Being Innovative in a Time of Rapid Change – Josh Linkner

On the inaugural episode of the Healthcare Executive Podcast, Chris Coraggio sits down with Josh Linkner giving a preview of Josh’s Opening Session Lecture: Being Innovative in a Time of Rapid Change at ACHE’s 2019 Congress on March 4th about the mentality and tactics to inspire all team members to innovate in a time of accelerating change.
*Note: Also available on iTunes.


Chris: Hey folks, my name is Chris Coraggio. Welcome to the American College for Healthcare Executives in the lounge podcast. The ACHE’s in the lounge provides a relaxed setting where real-time discussions take place on topics healthcare executives deal with every, single day. Our guests range from innovative thinkers to industry insiders who share our common goal – one common goal – and that is improving health for our patients and the communities they live in. Before we get started, a quick reminder to tell you to subscribe to ACHE’s in the lounge podcast so we can let you know about the new episodes just as they are being produced.

Okay, today’s special for a couple of reasons – one, it’s the very first episode for the ACHE in the lounge podcast, so that’s why we’re very excited about that, and to launch us off if you will – we’re very excited – it’s special because we’ve invited Josh Linkner to the lounge to talk about innovative approaches to rapidly changing and challenging times specifically, indeed, in healthcare.

Before we speak with Josh, let me give you a little bit of a background on this impressive gentleman. As the founder and CEO of four tech companies which sold for a combined value of over $200 million, Josh is the author of four books, including two New York Times best sellers. He has twice been named the Ernst and Young Entrepreneur of the Year, and during the Obama administration he was named as a White House Champion of Change. Josh has experience consulting with many leading healthcare organizations. I’m gonna list ‘em: Johnson and Johnson, MedTronic, BlueCross BlueShield, University of Michigan Health System, Eli Lilly, Oakwood Health, Proctor and Gamble, National Hospice Care, Glaxosmithkline, ExacTech, Owens and Minor, and Kimberly Clark – so a long, long list there. He also serves on the board of trustees of Bowmont Health System, one of the top large hospital systems in the US as ranked by US News and World Report. To top everything off Josh is also a professional jazz guitarist, and that’s where I want to begin. Josh you there?

Josh: I sure am. Thank you so much, and what a privilege to be here for your inaugural session.

Chris: First, before we get into anything, the jazz stuff. Are you more of a Wes Montgomery guy, are you Joe Pass guy, what are you?

Josh: Haha, well I love both of them dearly. Wes Montgomery has always been my personal hero. I’ve actually been playing for over 40 years and put myself through college playing music, and ironically, playing jazz was a wonderful teacher to becoming an entrepreneur, and I think there’s so many things that healthcare executives can learn from jazz. When you’re playing jazz it’s this very interactive, messy approach, and sometimes you have to adapt in real time, and of course that’s what we do when leading healthcare organizations.

Chris: Yeah, you gotta adjust, you gotta improv, all that, so it lays right out there for you.

Josh: Furthermore, even if executives – while our title may be one thing, we have to pass the baton of leadership back and forth at various times to our team members, our colleagues, clinical practitioners, etc., and jazz does the same thing. The sax player hands off to the piano player, who hands off to the drummer, and it’s this very free-flowing, collaborative, responsible, risk-taking environment, and I think there’s so much that we can learn from the field of jazz.

Chris: Great way to tie that all together. Yeah, and I love George Benson too; he’s a guy that doesn’t get named a lot because he went in the mainstream, but what a jazz musician Benson was and is. Let’s get into it, Josh. Why don’t we? Okay, let’s launch this all off. You’re gonna have a keynote address here coming up, right? The title of the address during this year’s congress on healthcare leadership in March, coming up soon, is, “Being Innovative in a Time of Change.” Is that all correct?

Josh: It is. We often misdefine the term innovation. We think of it only as giant, technical breakthroughs – people wearing lab coats, of course, a new drug therapy, but I’m gonna really show the notion of being innovative on an everyday basis.

Chris: Got it.

Josh: As administrators we can be innovative, as people on the front lines, even if people are in things like facilities management, we need not be a CEO wearing a lab coat to be innovative. Quite the opposite – all of us – and to the extent that we can read innovation, deep and wide in our organization, it will not only drive better economic performance, but it’ll also drive better patient outcomes.

