Providence Kitty Powell Innovation Fellowship: Human-Centered Design Workshop Series.

The Opportunity

Healthcare is notoriously slow-moving, resistant to change, and subject to intense regulation. However, a series of shifts has occurred, and leaders in the industry are ready to embrace new ways to both connect with consumers and deliver care. There is a growing optimism and desire within healthcare to look for ways of thinking outside their industry, and to introduce innovation into a conservative and historically risk-averse system. Providence Healthcare cares about leading by example, and has committed significant funds for innovation training to inspire and develop the next generation of healthcare providers.

"The outside of healthcare perspective is important, we have a lot to learn from what others have done in other industries." Dave Underriner, CEO

Innovation is hard; it needs to be championed within an organization and requires stewards to guide it. At Evolve, we have been working closely with Providence's internal innovation team to build new capabilities within the organization, foster innovation leadership, and develop the ability to collaborate with external partners.

Each year, Providence's Kitty Powell Fellowship Program selects a class of innovation fellows from within the organization. These candidates have been identified as future leaders and innovation advocates for Providence. Fellows are challenged to behave like entrepreneurs and drive change within the organization.

The innovation fellowship is comprised of a series of learning modules including Evolve's approach to Human-Centered Design (outlined here).

Why so serious: A guide to innovation is a Human Centered Design (HCD) curriculum that approaches the design & innovation process through four key modules supported by 1:1 coaching sessions. It is an inspiring series of workshops that helps the fellows think from an outside-of-healthcare perspective, introducing HCD best practice techniques and tools.

The modules are taught over the course of a year and run in parallel with a series of live capstone pilots within the Portland community. Each module introduces HCD tools which fellows are then required to apply to project opportunities that have been identified by the leadership team.

Two fellowships have been coordinated during 2016 (the Class of '16 and the Class of '17). This entry is comprised of highlights from each of these classes.

"Just because you read the manual doesn't mean you know how to play tennis."

Human-Centered Design methodology, process and tools have been practiced for decades, but they are still relatively new to healthcare. Shifts towards consumer- rather than patient-centered care and services has opened the door for healthcare to reframe its approach to innovation.

HCD resources are readily available thanks to some amazing organizations (shout-out to IDEO.org for their efforts). HCD is often a practice of checking boxes and following process, which is never a guarantee of success and is often quite dry. Innovation is a serious game, but one that doesn't need only to be played in a serious way. Knowing how to play scrappy, get the most out of the tools, embrace humor, and shift your mindset at the right times are necessary to really give innovation a chance to flourish. Process is a foundation; not an approach.

At Evolve, we believe in a "thinky thinky, makey makey" mindset. Our approach and tone are playful at their core. We believe that play unlocks creativity and is the main ingredient for successful innovation (especially in a collaborative setting). After all, there's nothing more difficult that starting with a blank canvas or brainstorming without inspiration.

At the same time, our workshops are clear that HCD is not for your entertainment, it is not simply about having fun. The problems Providence is trying to solve are wickedly difficult, need sensitivity and empathy, and require appropriate and thoughtful application before being launched into the community. We believe bringing irreverence to the process helps to unlock big ideas, and will ultimately have a huge impact, but there is a time to get serious and work through the details, and it is important to recognize how to switch between these two mindsets.

For this reason, the tone of our workshops is very important; it has a huge influence on the fellows' engagement and inspiration and the session's stickiness.

We believe that the best way to learn is by making connections to culture, context, story, and personal experiences. Our workshops embrace this and bring HCD to life through referencing film, music, TV shows and games.

Meet the Fellows

Fellows are a combination of front-line staff, healthcare providers, and project managers. They have been identified as future innovation leaders within the organization. It is their opportunity to step up and make change happen.

The Nuts and Bolts

If we had 30 minutes we could dive into some of the details over a beer. But we don't, so here goes: the curriculum is based around four core modules (each one a one day workshop), supported by 1:1 coaching and a series of pilots and pitches.

Core Modules

1) Why so serious: A guide to getting started - This session focuses on framing opportunities, understanding users and building a hypothesis to give the team some momentum.

2) Why so serious: A guide to getting out there - Building empathy by connecting with users and the target population. Understanding the context and their existing frame of reference. Some teams will also use this as an opportunity to introduce co-design elements into their pilots.

3) Why so serious: A guide to bringing ideas to life - Introducing collaborative ideation techniques to kick start the design process and prioritize concepts. Teams will ideate against the actionable insights they uncovered.

