Question

• Discuss what barriers you perceive existed within the segments of the consortium that hindered change prior to the innovative and improvement approach that was launched. Answer based on below scenario.

Scenario: Kaiser Permanente’s Innovations Consultancy

Lew McCreary (2010) describes how Kaiser Permanente, a managed care consortium based in Oakland, California, has developed a novel approach to innovation and improvement. The company set up its own internal Innovation Consultancy unit. This unit employs change experts to observe people, ask them how they feel about their work, take notes and photographs, make drawings, and identify better ways of doing things. This involves, McCreary (p. 92) suggests, “a combination of anthropology, journalism, and empathy,” exploring how staff and patients live, work, think, and feel before trying to solve a problem.

A key part of the approach involves “uncovering the untold story”—finding out “what is really going on here?” For example, to prevent nurses being interrupted during medication rounds, and thus to reduce errors, a “deep dive” event was held, including nurses, doctors, pharmacists, and patients. The event generated around 400 ideas, some straightforward and some “outlandish.” This led to the design of a smock that said “leave me alone” on it (known as “no-interruption wear”) and a five-step process for ensuring the correct dispensing of medication.

Another example concerned the exchange of patient information between nursing shifts. This used to take 45 minutes and delayed the next shift’s contact with patients. In addition, nurses would compile and exchange information in idiosyncratic ways, potentially missing important details. The revised Nurse Knowledge Exchange is faster and more reliable, with new software and with information presented in standard formats.

Members of the Information Consultancy unit do not dictate the changes that are to be made, but work with staff as “co-designers” on change projects. This approach allows Kaiser Permanente to achieve the aim of implementing innovation and change quickly and economically.

Answer 1

Delays in processing time, micromanagement and lack of planning, lack of quality focus, new software modifications all created entry barriers coupled with risings consumer needs which formed barriers to entry.

Multiple changes which were in unplanned and changing dynamics willl see company lose its focus amd cause resistance to change which is biggest entry barrier.