Chris: Regarding healthcare, though, how is this innovative thinking maybe different from other industries?

Josh: Well, we have a lotta challenges, of course, in healthcare. It’s a highly regulated field, and we’re not playing around with video games. This is life and death, and so sometimes what that does, though, is I think that the burden of the regulatory environment and the deep concern, of course, for patient safety, may give us an excuse – to a degree, give us as a hall pass for passing on innovation, but really, I think we can be innovative in responsible ways. I’m certainly not suggesting that we take irresponsible risks with patients. Absolutely not; of course not, but nonetheless, the skills of innovation – understanding the dynamics and looking for inputs from other areas of life that we can apply to try better outcomes – all these skills can be practiced in an appropriate, responsible way in the field of healthcare, both in terms of, again, patient care and healthcare administration.

Chris: Does innovation just mean that significant change in outcomes, or is it maybe a new way to get to the same place?

Josh: When I think about outcomes – to me innovation is often thought of only as these giant breakthroughs – curing disease. True, that’s innovative. Nothing wrong with that, but we can be innovative on the little stuff, too. If we’re able to save three minutes on a clinical procedure, that’s an innovation that may not make the cover of a magazine, but really adds up over time, and that can mean we can provide better patient outcomes, and of course better economic results. To have a good outcome can mean doing something that we’re not changing the end state that we’re going for, but we can get there in a more efficient way – that in and of itself is a changed outcome.

I like thinking of it this way: if you think of innovation as a laser gun, we can use that laser gun to come up with a new drug therapy to cure disease, obviously, but we can also use that laser gun for things like recruiting midnight shift workers in the middle of a critical care environment. We could use that laser gun in driving efficiency, or improving safety conditions, or reducing cost. This powerful weapon that we have that’s this incredible gift that we all have of human creativity can be deployed, certainly on the big stuff, but also on the little stuff, and in turn, as all the little things add up, amazing results ensue.

Chris: Said perfectly. You’re right. Being creative, having that innovation on the big things is great, like you said, but if you can stack together some little things that have changed because of some innovation or creativity, it can make for something big, and I know that’s certainly true. Let’s marry these two things. How best can maybe the old guard and new talent work together to ensure care for patients is front and center for everything that’s done?

Josh: You’re right. Centering around the notion of patient care clearly is priority number one, but when we zoom out, and we say how do we do that – one thing that we know is that business as usual is just not gonna cut it. With rapid changes in drug therapies, and in clinical care procedures, and everything else, just relying on the models of the past clearly is not going to advance patients nor our organizations. Also, let’s face it, healthcare has been an increasingly competitive environment, and so if one provider stands still and the others leap forward, then the standing still one is, in fact, falling behind. I think it’s an acknowledgement that this type of thing isn’t just for the fun of it. It’s not only an intrinsically rewarding effort to express one’s creativity, but it’s mission critical to drive the both business and patient outcomes that we seek.

Once we center around that, and we realize that this has to be a priority – one could argue it’s job number one of leaders to create an innovative environment – one that fosters creative thinking rather than restricts it – then we get onto the hard work of how. First of all, I think it’s important to look at what the stakes are. Too often we tend to overestimate the risk of trying something new, and so once we get past that, job number one of leaders, frankly, is to create a safe environment. If people are fearful – fear actually is the number one blocker of human creativity, not natural talent – fear. If people are so afraid to try something new, so afraid to raise their hand and make a suggestion, so afraid to look at a problem in a different way with fresh eyes, it’s gonna restrict the massive amount of creativity that lurks beneath the surface of most organizations.

Again, as leaders, if we can, number one, recognize this is job number one, it’s important – it’s gonna allow us to achieve our broader goals – and then number two, create a safe environment where people, again – not irresponsibly. I’m not suggesting they goof off in the middle of a surgery. Of course not, but as we’re going about the work, as we’re reflecting on our procedures, let’s make sure that we’re using that creative eye to always find a better way forward, to continue to improve on our previous systems in order to create new, more effective ones.

