Speedboat or Tanker? Innovating in or outside the medical university hospital
Creating innovation space outside the medical university center has clear advantages for rapid innovation (as they can move as a speedboat in stead of being part of a bigger, slow moving tanker), but also has clear disadvantages in dealing with complex external demands as well as hindering knowledge transfer between the outside IPU and other IPU's within the medical university center. My main question is: Should we develop IPU's within or outside the medical university center?
In our medical university center in there is an ‘avant la lettre’ IPU for a specific chronic medical condition. A multiprofessional group (of medical specialists and allied health professionals) have set up a multidisciplinary focused clinic for patients with this specific chronic medical condition already more then a two decades ago. Around a decade ago they started with initiating local primary care networks around the country and supporting them with guidelines, training and quality measures. This cumulated in a national coverage of local primary care networks and the coordination center broadened their support with a digital platform for patients and health care professionals. Currently, more and more health care organization as well as national health services adopt the network concept and the coordination center has broadened their services with consultation on implementing the network concept. This multiprofessional group has been able to develop the network concept due to the fact that they could develop it outside the medical university center (with more freedom and less organizational obligations). In other words, they had the advantage that they were allowed to be a (fast moving) speedboat not being part of the bigger (slow moving) tanker called the medical university center.
The multiprofessional group would like to continu being a speedboat for their future development. However, there a several reasons for changing this approach: 1) as complex external demands increase (like JCI accreditation, new stricter privacy legislation) a closer link to the medical university center seems necessary so that the IPU does not have to handle these challenges on their own, 2) the network approach could be applied to more chronic medical condition within the medical university center, and being closer linked to the medical university center could speed up the knowledge transfer to other IPU’s, and 3) the big risk of creating IPU’s outside the medical university center is that it stimulates solidarity within the IPU but little with the medical university center leading to a fragmented, loosely coupled system of IPU’s who do not help each other when needed.
In summary, creating innovation space outside the medical university center has clear advantages for rapid innovation (as they can move as a speedboat in stead of being part of a bigger, slow moving tanker), but also has clear disadvantages in dealing with complex external demands as well as hindering knowledge transfer between the outside IPU and other IPU’s within the medical university center. My main question is: Should we develop IPU’s within or outside the medical university center?
My initial thought would be – IPUs should be developed outside of the medical university center, but, once established, should quickly be integrated into them. This is much more complex, but in general, I agree with your summarization that innovating outside has advantages for rapid innovation, and then disadvantages later on. To try to capitalize on the advantages, I think development could occur outside. There are a few things I would try to do, though, while still developing outside:
1. Set up a “steering committee” or board to oversee the IPU development, with members of the medical university center on it, so that they can stay engaged and bought into the concept while it is being developed
2. Encourage the team developing the IPU to recognize what the medical university center can bring to the table, and how best to engage with them. Most people developing IPUs acknowledge that while their work is innovative, it is not comprehensive, and it needs to be partnered with other, broader organizations. For example, the point about stricter privacy legislation, the IPU should be able to “borrow” this expertise from the university.
3. Determine early on what success looks like, and then, create a plan for how to transition the IPU back into the medical university center once it achieves success.
Another thought would be to have one steering committee/group oversee all the IPU development, if there are many going on, so that knowledge can be shared across the board. And then, if many IPUs are being developed, it would be great for IPU project leads to share best practices and lessons learned with the groups developing new ones. This steering committe could help facilitate this too. Best of luck!