Masters in Healthcare Innovation at ASU

It was a warm Arizona morning, the buzz in the Innovation lab was humming as the new cohort of students sat patiently awaiting the much anticipated Sunday Sermon traditionally given at immersions by Dr. Tim Porter-O'Grady. A hush swept over the crowd. Ok, it really wasn't that dramatic, but it did hit home as always.

Dr. Porter-O'Grady began with an adaptation of Taguchi's 3rd rule: The further from the point of care that a decision is made the higher the cost, lower the value, and the lower the sustainability. This seems to be a chronic condition of healthcare. In the current reality, Top-Down is the drug of choice to cure the problems of quality, safety, through-put, and accountability. So in essence, bringing the decision making to the care providers at the point of care would have the opposite effect. A ground up approach to problem solving best explained by the theory of Complex Adaptive Systems.

Dr. Tim then went on to adapt Taguchi's 4th rule stating, "Acountability always escapes the locus of control." Accountability takes energy, and according the the 2nd law of Thermodynamics, energy dissipates. That is to say that the universe tends to move towards lower energy interactions. We see this in chemistry, large reactions need a catalyst before starting, an insertion of energy into the system in order to get an output that is desired. This is true of systems involving people as well. It is fundamentally easier to not hold oneself and others accountable, because this requires less energy. It takes work and energy from the system to reverse this process and should be expended accordingly, as accountability is KEY to success full change and higher functioning systems.

So, if I have not totally confused myself, or you, the reason for systems to focus energy on core areas such as accountability, and not to dissipate it into space, is because if a system continually moves towards lower energy, eventually it dies. If we look at nature, according to the chaos theory, stability and equilibrium means death. The key for hospitals to stay adaptable, thriving, complex systems is for them to live on the edge of chaos. An example of the edge of chaos is give in Kevin Kelly's book Out of Control. If we look at the planets in our solar system and examine the atmospheres of these planets, the chemical relationships are in an equilibrium, and as we know there is no life on the other planets (maybe Mars, but not sure yet). Earth, on the other hand, has an atmosphere that is in constant chaos and change and has thriving life of all kinds.

Think of the organization you work for, is there constant change? Are there self-organizing groups that emerge and dissolve to solve problems? Can your organization adapt to change quickly and with a bottom up approach?
As Innovative leaders we need to take a hard look at how we are handling adaptability and knowledge management. Using the Taguchi's Rules, Complexity Theory, and Quantum Leadership, we need to evaluate the incoming barrage of information for Relevancy, Utility, and we need to have the capacity to let knowledge that does not serve our purposes any longer go.

So, is the information your giving your workers access to knowledge? Is it relevant? And how are you helping them utilize it for self-organization and change?