1. By
Robert Anderson
Arizona State University
College of Nursing and Healthcare Innovation

2. Introduction
 Healthcare (HC) in a state of flux due to technological advances
 HC innovation comes from the top-down, instead of bottom-up
 Point-of-service innovation is subdued, not championed
 Decisions are unilaterally made by providers/managers/execs
 Employee “buy-in” suffers from lack of ownership of initiatives
 Compensation/equity is based on the market, not performance
 Patient care is driven by process/reactive instead of value/adaptive
 Patient care is judged by financial metrics vs. patient satisfaction
 Overall, there is an “illegitimate locus of control for authority and
autonomy that should rest with the professions who own it”
(Porter-O’Grady & Malloch, 2015, p. 131).

3. D.I.D.E.
 Democratizing Innovation
 Program for independent, daily experimentation or “tinkering” by staff,
managers, executives; participation is optional but encouraged
 Patient satisfaction (HCAHPS) monitoring with additional patient care,
financial, & time metrics evaluation; requisite to participation
 Experimenter is allocated dedicated daily time for experimentation,
evaluation, & presentation of projects w/in operational constraints
 Democratizing Decision-Making
 System of team, departmental, & organizational forums where experiments
are evaluated & initiatives voted into implementation by forum members
 Voting is only available to members & presenters w/in each team,
departmental, &/or organizational forum where experiment is presented
 Team leaders, departmental heads, & executives preside over team,
departmental, & organizational forums, respectively; awarded veto power

4. D.I.D.E. (Cont.)
 Democratizing Equity (Compensation)
 Equity in the form of recognition, bonuses, pay raises, profit-sharing,
company shares, & allocated funds may be awarded to individuals,
teams, & departments for participation, performance, & loyalty
 Individuals, teams, & departments are all awarded proportionately
according to initiative successes, patient satisfaction scores, financial
savings; individual performance evaluations & seniority also considered
 Individuals, teams, & departments are compensated (after trial period
of 6 months) for each proceeding forum (e.g. team -> departmental ->
organizational) in which their initiative is implemented & yields results
 Link to Current D.I.D.E. Mindmap
 https://mm.tt/550192675?t=Esnp9jPGEO

5. How is this Innovative?
 By referring back to the Introduction, you see:
 DIDE is a program that essentially revolutionizes HC operations,
democratizing innovation, decision-making, & compensation structures
 “Bottom-up” innovation is used by companies such as Google, 3M, &
innovative “giants” yet only very few HC organizations practice it today;
“When there’s no experimenting, there’s no progress. Stop experimenting
and you go backward” (Gelb & Caldicott, 2007, p. 68).
 This shifts the balance of power in decision-making to the point-of-service,
empowering employees, increasing input & “buy-in”, & overall giving
employees “ownership” of their work & the patient’s care
 Compensation becomes performance-based, allowing exceptional
employees to excel, attracting a better standard of worker, increasing
motivation & feelings of recognition, & improving patient outcomes
 In effect, patients receive better, more-invested care from nurses &
providers b/c staff compensation is tied to their value/satisfaction

6. Desired Outcomes
 Implementation of DIDE in a healthcare organization yields:
 Increases in patient HCAHPS scores, satisfaction & care value metrics,
better outcomes, overall health & awareness
 Increases in worker well-being, motivation, “buy-in”, autonomy,
initiative, productivity, consistency, community, loyalty to organization,
communication, adaptive capacity to constantly changing conditions
 Increase in provider ratings, patient reviews & recognition
 Increase in organization innovation, community & industry recognition,
revenue, job applicants
 Decrease in patient complaints
 Decrease in employee errors, turnover, “career entrenchment,” &
“retiring in place”

7. Beneficiaries
 Patients
 Patients are the main beneficiaries; they receive better care by linking
employee performance & compensation to patient care value & satisfaction
 Nurses
 Nurses benefit by receiving the ability to innovate, make decisions, receive
recognition, & be compensated for their creativity & hard work
 Providers
 Benefit from happier & healthier patients, better patient outcomes, increased
operational efficiency, & employee motivation, well-being, & initiative
 Managers
 Managers benefit from a decreased workload & less stress by having motivated
employees who are self-directed w/ similar goals & initiative to themselves
 Executives
 Executives get the industry recognition for being innovators, along w/ company
success, financial well-being (thus, executive perks), & operational autonomy.

8. Aligning Passions with Goals
 DIDE SMART EDISON (Gelb & Caldicott, 2007, p. 50)
(S) I want to implement DIDE in a small healthcare facility w/in three years of today.
(M) I will measure my progress using a GANTT chart of projects & tasks. (A) I am
accountable to my mother & an advisor that I will choose by the end of the Fall 2015
semester. (R) I feel my purpose in life is to dedicate my career to creating a better, more
efficient system of healthcare in the United States; my goal of implementing DIDE is
relevant to my overall purpose. (T) Within three years, I want to have implemented some
form of DIDE in my healthcare organization. (E) I am passionate & dedicated to improving
the lives of nurses & patients; my mother has been a nurse for 40+ years, I grew up in
hospitals, & see nothing more noble than improving their lives by implementing DIDE (D)
For that reason, I will not stop until nurses have more power over innovation, decisions, &
compensation in healthcare. (I) Implementing DIDE integrates perfectly into my goals of
obtaining my MHI degree, starting my healthcare career, & becoming an innovative
leader/administrator in a hospital. (S) I can see myself presiding over the first team forum,
seeing my colleagues faces, & hear them presenting their solutions to problems, knowing
that this program could result in employee autonomy. I feel excited! (O) I am going to
achieve this. My mom loves the idea. It’s a great Capstone project, & it’s beneficial to so
many. I’m going to do this. (N) I am doing this right now!

9. Potential Barriers
 General resistance to change
 To overcome general resistance, I will outline DIDE’s potential risks &
benefits, represent it visually, & cultivate charismatic optimism
 Executives uneasy to relinquish control
 The most probable barrier; to overcome executive resistance, I must be
able to show the benefits of DIDE, that it is profitable, well-thought-out, &
ultimately, the executives are still in charge
 Establishing an equitable-yet-profitable compensation system
 To overcome this barrier, I plan on studying models of compensation
systems used in other industries/companies and applying what I’ve learned
to create something that will work in a HC organization
 Difficulty in organizing forums & getting staff together
 Technology may be the answer; maybe creating an online forum system
with discussion boards & voting on the website would work

10. Literacy Blueprint Barriers
 Express Ideas Visually
 I need to be able to show people DIDE visually for them to “buy-in”; to
do so, I will make diagrams & schematically outline the program
 Become a Master Networker
 In order for DIDE to gain supporters, I must keep in touch w/
colleagues; to do so, I will network regularly w/in the industry & aim to
develop positive relationships w/ contacts w/ particular backgrounds
 Understand Scale-Up Effects
 To make truly innovate & revolutionize HC operations in an
organization, I must budget & plan for scale-up; thus, I will start small,
monitor & evaluate, & outline scale-up incrementally in steps

11. References
Gelb, M. J. & Caldicott, S. M. (2007). Innovate like Edison: The
five-step system for breakthrough success. New York, NY:
Penguin Books Ltd.
Porter-O'Grady, T., & Malloch, K. (2015). Quantum leadership:
Building better partnerships for sustainable health.
Burlington, MA: Jones & Bartlett Learning.