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Driving Innovation – Think Big, Start Small and Move Fast

Driving Innovation – Think Big, Start Small and Move Fast

Clayton Christensen’s disruption theory, first introduced in 1995, suggested that major innovation redefines the segment or market it is aimed at and many start-up companies (such as Google, AirBnB and Uber to name just a few), have taken this theory very much to heart in their business models and attitude to innovation. But in recent times a new model has emerged. In the book “Think Big, Start Small, Move Fast”, three professionals from the Mayo Clinic take a more skeptical approach to disruption theory. Nicholas LaRusso, Barbara Spurrier, and Gianrico Farrugia, all of whom work for the Center for Innovation (CFI) at Mayo, use their book to debate “what is real innovation” within their familiar health care environment, but then apply what they learn to the wider world. They conclude that although some innovation is disruptive, smaller or incremental innovations are also important and can count just as much in the long-term. So how does this more incremental innovation model work?

One of the early examples the authors use is the development of a Pediatric Phlebotomy Chair (designed to be very comfortable with built in iPod and iPad) or a specialized seat which allows nervous children to be distracted and calmer when blood is taken from their veins. It’s certainly not disruptive innovation – it’s just a fancy chair after all, but they say it has significantly transformed the experience of the children using it in recent times, and was innovative versus what went before it. 

What the new phlebotomy chair example illustrates is the Mayo Innovation center is taking a holistic approach to workplace creativity, whereby a series of quite small innovations can often be enough to make quite a dramatic change or leap forward – in this case making the customer experience as different as “night and day” according to the feedback. In other words, what they call “the spirit of innovation” in many quarters will often lead to many relatively small changes for the better that in combination will make a big difference. In fact, these kind of incremental innovations can take place much more frequently until a large scale or more disruptive innovation comes along. For instance, cart technology (to go behind a horse) evolved in numerous innovative ways over many hundreds of years before the automobile and internal combustion engine arrived disruptively on the scene. Now small engine and vehicle innovations take place in their thousands, just waiting for the next big innovation to come along. IDEO CEO Tim Brown puts it this way: “Complex systems don’t get solved by a few people in a room. They get solved incrementally, layer by layer, by implementing sequential and layered designs that connect to deliver a better whole”.

So how does the more incremental or “layered” approach to innovation work in practice. To this end the authors suggest four key platforms as follows:

Carefully identify the needs of the end user or customer

This may sound obvious but no matter what your product or service, the end user of it will always have ideas on how it might be improved or made better in some way. At the simplest level therefore, we just have to have effective mechanisms in place to collect this feedback, on an ongoing basis, and then assess or filter the ideas to see what looks both most valuable and viable. The key here is to really drill into the customer experience with the product or service (both good and bad) in order to investigate what could change for the better.

Think Big

Even though the Mayo CFI starts with the customer experiences, in the myriad forms in which they exist, ‘thinking big” is about taking a 50,000 foot or “big picture view” at the outset. Put another way, they look for the broader themes and wider implications of what customers are suggesting or even complaining about in order to find new innovation pathways. A good example here is the computer industry in its early days in the 1980’s and 1990’s hearing that customers wanted faster processing speed and more storage space (and innovating constantly in these two areas) but failing to hear the customer desire to be more connected, especially when the Internet arrived. In practice the mobile phone companies were far quicker to see this and made connectivity via “smart” phones a primary innovation pathway. If we apply this bigger thinking to the healthcare world, it means thinking not only about incrementally better service and care in the current delivery systems (largely where patents come to facilities like clinics and hospitals) but in the ways this is likely to occur in the future, with care and service potentially distributed to the patient’s home. Hence our big picture focus has to be on the explicit, tacit and latent needs of the customer.

Start Small

If a big picture customer need (explicit, tacit or latent) is figuratively to swim in a warmer ocean it would consume way too many resources to boil the entire ocean until it is sufficiently hot. This is often time consuming, costly and resource hungry (consuming all an organization’s available “bandwidth” to innovate). To continue with the analogy, it is therefore better to start with a very small body of water and get it to the “right” temperature and see if this meets some of the customer’s needs. In other words innovative changes can be “tried out” or piloted first to assess their efficacy. In practical terms this means that a given innovation is best tried out in a small-scale prototype or trial way so that it can be well-understood and adjustments made before trying to scale it up. This approach (which is similar to the “fail fast” methodology often talked about in lean start-up companies) allows for quick changes to be made where necessary or for the particular innovation pathway abandoned and another idea tested.

Move fast

Once a trial or prototype innovation has proved to be successful on a small scale, it should be broadened in use or “scaled” as quickly as possible for two reasons. Firstly, moving as fast as possible at this stage helps to get early returns or benefits and even get customers to rapidly perceive the benefit. Secondly, moving quickly often creates enthusiasm in the wider team and even across the organization, thereby encouraging more innovative ideas to be generated on a parallel basis (creating a virtuous circle). This last step may seem obvious but many innovations, even if they have proved to be successful at pilot stages often get held up in bureaucratic ways for much too long and this can cause frustration and apathy in people. Good project management skills and perseverance are therefore critical at this stage.

In summary then, the overall process for this more incremental and continuous innovation model is:

  1. Understand Real Customer Needs in order to identify what will improve the product or service experience in looking to make changes and improvements to meet those needs.
  2. Think in a “big-picture” way initially to ensure that larger trends are not missed and that they inform even minor changes (that should combine to make for transformational change in combination over time).
  3. Find small pilot ways to test all innovations on a limited scale that can be readily assessed and measured (and adjusted and/or dropped where they don’t realize the expected benefits).
  4. Move as quickly as possible once an innovation has proved itself at pilot stage and make sure that the changes necessary are implemented with as much persistence as necessary before moving on to the next improvement project that customers would value.
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About Dr. Jon Warner

Dr. Jon Warner is a prolific author, management consultant and executive coach with over 25 years experience. He has an MBA and a PhD in Organizational Psychology. Jon can be reached at

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About the Editor and Primary Author

Jon Warner

Jon Warner is an executive coach and management consultant and in the past has been a CEO in three very different companies. Read more

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