Seven thousand hospital patients in the U.S. health-care system die every year after receiving the wrong drug or dosage, and more than a million are sickened. To improve those numbers, Christi Zuber, the director of Kaiser Permanente's internal Innovation Consultancy, invited 75 nurses, doctors, patients, and vendors to the California hospital network's Sidney R. Garfield Health Care Innovation Center in Oakland, Calif., in April 2007—not for a training session but for a brainstorm.
Brainstorming is a critical part of Kaiser's innovation process—and one that shows results. For instance, as a result of this session, Kaiser launched a brand-new process for delivering medications that has led to a 50% decrease in nurse interruptions and a 15% increase in efficiency.
Taking this event as a guide, here's a look at how Kaiser runs its idea-generating sessions.
The participants were settled into a large, nondescript room, sitting in teams of seven at round tables, each led by one or two Kaiser facilitators trained to brainstorm. "The first thing we do is frame the day's challenge by telling some of the stories that came out of our research," says Zuber. These stories illustrated four problems to be tackled: how to reduce nurse interruptions, streamline the medicine administration process, close the loops, and sanctify the activity.
The organizers also explain the ground rules of brainstorming laid out by Alex Faickney Osborn in his 1953 book, Applied Imagination, and still used today by innovation consultancies including Ideo, which Kaiser has worked with in the past. These include the need to focus on the quantity of ideas rather than quality, withhold criticism, welcome unusual ideas, and combine and improve on them.
Each team had previously visited a company in a different industry in search of ideas or practices that might be relevant to the problems, and as part of the brainstorm warm-up, each team recapped its findings. One team had visited a flight school, for example, and learned the idea of the "sterile cockpit," an aviation term for the minutes before and during takeoff and landing when the pilots are only allowed to speak about flight matters. Such analogous research isn't essential, says Zuber, "but we find it helps people start thinking differently."
Then the idea-storm kicked off, with each team focusing on two or three assigned questions. Kaiser has participants write down ideas on Post-It Notes using Sharpies because, says Zuber, "if they use ball point pens, they write too much and it's hard to read once its put on the wall." (There's no single right way to collect ideas in a brainstorm: Ideo uses Post-it Notes, innovation consultancy Gravity Tank asks for simple diagrams or sketches on 8 x 11 sheets, while Frog Design gives brainstorm participants very structured worksheets that, says Frog creative director Adam Richardson, "lead to more useful results.")
Brief silences are inevitable. "But if it goes on too long, the facilitator might suggest going after the problem from a different angle, saying something like, 'Let's think about tools and technologies,' " says Kaiser innovation specialist Chris McCarthy. (A P&G silence-buster: Ask participants to think about bad solutions to the problem at hand, which ultimately stimulates thinking about what a good solution might be.)
After an hour, when the walls were papered with Post-It Notes, each team reviewed its ideas, selected the two or three they were most passionate about, and built a quick prototype to present to the entire group. (Kaiser combines brainstorms with rapid prototyping, a topic we'll address in a later article in this "How To Innovate" series). The end result: 15 to 20 ideas promising enough for further development.
In 2008, Kaiser launched KP MedRite, a new process for medication administration based on three of those ideas. It includes an official step-by-step workflow process; a sash that would indicate "I'm delivering medication so please don't interrupt me"; and a "sacred zone," à la the pilot's sterile cockpit, around the medication dispensing machines in which no unrelated conversations are permitted.
What can executives learn from Kaiser's approach to brainstorming? Follow the Golden Rules
Focus on quantity of ideas rather than quality, withhold criticism, welcome unusual ideas, and combine and improve on them. Define the Problem—and Stay on Target
As Ideo's Tom Kelley says, "a brainstormer without a clear problem statement is like a company without a clear strategy." Often the most effective brainstorms look beyond the initial problem (say, medication errors) to focus on its root causes (nurse interruptions, etc.). Space Matters
You don't have to have a state-of-the-art facility like P&G's Clay Street Project to hold a brainstorm. A basic room with lots of wall space works just fine. Formal conference rooms can be a bit stuffy, but if that's the only option, cover the table with objects or materials that will stimulate creative thinking. Build Your Team
Research shows that multidisciplinary teams are better problem-solvers, so invite people—aim for six to eight—who will bring a range of skills and perspectives. Learn from the Experts—Then Make Their Methods Your Own
Jump-start your brainstorming practice by working with an experienced innovation consultancy. Then adapt their methods to work in the context and culture of your company. Practice
Just as becoming a Six Sigma black belt takes considerable training, you'll never become a champion brainstormer if you don't practice regularly.