|By Paul E. Plsek, MS, Paul E. Plsek & Associates, Inc.; Author, Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience; former member, Innovations Exchange Editorial Board|
The goal of idea generation is to come up with a variety of new approaches or solutions to an issue at hand. Whether done alone or in groups, idea generation is more productive when you follow a few guidelines and use a variety of simple techniques that encourage divergent thinking (suggesting many different options) and the deliberate mental processes of attention, escape (challenging an existing concept), and movement (generating ideas freely).
Four Classic Guidelines for Idea Generation
Alex Osborn, the developer of the brainstorming technique, suggested four basic guidelines for generating ideas in groups:1
Three Techniques To Try
Criticism is not allowed.
- Outlandish ideas are welcomed; the wilder the ideas, the better.
The more ideas, the better.
Building on and improving ideas is encouraged.
A variety of publications and Web sites describe methods and tools that, when used with these guidelines for group idea generation, focus attention and promote escape and movement.2-7 Three techniques—breaking the rules, provocation, and the concepts fan—are summarized below.
Technique #1: Breaking the Rules
This technique has two steps:
The Institute of Medicine’s design for the 21st century health care system is described as a transition from a set of current rules to a proposed new set. For example, the current unwritten rule, “care is based on visits,” gives rise to a host of problems involving access, appointment scheduling, and so on. If you imagined an alternative rule, such as “care is based on information exchange,” you could almost immediately think of innovative approaches involving telephone, e-mail, videoconferencing, telemetry, or other Internet-based technologies that could be effective. Some of these alternatives might be especially useful in providing access to care in rural areas.
List assumptions or other taken-for-granted aspects of the current situation that seem to have become the unwritten “rules” that govern your way of thinking.
Temporarily escape these (e.g., “pass a law” against them, or imagine a different rule) and use free association to generate novel ideas.
Technique #2: Provocation
You can use a provocation to get your mind out of its regular thinking process. One approach is to suggest an outrageous scenario, but then use mental movement to seriously examine its implications (i.e., “What would we do if … ?”). A common tactic involves removing structures or resources that are thought to be essential to the system.
The Commonwealth Fund employed this technique when it sponsored an effort to create an innovative vision of the future for well-child care. The foundation used a variety of Internet e-mail lists to circulate a scenario in which a strange disease had shut down all but one pediatric practice in New York City. Health care professionals generated 21 innovative ideas about how well-child care could be carried out, e.g., in schools, via television broadcasts, using Web-based tools, and through better parent education. Some of these approaches might be especially useful in addressing the needs of ethnically diverse or disadvantaged populations.
Technique #3: The Concept Fan
In this technique, you first construct a high-level flowchart describing the steps of an existing process and then identify the concepts underlying the steps, recognizing that some steps may have multiple concepts. Finally, you generate alternative ways to achieve each of the underlying concepts.
Clinicians at a large health maintenance organization in Minneapolis used this technique to explore ways to improve access, workflow, and quality of care. Starting with a flowchart of a typical clinic visit, they identified one step as “check in.”4 The underlying concept behind this step was the need to recognize the patient’s presence. Improvement groups then identified a variety of alternative ways to recognize a patient had arrived that could replace the usual approach to check in. For instance, one idea was to provide patients with cards they could scan through a reader for entrance into the parking lot. This entry of information could generate a look-up in the appointments database that sends notification and a picture of the patient to the appropriate clinic. Clinic staff could begin preparing the patient’s record, greet the patient by name, and immediately place the patient in an examining room upon arrival.
About the Author
Mr. Plsek is an internationally recognized consultant on innovation in complex organizations. A former research engineer at Bell Laboratories and director of corporate quality planning at AT&T, he now operates his own consulting practice and is the developer of the concept of DirectedCreativity.™ His health care clients have included the National Health Service (NHS) in England, Kaiser Permanente, the Veterans Health Administration, the SSM Health Care system, and the Mayo Clinic. Mr. Plsek is the chair of innovation at the Virginia Mason Medical Center in Seattle, an innovator-in-residence at MedStar Health (Washington, DC–Baltimore), director of the NHS Academy for Large-Scale Change in the United Kingdom, a former senior fellow at the Institute for Healthcare Improvement, an active research investigator, a popular conference speaker, and a former member of the Innovations Exchange Editorial Board. He is the author of dozens of peer-reviewed journal articles and seven books, including Creativity, Innovation and Quality; Edgeware: Insights from Complexity Science for Health Care Leaders; and Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience.
Disclosure Statement: Mr. Plsek is an independent management consultant who advises health care organizations on innovation strategy.
1Osborn A. Applied imagination: principles and procedures of creative problem-solving. New York: Charles Scribner’s Sons; 1953.
2Higgins JM. 101 creative problem solving techniques. Winter Park, FL: New Management Publishing Company; 1994.
3Plsek PE. Creativity, innovation and quality. Milwaukee: ASQ Quality Press; 1997.
4Plsek PE. Innovative thinking for the improvement of medical systems. Ann Intern Med. 1999;131(6):438-44. [PubMed]
5Kelley T, Littman J. The art of innovation. New York, NY: Doubleday; 2001.
6Frey C. Free creative thinking tools on the Web. Innovation Tools [Web site]. September 21, 2004. Available at: http://www.innovationtools.com/Articles/ArticleDetails.asp?a=155.
7Michalko M. Thinkpak: a brainstorming card deck. Revised ed. Berkeley, CA: Ten Speed Press; 2006.
8Committee on Quality of Health Care in America, Institute of Medicine. Crossing the quality chasm: a new health system for the 21st Century. Washington, DC: National Academies Press; 2001. Available at http://www.iom.edu/Reports/2001
9Bergman D, Plsek PE, Saunders M. A high-performing system for well-child care: a vision for the future. New York: The Commonwealth Fund. October 2006. Available at: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=417069.