - to help design the program, pick the cohort 

Additional ideas from 30 november (not included above or below)
  • Cyclisch proces/vernieuwing  [cyclical process / renewal]
  • F2F  &  Digitaal [face to face and digital]
  • Slim delen en kennis [smart knowledge sharing]
  • Door budget/uitbesteden co-produktie [if limited budget – outsource co-production]
  • Linked-In ipv Slack education  [LinkedIn instead of Slack education]
  • Automatisch inzicht event-agenda/onderwijs [Automatic insights expertise, interests]
    • Foto-overzicht [photo overview]
    • Boek, per persoon [book, per person]
    • Wat doe je precies [What exactly are you doing?]
    • Halen/brengen [What you are looking for, what you bring]
    • Tel nr / woonplaats [contact information]
 
o   Korte les creëren ter verspreiding [Create a short lesson for distribution]
o   Koppelen aan projecten en verenigingen [Linking projects and associations]
o   Kennisintegratie in het werk [Knowledge integration in the work]

Connect 2017 alumni to the new cohort(s) formally?
 
Create some optional programming for the alumni
1. Experience tours -- to other sites that are doing human centered design.
  • facilitate the possibility to have an alumni- tour so alumni can explore eachothers workspace. Also available for students
2. Invite to programming- invite alumni to webinars, zoom sessions
  • other alumni alert each other of opportunities or events (via Slack)

IDEA: Ask an alumni to take on some of the work eg, host the next in person 

IDEA: Can alumni run a mini-local of the school? for a region? With some support from the core team
]]> 2017-11-19 13:27:27 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467073 III-a ACTION PROJECTS - selection, teams, process, coaches, implementation, ... khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467887 Value of action projects
  • an essential part of the School 
  • value of projects -- gives you something to do, chance to apply the principles
  • people were very motivated to work on the project because of the system change perspective across a network of 50 people

Project selection
  • Give feedback on why project ideas were not included/selected
  •  .... and why the 10 projects were selected
  • Include topics from all Sectors
  • Leave some room for options for new project ideas to be created
  • Some people would like to have picked a project close to their field - for example, Team 9 was in diabetes; there is interest in the ecosystem in continuing their project ... they need to decide wether to continue investing time; hard to justify if they do not work in the topic area
  • IDEA: have 2-3 groups work on a same topic at the same time?
  • The focus was now mainly on strengthening / renewing existing ideas / initiatives. I think that's fine, provided that the sponsor (owner of the idea / initiative) helps you with that. The disadvantage of something existing is that you actually have a tunnel pulled in, while you actually want to look at it with a fresh look. Personally I would find it much more interesting to come up with something completely new, to work out and then to win sponsors. Or find a sponsor with a problem for which we come up with the innovative solution (with all the steps in the innovation process that come with it).
  • Should the project have a hard deliverable and a sponsor?  tradeoff: the learning opportunity might be diminished. instead, could this be the next step? or - as long as you set the expectations right, a sponsor could work. 
  • IDEA: offer 2 options for the project. if this is your first experience, take a less committed path; if you are experienced, then choose the sponsored path

Scope / deliverables
  • Provide clearer expectations of the outcome of the project , what was ok/what was not ok. 
  • Clarify expectations at the beginning so there are no surprises example - Pitchbook
  • apart from the (useful) roast perhaps more intermediate feedback loops on the action projects can be organized
  • coach -- what to expect from coach? was not always obvious
  • coach - matchmaking was fairly random
  • is the horizon for the project to be implemented?

Methodology
  • focus on human centered design process was a bit rigid
  • for example, following the steps. Is it always the right model or tool? especially when you have not had a lot of experience with it. 
  • could there be more flexibility?

Coaches
  •  what was expected coach was not clear clear -  liaison role with the School was sometimes expected or more a teamcaptain. 
  • coach should only step in based on questions from the team, but it did not function like that, so became more a process and sometimes content adviser.

After the program - what happens to projects?
  • what happens next? do they continue to work on the project.
  • 50 people, 100+ hours in 6 months ... waste of time if they do not create more opportunity to bind more organziations in the process along the way -- involve CIO, etc to ensure they participate

Pitch op ILN was voor vermoeid publiek [pitch at ILN was a tired audience]
]]> 2017-11-19 13:37:03 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467887 PATIENTS/FAMILY ADVISORS - how can we more effectively integrate with patients? khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467938 Involve patient advisors more as trainer or teacher in the in-person sessions

They provided a lot of important information - but not all had the right level that is needed to work with
  • Critical to distinguish between a patient Expert (IKoNE) and a patient with lived experience (who may not be trained). Need both

How to really listen

Make the advisors more explicit/visible in the program        

Include less medically complex patients eg "normal"/primary care instead of only chronic care; vulnerable patients

Make patients more part of the team - every team have one

Risk: sometimes if patient is too much at the center - it is hard to get other opinions integrated. can dominate with 1 point of view
 - how to build more mutual understanding between patients and the other players who are in the cohort

Patient experience tour -- could sometimes get too personal instead of considering the bigger picture learning opportunity. 
IDEA: Perhaps have a nurse  or other health professional there too?
OR - involve the alumni with patience experience to connect and help deliver patiënts who van contribute and overlook own experiences.