4) Why so serious: A guide to telling stories - Sharing pilot success stories and building support within the organization. The teams will prepare their final pitches for leadership feedback.

Tools and Techniques

Like any good garden shed, the Human-Centered Design process is full of tools. There are essentials that you use over and over again and others with that are more specialized, only to be used when necessary. Our cornerstone tool is based on understanding and mapping the consumer journey which can be used in generative and evaluative ways.

We love it when fellows take what we share as a start point and develop tools and approaches to use with their own teams. Especially when they smash them up entirely in ways we didn't expect. Here are a few of our favorites:

1) Learn To Love Someone Unfamiliar (building a hypothesis) - Before teams are able to meet their population in the flesh we like them to use their existing knowledge to build a hypothesis of their population or user. This is a great way to identify any assumptions or bias the team currently has.

2) Coffee Shop Ethnographies (getting out there) - Before fellows meet their actual target populations we send them on a mission to employ a series of ethnographic approaches in Portland coffee shops. Fellows experience the thrill and fear of immersive research firsthand to get a taste of the tools they will be using.

3) Brand Slam (rapid ideation activity) - How would ______ approach your challenge? We randomly introduce brands under intense time pressure to help fellows ideate quickly by begging, borrowing and stealing from other categories. After you finish ideating you'll need to think about how your brand could apply those great ideas.

4) Shark Tank (pitching your idea) - Challenge your colleagues to channel their inner Mark Cuban, and pitch them your idea. With nothing more than your well-rehearsed pitch, wit, and all the charm you can muster, you'll need to share your concept with a frenzy of mustache-wielding sharks. You'd be surprised how a mustache on a stick can remove the inhibitions of even the most introverted team member.

5) Best Of Times, Worst Of Times (projection activity) - It's 2020 and your idea was a total disaster. The New York Times is writing an article about where it went wrong - complete with a quote from your former CEO - and they are not holding back!

These are just a few of the activities the workshops are built around. Each one is highly interactive and can be used to inspire even the most passive co-workers.

Going Live

To date, twelve pilots have been built on HCD principles and completed in the Portland community across a range of disciplines, including: Consumer Experience, Tele-Health, Employee Experience, Behavioral Health, Pediatrics, Cardiovascular Services, Diabetes Management, Kids Concussion, and Senior Care.

Following the completion of the pilots, the findings are reported back to a senior leadership council. Projects pitch for continued funding to enter a second phase of piloting or explore their potential to scale and implement as a full-time service.

Learnings from the successful and the 'failed' projects have been embraced and socialized within the organization, reinforcing leadership support for experimentation and change.

So what was our collective impact?

We are pleased to share that Providence senior management has reinvested in the program for a third successive year. Cohort 3 (The Class of '18) started their journey in March of this year and are due to graduate in March of 2018.

Previous fellows have been applying HCD to their own projects outside of the fellowship and continue to build advocacy and support in the organization as an innovation alumni.

Impact in stats:

- 53 graduated fellows

- 12 live Portland community pilots completed to date

- 57% of first cohort promoted within a year of graduating (Class of '16)

- Fellowship enters its 3rd year for 2017/18

- 100% of Fellows rated program 4 or 5 on overall satisfaction (2 years running)

- On track to reach over 2000 people in Oregon with new care approaches

- Shared the fellowship story with 12,000 people (including Mayo Clinic and IHI conferences)

- 38 new community partners developed through the fellowship

- Dave Underriner, Regional CEO, continues to endorse, support and attend the fellowship

- We are still working with the same team, developing better ways to improve the curriculum for the fellows and the effectiveness they are able to apply their training within Providence.

But what did Providence say?

"Human-Centered Design has become a centerpiece of our innovation efforts at Providence. Through the Evolve training, our caregivers in the Providence Innovation Fellowship Program are better able to understand people, their physical and emotional needs and what is most valuable to them." - Gwen Conner, Director, Business Accelerator

"Evolve's designers have brought a new way of thinking about how to solve health care problems to Providence. Evolve challenged us to embrace our customer and understand their problems in a much deeper way. On top of that, they have helped us develop an Innovative Fellowship Program that is teaching young professionals in our health system a different way to problem-solve." - James Harker, Chief Strategy Officer

"Evolve Collaborative was an integral part of our Explanation of Benefits (EOB) redesign project. They guided us through a series of inspiring and enlightening workshops and activities that helped us better understand our customer and ideate in new ways to deliver a 'wow' experience for our members." - Jill Nowak, Class of '16 Fellow, Manager Group Sales