UAB Medicine Issues Innovation Challenges to Frontline Employees

By Jennifer J. Salopek

socialized_medicineWith more than 5,000 employees, the folks at UAB Medicine knew that there were good ideas out there. But how to uncover them? Melissa Mancini, director of strategy and business development, wanted to engage frontline employees on a social platform along the lines of what she had seen at Dell and Starbucks. The foundation was firm: UAB Medicine had established a formal innovation program three years before, with such features as a solid infrastructure, an innovation board—even an internal venture capital fund, which makes small ($5,000-$10,000) proof-of-concept grants to employees who submit worthy ideas. Partnering with consulting firm Imaginatik, Mancini and her team issued the first innovation challenge to employees in June 2014: “How can we improve the patient experience and daily efficiency?”

The goal of the challenge was well-defined: to identify ideas suitable for pilot or immediate implementation that would have a direct impact on key organizational goals and targets. The question was posed via Imaginatik’s online portal, which had been customized for UAB Medicine. Why the social media approach?

“Employee communication is always a challenge and evolving,” explains Mancini. “Employees wanted ways to interact. We wanted transparency with the ideas, as well as venues for involvement, such as voting, rating, and commenting.”

With participation lagging on the single, open-ended question, the team added three more specific questions about throughput:

  • How can we dramatically increase daily discharges and open beds by noon?
  • How can we optimize the way patients are placed?
  • How can we move emergency department patients to inpatient units more quickly?

“We found that when we tweaked the language to increase engagement, participation spiked. We adjusted the language to make the questions very patient-centric, which clearly resonated with people,” says Mancini.

“It’s normal to have a slow participation curve,” she adds. “The organization must build trust by showing that the community is a good steward of ideas; creating a positive, respectful environment; and demonstrating that leadership is listening.”

Eschewing the idea of a monetary prize, UAB Medicine incentivized employees to submit ideas with recognition and involvement. Within three weeks, the challenge website received more than 3,900 hits. Fifty-eight ideas were submitted, which received 158 comments and 181 votes. Those ideas were then grouped into 49 “parent” ideas for review and prioritization through Imaginatik’s “head-to-head” approach. In that model, the website pops up two ideas at a time; evaluators rank them on a sliding scale based on:

  • Impact on organizational pillars/priorities
  • Resources needed to implement
  • Time needed to implement
  • Multidisciplinary impact/benefit
  • Potential ROI.

Rankings categorized the ideas into Quick Hits, Priority 1, Priority 2, and No Action. “The Quick Hits are ideas of projects that are already underway or that involve low politics and low cost—things we clearly should be doing,” Mancini explains. An organizational lead was assigned to each Quick Hit, and the person who submitted the idea was invited to serve on the implementation team.

One winning example involved regular daily lab work. Since time immemorial, for reasons no one remembers, routine labs at UAB Medicine were collected and sent down between 1 and 4 a.m. “Not only were we waking up patients in the middle of the night, but we were sending them down when the lab is most sparsely staffed. This created delays in stat testing and in the discharge process,” Mancini says. Examining this unexamined process “began to really open up a lot of questions,” she says. Changing routine daily labs to a daytime process had a lot of impact, she reports, including on productivity and patient satisfaction.

Before issuing its second innovation challenge a few months later, Mancini and her team took stock of the lessons learned. They discovered that the timing of the challenge as it relates to engagement can be a critical success factor; that the challenge topic must be meaningful to participants and align with their personal and professional values; and that active moderation was critical to continuing the conversation with other participants.

The most important lesson, however, dealt with communication to drive participation. “A robust engagement and communication plan is required. We discovered that our usual multimedia channels were helpful but not sufficient, so for the second challenge we really used every way we had to engage employees,” Mancini says. “I went personally and sat at a table at employee benefits fairs.”

The questions posted in the second innovation challenge were:

How can we improve communication?

  • What are the topics in which you are most interested?
  • Who do you feel like you’re not hearing from? Or what messages do you feel you’re missing?
  • What communication tools are underused, overused or could be improved?
  • Are there tools not currently in use that you would find useful?
  • What’s the best way to deliver critical organization news?
  • How can we improve communications between staff, shifts and departments?
  • How can we improve the ways employees give input to leadership?

Launched in October, this effort generated 1,850 hits to the challenge website, 23 ideas, 67 comments, and 142 votes. Although fewer ideas were submitted, the proportion of votes was higher. Another positive outcome, says Mancini, was “new voices:” “We heard from people who were not our typical contribution sources and had not participated in the first challenge.” Ideas being implemented include sending routine employee communications via secure text message, a “headline news”-type television program, and improved telephone etiquette.

Mancini has some words of advice for other institutions that may want to try innovation challenges. First, “make sure you have strong advocates for ideas across the organization, and use the challenge to find solutions to real problems,” she says. Second, keep communicating back to employees on the status of the challenge and the ideas. “What happened with the ideas? How are things being implemented? What is the progress on ongoing items? Tell the story!”

UAB Medicine continues to tweak the model. The goal for 2015 is to roll out focused innovation challenges to targeted groups, leveraging a focused population rather than organization-wide. Which leads to Mancini’s final piece of advice: Always be willing to test new things.

Jennifer-1990-webJennifer J. Salopek is founding editor of Wing of Zock. She can be reached at jsalopek@aamc.org, or follow her on Twitter @jsalopek.

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