RamaOnHealthcare May 31, 2022

Many times we expect corporations to innovate like it is a skill inherent in their DNA. It is not, innovation is less talent and more practice. But to practice is to learn. Diana Joseph, PhD is a learning science expert who I interview about how organizations learn innovation.

Mohan Nair, CEO of Emerge Inc.

Mohan Nair, CEO of Emerge Inc.

Dr. Diana Joseph, PhD, Founder and CEO, Corporate Accelerator Forum (CAF)

Dr. Diana Joseph, PhD, Founder and CEO, Corporate Accelerator Forum (CAF)

Mohan: Healthcare speaks of innovation as the way forward but, from my perspective, it is not as evident in this industry as that found in high-tech, communications, transportation, or even planetary travel! We are still not realizing our potential as an industry, and it is the goal of this interview to emphasize one aspect of innovation that is often neglected or misunderstood.

We hire Innovation Officers or demand innovation within our organizations by mandating or hiring. We seldom utilize a process within the organization to withstand the unknowns of the future by creating a culture of innovation based on our values to serve healthcare.

Dr. Diana Joseph is an expert in Learning Sciences. She specializes in the research and deconstruction of what it takes for humans to learn and build effective learning environments. Diana is also CEO of the Corporate Accelerator Forum. The Corporate Accelerator Forum seeks to bridge the paradox between corporate innovation inertia and startup domain inertia. She likes to say she is a premarital counselor and matchmaker for corporate-startup couples. I have been extremely curious about how organizations learn about innovation and practice this learning. Therefore, I wished to inquire of her expertise regarding connecting innovation with learning to enlighten healthcare companies.

Mohan: I’m honored to interview you and pursue your insights into what it takes to bring innovation learning to healthcare organizations. Welcome Diana. Let’s get right to it. Why do organizations fail in their own learning, especially after all the work and study introduced by Peter Senge introducing the “learning organization” in the late 90s?

Diana: Thank you, Mohan, so glad to talk with you. It’s hard for learning to compete with core required job functions, so there’s a prioritization problem. And there’s also a vulnerability problem: Typically, corporate cultures celebrate polish, completion, and expertise. Conversely, learning means you aren’t already polished, the work is not finished, and you’re not an expert yet, so you must be vulnerable to admit you are learning. The social environment in most organizations is not very welcoming to that kind of vulnerability.

Mohan: If you would, describe how an organization can understand the measure of the learning in their own employees?

Diana: Think of learning as change. How do you measure change? For individuals, ask the employee how their thinking, behavior, quality of work, ambition and relationships have changed. Keep it qualitative, or at least include rich qualitative information so that you can understand how to improve your learning systems and avoid system-gaming. At the organizational level, learning is visible in resource deployment. If you didn’t change anything you are doing, maybe you didn’t really learn.

Think of learning as change.

Mohan: What are the best practices for organizational learning; another way to ask that is how do employees learn?

Diana: There are some core universals in how people learn:

  • We learn by doing: We remember what we say and do, far better than we remember what someone else says and does.
  • We learn when it’s just hard enough: We learn best when we’re operating in the sweet spot between our current expertise and the level where we are completely at sea.
  • We learn best in social environments that are diverse in terms of skill level so that we are always learning from more advanced colleagues and crystallizing our understanding by teaching newer learners.

All of this applies to known domains where someone already has expertise – playing an instrument, tailoring, answering the phones in a call center or following the innovation process. (The Professional Terms are: Constructivism, Zone of Proximal Development, Cognitive Apprenticeship). Some of what we need to learn is not known yet. There aren’t any experts when you’re inventing a new technology or business model. To learn in the domain of uncertainty, we must push on the world and get it to respond so we can read the feedback. And that entails some risk.

There aren’t any experts when you’re inventing a new technology or business model.

That’s why methods drawn from exploratory practice in the arts & design (like design thinking), exploratory practice in the sciences (like Lean Startup), and exploratory practice in engineering (like Agile development) have been so impactful in the last decade or two. I hope and believe practices like these can give organizations more capacity to convert risk into learning. I hope organizations recognize that sticking to the familiar is risky in a changing world, and keeping the familiar is also a lousy environment for learning.

…sticking to the familiar is risky in a changing world….

Mohan: What are the essential conditions for people in an organization to learn?

Diana: It is essential the organization makes learning psychologically safe for making mistakes and guessing. A mistake is evidence of operation outside the comfort zone where the learning happens, and that’s a good thing. Guessing primes the learning pump and organizes your mental structures so you’re prepared to be surprised and therefore changed. Good-faith mistakes and guesses must not be punished – the pain that comes from someone missing their intention is enough. Further punishment by the system will cause a retreat to the comfort zone and the end of learning. How can your culture celebrate good-faith mistakes and guesses that lead to learning?