Share how a range of patient participation techniques were used to move an innovation forward in other examples - include this in the programming
  • Help students learn to integrate patients in their daily work 

Other sources of patient experts beyond IKoNE:
  • some alumni can contribute via HIS to Ikone and other organisations who are working ( and often struggling) with implementing experienced experts
  • Sharing experiences, education possibilities for patients who want to learn how they can contribute with their experiences in Innovation and healthcare, for a culture change.

Start as the first students from HIS in building a strong national network for patients included , using our network and knowledge!

IDEA: Extend this group to other experts from the practice of not only looking at patients, but also, for example, to the professional group / volunteers etc. 
  • Select this on the basis of the project assignments to be elaborated. 
  • For example, we would like to have a nurse with our team who wanted to share his / her experience with us. 
  • On the other hand, we have just started looking for nurses within our network, so it is mainly a nice to have.
]]> 2017-11-19 13:37:39 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208467938 V. OVERALL PROGRAM DESIGN - timelines, in person sessions, virtual sessions, etc. khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208468006 # of Days / weeks?
  • Project time commitment: 5 months too short?  Often it was more than 0,5 days/week
  • keep the time in between the in person sessions
  • IDEA: Add at least 2 (ideally 3) days for the teams, outside of the training sessions
  • IDEA: Switch to a 5 day bootcamp model? (instead of 2 days X 2)?

Mandatory ‘terugkomdagen’ between the in-person sessions

Need to spend more time together as a cohort, often did not know each other outside of the team
  • IDEA: Gift basket –every participant offers a “gift” example: 2 hours of my time to learn X 
  • IDEA: Randomized Coffee chat (Slack feature) 
  • IDEA: # Deals done between cohort members? (as a way to track new collaborations

Include other 'tours' 
  • Innovation safari at other health systems' innovation teams/sites
  • visit other industries doing innovation, outside of healthcare
  • make this an option, alongside patient experience tour - but keep patient tour mandatory?
  • Go as a team
  • Invite alumni from first cohort

Tools: 
  • Keep using (new) digital tools like Slack and Padlet; it confronts students with digital transformation. :-)
  •  Important to model what is happening in real world of healthcare's digital transformation
  • BUT: combination of lots of new tools - google drive + slack costed a lot of time; IDEA - provide some basic training for people who are new to these tools
  • is there a way to get other tool suggestions from others in the cohort?
  • IDEA: Paperless?
  • IDEA: LInkedIn instead of Slack for community discussions
  • IDEA: Switch from pure Google drive to a Team Drive using the Google Sites platform (example - https://zapier.com/learn/g-suite/google-sites-tutorial/)

 A bit frustrating to have things added to the program that were not expected from the beginning. eg experience tours, pitchbook.

Make sure we are not sitting so much in the classroom

Charge a fee?  will get commitment. 1000-5000 Euros? A lot cannot afford it. Need to ensure it is easy to access. Could have tiered pricing, with some grants (free).
]]> 2017-11-19 13:38:24 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/208468006 III-b. TEAM SELECTION & PROCESS khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/210794239 Group dynamics is a key part of the experience 
  • give team more time to get to know each other - and the project
  • IDEA: add more teamwork time explicitly - do it outside of the 4 days.  at least 3X together - planned  DONE
  • IDEA: organize the start (kickoff) of the team more formally
  • Ideally: they can together define the project and have ownership
  • more science around the teaming process - who do you need on each team, based on evidence?
  • Optionally, the people you need for the project in advance, and take this into account during the selection process. Within our team if expertise was not there, we were looking for it in the form of colleagues / own network.
  • diversity of the group really shows how different people look at a problem in different ways
  • would have liked more guidance in the group dynamics
  • virtual tools for a project are challenging when people are spread across the country; in-person was very difficult due to holiday time too
  • more patient participation in the group ... 
  • Team members speak a different language and see the project problem differently - therefore having a deliverable could help keep focus; days together should also help to create a common language.
  • Should coach help with the team dynamics when there are gaps or challenges?
  • More time, during the two days, but certainly also a number of fixed days outside it is necessary to make speed. The summer vacation that we were working with did not really work with that. In addition, it is important that it remains a team, within our project I noticed that the pressure was a lot of one to two team members, because of their personal interest. That is fine in itself, but as a result the pressure was not on the entire team. There I see a role for the coach
  • More space for each other's projects
  • IDEA: Include a question in the application for next cohort about team experience, philosophy, etc.  DONE
]]> 2017-11-28 09:33:15 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/210794239 https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/211020393 2017-11-28 16:57:43 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/211020393 khayat_zayna https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/214978349 2017-12-11 12:37:59 UTC https://padlet.com/khayat_zayna/vsxd9yzynft9/wish/214978349