Chris: You mentioned fear. How does one overcome that, to have that great idea, to have that confidence, if you will, to raise your hand – like you said – to speak up, to delve into an idea, to take that first step and get past that fear? What are some bits and pieces of advice you can give somebody in that regard?

Josh: There are some very simple techniques and systems that we can put in place that removes fear and liberates creativity. For example, one would be that – what if we said that every person was required to bring five fresh ideas each week to the table, and knowing full well that these ideas may not work out. They’re not looking for 10 perfect ideas, just 10 new ideas. They could be the littlest things, like where you keep the cart in the middle of a procedure – of extra equipment – or it could be something much bigger, but the idea is systematizing the notion that all ideas are celebrated as opposed to judged and punished.

Chris: In your expertise in healthcare, when you’re speaking of the importance of innovation, the importance of being creative, having these ideas, where are we today where we weren’t a decade ago in the healthcare space?

Josh: You mentioned the term “old guard” and “new guard,” and I always shy away from black and whites like that, but I think that, overall, while there are still concern – appropriately so, and people, obviously, have had success in the past, and that tends to be something that we choose to double down upon. I think for the most part, people are on this bandwagon. They understand that we need to evolve, we need to change, we need to create new ideas, we need to embrace new approaches to patient care and administration. A lot of people, though, are just now getting onto the saying, “Okay, I get it. I gotta do it, but how do I do it?” and that’s what I’m so excited to cover in my upcoming keynote to the group, is very simple, specific, practical tools that can elevate people’s thinking and results in the months and years to come, giving them a systematic approach to harness creativity.

Chris: Can you give us a few examples of those tools that you’re talking about, that you can get across to folks to achieve that?

Josh: I’ll give you a couple very fun ones – and I always like finding simple things that people can really just remember and embrace, but one of my favorite techniques of all is called the judo flip, which is essentially examining an idea, or an approach, or a system, or a methodology, or even a clinical approach and asking yourself, “What would happen if I judo flipped it?” In other words, what would happen if I did the opposite of conventional wisdom? It involves taking an inventory of how have things been done in the past, how do we always do things around here, and saying, “What’s the alternative? What’s the flip?” and it may be a physical thing, but of course it just might be a perspective flip. Before just routinely going forward with rote, and just assuming that what was set up in the past in still ideal, it’s challenging ourselves to judo flip our thinking a bit, and imagine what’s an alternative to this, what’s an oppositional approach, that perhaps could lead to a better outcome.

Chris: What about those – ‘cause people are so eager to resist change, so when someone does flip that, and come up with an idea, how receptive, usually, is that, and what are some tools to help people become receptive to those newer ideas?

Josh: I think the best thing to do is this: if we have an idea, and we go to make the case for the idea, and say, “Oh, hey dude, let’s be all creative in the middle of” – they’ll call security. [Laughter 11:06] position and idea that it makes it palatable, and to a degree de-risk it. One interesting thing in a clinical setting – there was a hospital in Brazil. They were finding that it was very expensive to clean the floors. Obviously have to be cleaned all the time in a hospital setting, there’s chemical usage, there’s high water usage, etc. They came up with a better idea, which was using essentially a commercial-grade Swiffer in a clinical setting, and someone came up with this idea, and there was, obviously, a vendor that proposed it.

Instead of saying hey, this sounds great, let’s just do it system-wide in 13 hospitals and thousands of rooms, they said, alright, let’s try it on one floor for one week, and that was a much more palatable thing because what’s the risk? If it didn’t work, great, so you go back to the old way, and so because it was broken down into a manageable, fixed-time, fixed-money experiment, they could manage the experiment and then test it, and say, “How’d it work?” Oh, it worked pretty good. Instead of now rolling it out system-wide and taking a giant risk, they say, now let’s try it on a second floor for a second week, and pretty soon it was let’s try it in one building for a month.

By the time they made a system-wide change, they already knew the odds were stacked in their favor. In other words, they de-risked the creative process by taking small bets, little, teeny experiments, letting the data continue to guide and refine the idea. Ultimately by the time it was rolled out system-wide, it wasn’t risky at all. I think that the message here is making the case for change, proposing lots of little ideas, testing the heck outta them, and by the time it’s ready to go global, we’ve already de-risked it to the point where it’s frankly riskier to stand still.

