The five myths of scaling and diffusion

DAVID ALBURY Director, Innovation Unit Associate, Institute of Government Consultant to Global Education Leaders Partnership former Principal Adviser, Prime Minister’s Strategy Unit

WHAT WORKS IN SPREADING INNOVATION? Encouraging the spread of new care models 18TH JANUARY 2016

THE SCANDAL OF SCALING:

Benefitting only the lucky few

INSANITY: trying the same thing over and over again and expecting different results

Attributed (wrongly) to Einstein

FIVE DECADES OF RESEARCH

FIVE MYTHS

MYTH 1

Scaling innovation is an informational issue

So don’t rely on: ! conferences ! exhibitions ! websites ! good practice guides

MYTH 1

evidence is not enough

Scaling innovation is an informational issue

The dominant mechanism of spreading is transfer from one organisation

to another

MYTH 2

Radical innovations often spread by the

innovating, higher-performing

organisation gaining a larger sectoral or

market share either through take-over or

displacement

MYTH 2

The dominant mechanism of spreading is transfer from one organisation

to another

Innovation and spreading are separate

and sequential processes

MYTH 3

‘Pilots’ + ‘roll out’ often an ineffective

mechanism

Think about spreading from the

outset: engage potential adopters

MYTH 3

Innovation and spreading are separate

and sequential processes

Increasing the pipeline of innovations

increases the likelihood of spread

MYTH 4

Innovation and scaling require dedicated

resources and effort and application of disciplined

methods: focus on a limited number

of priorities

Pay attention to demand: rewards, recognition

and incentives

MYTH 4

Increasing the pipeline of innovations

increases the likelihood of spread

Professionals (clinicians) are the key agents of spread and adoption

MYTH 5

Users (patients) can be key drivers of

spread and adoption

MYTH 5

Professionals (clinicians) are the key agents of spread and adoption

Will the set of practices improve outcomes and users’ experience?

!  Can the necessary systems and processes be put in place to support the scaling of this set of practices?

!  Can the necessary workforce roles, skills and culture be developed?

!  Will scaling this set of practices achieve savings in excess of the investment required for scaling?

!  Are the required contracting and payment mechanisms being developed?

SCALABILITY CRITERIA

from international research and experience

MOBILISING DEMAND/MOVEMENT

BUILDING

ORGANIC GROWTH

Three sets of more effective mechanisms for scaling and diffusion:

ENABLING CONDITIONS

‘ORGANIC GROWTH’

COMMUNITY OF INTEREST

COMMUNITY OF ENGAGEMENT

COMMUNITY OF PRACTICE

vanguards innovating on behalf of the NHS

COMMUNITY OF INTEREST

COMMUNITY OF ENGAGEMENT

COMMUNITY OF PRACTICE

Structured, facilitated communities of vanguards, intensively supported with disciplined innovation methods, to learn from each other and increase the generalisability of each model

Separate communities for vanguard leaders and for service re-designers

COMMUNITY OF INTEREST

COMMUNITY OF ENGAGEMENT

COMMUNITY OF PRACTICE

Community of potential adopters supported to have meaningful interactions with communities of practice to act as critical friends, think about how the model would work in their context, and help codify the model and protocols for implementation

COMMUNITY OF INTEREST

COMMUNITY OF ENGAGEMENT

COMMUNITY OF PRACTICE

Individuals and organisations who express an interest in new models, kept in regular touch with developments through social media, newsletters, webinars and events: the pool of new potential adopters

MOVEMENT BUILDING: MOBILISING DEMAND

REWARDS

& RECOGNITION (PULL FACTORS)

ENABLING CONDITIONS

REGULATION & OPENNESS

(SUPPLY)

SUPPORT & INVESTMENT

(PUSH FACTORS)

Encouraging the spread of the new care models is a major challenge …

... for this to lead to system transformation, vanguards also have to be sites of integration

of discrete innovations