Mohan: I’m guessing there is continuous learning and discontinuous learning – like a burst of learning demanded of teams to produce outputs. It seems as if many Healthcare organizations do the second – perhaps because the reward systems favor this behavior. Is that good or destructive?

Diana: I think you want both: Continuous skill learning, regular opportunities to learn in uncertainty, and you will absolutely, like it or not, have discontinuous bursts of learning when something surprising happens. Overall, I think it’s OK to have bursts of learning followed by periods of reflection. That said, it’s incredibly important to get the reward systems right. Salaries and bonuses are designed to encourage high-level, expert performance in the known core business. If employees are also supposed to learn and innovate, they need to be rewarded for taking time to try new things, make mistakes and guesses, reflect, change their minds, and change their practice. One way to align this kind of practice might be to tie some aspect of compensation to uncertain outcomes. Do your employees get to partake when they’ve taken a risk and it pays off?

…it’s incredibly important to get the reward systems right.

Mohan: The Corporate Accelerator Forum, in a sense, drives home that larger organizations can learn from startups and vice versa. You are attempting to bring that connection. What works here and what is still evidently inertia?

Diana: Large organizations need to learn about what’s coming around the corner. They need to plant a toehold in the future and partnering with startups is a great way to do that while limiting risk. Startups, on the other hand, need to understand how the economic machinery works in their industry, where the supply chains are, and which rules really cannot be broken. It is difficult for them to do that alone without a big established partner. By combining forces, they stand to learn much more together than either could alone.

The main cause of inertia in these learning relationships is lack of trust. Corporates can foster trust by being founder-friendly and delivering key resources in a timely fashion (not easy given existing processes!). Startups can foster trust through transparency, clear expectations, and full engagement. We are creating a readiness program for startups that we hope are helpful and lead to partnerships that are more productive on both sides.

Mohan: We live in a world of experts, but we know from learning theory, that the longer one is an expert, the worse a teacher you become. So, it is better for a less experienced or recently experienced practitioner to teach the basics than for an expert to. Shocking as this is, what does that theory bring us to for contemporary learning organizations?

Diana: You want people to do things they are not ready to do alone, with enough scaffolding to avoid lethal errors and mentors who are just a bit more advanced, so they still remember the individual steps and what it was like to not know. The role of the master is to reveal what’s possible in the domain. It is less about experts teaching classes and more about learning on the job from practitioners.

Mohan: Learning about innovation is multifaceted. There are basics like the tools we use. There is advanced work about how to develop insight and then there is how to bring ideas and succeed in convincing others to take these ideas to market and fund it. Where is learning best applied to smooth out this bumpy ride that seems to kill ideas for being different or a distraction?

Diana: The ride feels bumpy in part because of the way leaders make and communicate their innovation decisions. Leaders do have to kill ideas sometimes, when real world data points a different way, or when the idea gets too far away from the strategy. But they need to learn how to be patient long enough to make a data-driven decision or an informed gut-driven decision rather than a knee-jerk decision, and how to kill an idea without killing its owner’s spirit, how to give useful feedback, and how to recognize when an idea dies. Its owner has just completed the world’s best learning-by-doing education and should be immediately pointed at the closest possible challenge.

Mohan: I am in the convergence of innovation, executive education, and healthcare so this topic is very interesting for me to pursue further. However, the readers often wonder if organizations really commit to learning. Just because they have job titles for employee development, there seems in challenging times those are the jobs that are removed. Training is the first to go. What do you say to the importance of learning in a healthcare organization especially when many healthcare employees must be licensed and certified and that seems enough to get the job done. Why add innovation techniques and innovation principles to the load?

Diana: There’s no option, Mohan, we must learn and innovate. There’s no technology or service or skill in the world that can’t be commodified within a few years. There’s no technology or service or skill that won’t eventually hit a wall in terms of its market share. There’s no technology or service or skill that can’t be disrupted by a new approach to the problem. Our world is increasingly dynamic and increasingly uncertain – no matter how good you are at maintaining stability, eventually the ground will shift under your feet. Innovation is a requirement at the level of the organization. Someone must be responsible for that all of the time, even, and maybe especially, in times of crisis.

There’s no technology or service or skill that can’t be disrupted by a new approach to the problem.

For what it’s worth, I think that real innovation processes can turn out to be cheaper than innovation theater, if you design them properly and keep the bets small until you’ve learned enough to venture further.