Chris: It’s common sense. You test something. You have an idea, it’s not something that anyone’s come up with before, and maybe it’s completely opposite to the way something has been done, whether it’s in a clinical setting or another industry – you come up with this idea, and to de-risk it, like you say, it’s common sense that you should test it, have that data, and then you can think about making that bigger change, right?

Josh: That’s absolutely right, and one of the other things that I think we can really learn from in healthcare is – there’s another technique of mine that I like to share, it’s called the borrowed idea. The notion of the borrowed idea is that we can look for inspiration outside of our normal industry. In other words, as hospital administrators, clearly we study other hospitals; healthcare professionals, we study others in healthcare. My suggestion would be, yes, of course we should be stewards of our industry, of course, but in addition, what if we looked outside?

For example, if we’re saying hey, how do I better triage patients in peak periods when they’re coming into an acute care setting, instead of only looking at how other healthcare providers do that, what if you studied how they load and unload cruise ship passengers in peak periods? You may find a little notion, in other words a pattern or an idea that you could perhaps borrow and bring back to a clinical care setting, and that idea can become the game changer. In other words, it was an idea that was never considered before in healthcare, but we borrowed from another part of life and brought back home, and made a difference. It’s taking a look at a problem or opportunity that we’re facing, and saying, where else does a similar problem or opportunity exist? Maybe it’s in high tech. Maybe it’s in the fashion industry. Maybe it’s in music. Maybe it’s in nature. It’s going pattern hunting and looking for inspiration outside of our normal worldview.

Chris: That’s a great way of thinking, just being aware of what’s going on, maybe outside your bubble, that could help, like you said, borrow and put into your industry. Just on a personal note, Josh, how excited are you for what’s gonna happen in March with your keynote address? How do you gear up for something like that and how excited are you?

Josh: Scale from 1 to 10, I’m at 11 because for me, it’s such a privilege to be able to share ideas and make a difference in people’s lives. I’m very lucky to be able to do this often. I just love it because if I can move the needle, if this means there’s a single better patient outcome, or an economic benefit to a healthcare organization that allows them to reinvest in their community, what an amazing ability to make a positive difference in the world. I look at it not only as the opportunity to have some fun, and meet people, and hopefully give a rousing and inspiring keynote, but more importantly to leave a lasting impact, and I hope that when long after I’m gone, that my work around thought leadership and sharing these types of ideas, they look back and we can point to direct outcomes that are better as a result of people embracing the notions of creativity and innovation.

Chris: Josh, that is a perfect way to put a bow on this podcast. I really wanna thanks you for your time today. I know you’re busy. I know everybody’s anxious to hear more from you during that keynote address at the opening session of the 2019 congress on healthcare leadership, and that’s gonna be March 4th, correct, in Chicago?

Josh: Exactly right, and I’m really grateful that people are coming, and they’re taking the time to sharpen the saw and continue to advance in their own path. I just think all of us have an opportunity that’s profound. The world of healthcare is changing at such a dramatic rate, and we can either cling to the past and long for the good, old days, or we can embrace these types of changes, we can leave our fingerprints on things, and that is gonna make the world a better place. In this profession, as leaders in this profession, we have such a profound opportunity and, frankly, responsibility to lean into new possibility, and I’m hoping that I can at least forward that conversation in March.

Chris: We really appreciate that you’re a leader in this capacity, on this topic. We were very, very excited that you were the leadoff guy – you’re the leadoff hitter – for this In the Lounge podcast, so we really appreciate your time, and for those listening, don’t miss this year’s congress on healthcare leadership. The registration information can be found at Josh, again, thank you so much. We really appreciate it. We will talk to you along down the road.

Josh: Sounds great. Have a great rest of your day. Thanks again.

Chris: You got it. Again, folks, this is Chris Coraggio, and we wanna thank you again for listening to ACHE’s In the Lounge podcast. Don’t forget to subscribe so you don’t miss future episodes. We’ll see you later, folks.

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Innovation, Growth, Transformation, Opportunity, and Collaboration

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