Innovation has been a rallying call that has grown much louder in recent years.
The inaugural SingHealth Quality and Innovation Day provided a full day of workshops and seminars to attendees at Academia. Professor David Matchar from Duke-NUS’ Health Services and Research Programme gave the last presentation - a discussion about Singapore’s healthcare challenges and the need for innovation. After Prof Matchar, it was up to the organising chairman to close the event.
Dr Chow Mun Hong played piper, and the tune he played resonated in everyone’s core, “Can the healthcare system be better for everyone?”
Innovation has been a rallying call that has grown much louder in recent years. SingHealth has adopted a strong performance culture and if innovation is the buzzword, naturally there would be those who want to score some points. Staff have been asked to attend courses, learn skills and do more in the name of innovation.
There are the common questions: “What is innovation?” “How is innovation different from improvement?” and “What activities count as innovation?”
Dr Chow relates his experience with a particular series of Quality Improvement (QI) audits from his days as a doctor in the polyclinic.
“We spread the scope of patient care areas out and each junior doctor was given a particular area to audit. After collating the findings over several rounds, we found that despite everyone’s hard work, improvements were marginal.
“But, when we started applying QI methodologies, things improved substantially. We realised then that QI was about systems design and not about trying harder,” said Dr Chow.
The IQM Director conceded that when asked about how to improve quality, many immediate responses would be to “just try harder.” In a reality where healthcare professionals are already trying their best in a system that is severely stressed, “just try harder” can become counter-productive and demoralising.
“The challenge then is to see whether we can redesign the system and help these passionate people perform better – find a better way of doing something and not just try harder in a system that is problematic,” he suggested.
The goal of innovation is to design better systems that can lead to substantial and sustained improvement to the quality and safety of patient care - the more innovative the design, the greater the potential for improvement.
But with a staff strength of 20,000 spread across several institutions, it can be hard to connect everyone in SingHealth with common language and skills that can support collaboration and the flow of ideas. The EPIC framework was launched in 2009 to provide this common platform to support capacity building in innovation and improvement across SingHealth (see below).
Another key ingredient for QI success are open governance structures and processes.
“The testing of new ideas needs to happen, and it needs to happen safely. When employees have good ideas, we want them to function in a framework where they can approach a sponsor who lets them try it out and implement the idea if it works.” said Dr Chow.
“We also want to recognise successes. There’s a lot going on, and if we don’t celebrate the successes of people with good ideas, they might feel like they’re the minority. And that’s not true.”
In fact, Dr Chow revealed that QI practitioners are actually an insufficiently publicised majority. On many different levels, most of us are carrying out some form of QI, even if we are not aware of it. It doesn’t mean that QI or innovation only happens when there is a big project, and many people don’t give themselves credit for innovating and improving things.
“Creativity is about getting an interesting new idea. Innovation is finding a useful application for that idea. The purpose of innovation is improvement – making something better. Creativity feeds innovation that then supports QI.
“When we hold true to our purpose and keep making things better, we end up with improved processes, better impact for our efforts, more joy at work and of course better care for our patients.”