Mohan: What would you recommend a CEO or CXO in healthcare understand and act to begin their journey to bring about a Learning Sciences-based approach to innovation in their organization? What are the first two steps?

Diana: Step One – right away, starting this second, the CEO and CXO can begin to model learning. That means exposing times when new information changes your mind, or when you need knowledge or a skill you don’t yet have, or when you notice you are better at something than you were before. This requires a little vulnerability because it means you weren’t perfect to begin with. Your vulnerability will invite others to also expose their imperfections to the experiences required for learning. As a CEO or CXO, your influence on the culture is enormous. If you model a growth mindset, others will follow you. (Read anything by Carol Dweck to learn more about growth mindsets, highly recommended!)

Step Two – as soon as you can, figure out how to reward learning. Supporting training and certification is table stakes, I’m sure everyone is already doing that. How can you reward actual documented shifts in capacity due to learning? How can you reward the ruling-out of dead ends through real-world testing, trial and error? How can you reward the taking of appropriate risks? Keep in mind that not all rewards are financial, and not all financial awards are organized the same way.

How can you reward the taking of appropriate risks?

Mohan: Innovation is sometimes viewed as talent or a gift when according to your field of work, it is a learned craft based on principles of practice and study. How do we reconcile this distance of impression and how do we close that gap?

Diana: Any person is a result of their experience, their interests, and their response to the structure and culture around them. You can’t control their prior experience or interests, but you can certainly shift the structure and culture, and you can certainly offer new experiences. Take advantage of people who show up innovative from the beginning, of course! You’re leaving a lot of talent on the table if you don’t create an environment where others can learn how to innovate. Innovation requires both discipline and initiative. The people you think of as compliant (and therefore not innovative) should be great at the discipline side. What if they could also be great at the initiative side if your corporate structure and culture invited initiative, and they had a way to learn? Furthermore, what if the people you think of as innovative are already good on the initiative side but could develop that discipline muscle further so that their ideas have a better shot at coming to life?

You’re leaving a lot of talent on the table if you don’t create an environment where others can learn how to innovate.

Mohan: If you had a wish for healthcare organizations today to grow, what is that wish?

Diana: Well, I wish we could all get out of the trap we’re in around the way healthcare is paid for! A more grounded answer: I wish healthcare organizations placed lots of small bets on what’s going to happen 3, 5 or 10 years out, and tested our way to understanding.

Mohan: Conversely, if you had a wish for these organizations to stop today, what is that wish?

Diana: Stop trying to cost cut your way to success by shutting down every innovation engine after a year or two. In the healthcare space (outside of basic phone apps) you need at least 3 if not 5 or 10 years for an idea to bear financial fruit. Commit resources for an extended time. You can change out the people if the ones you start with aren’t testing the way they should, and you can still require the crossing of gates to release resources. But if you don’t have the resources committed in the first place, you’re not serious.

Mohan: I met you some months ago and we have forged a partnership of pure learning together. You with the accelerator and me with keynotes/moderating innovation agendas and together we found Innovation can be taught and in short periods of time with strong outcomes. What do you think is missing in this science within healthcare companies?

Diana: I think what we need is a balm for risk aversion, and the creation of (reasonable) risk-welcoming environments. How can people learn if they get punished for it? How can they make time for learning in the unknown if they’re rewarded only for meeting and exceeding expectations? The risks are plentiful in healthcare so I’m compassionate regarding risk-aversion, but it needs to be addressed, and it can be. There’s plenty to learn that’s well within the un-crossable boundaries.

Mohan: I’m very sure this work will continue as a discipline going forward and I am proud to bring it with you to the healthcare market. Providing a structure for innovation learning in our healthcare community that is inclusive and permits all to attain the title of innovator is exciting.

About Mohan Nair

Mohan is an expert in innovation. He is a three-time Author, three-time Entrepreneur with two exits, three-time Corporate Executive, and 10-year veteran Chief Innovation Officer building and launching more than six emerging businesses in healthcare. Reach him on LinkedIn or as keynote at Mohannair.com

About Diana Joseph

Dr. Diana Joseph, PhD is an entrepreneur and learning scientist with background in urban education, corporate innovation, philanthropy, and the arts. Diana serves as CEO of the Corporate Accelerator Forum, a guidance community for corporates who innovate through startup partnership, especially in complex domains like life sciences, healthcare, and advanced materials. She hosts the Ecosystem Show podcast and is initiating a readiness program for startups in 2022. She lives on Tamien land in Silicon Valley with her family. Reach her on LinkedIn or via the website above!

 
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