Section 1: How far have you got?

What's innovative about it?

We begin our consideration of how far you have got with your idea for an innovation with this deceptively simple question about it. Your understanding of what exactly is innovative about it may well have evolved as you have found out more about it and how people react to it. And much of what is involved in taking the idea further will be shaped by this understanding.

Whether or not you have studied other courses in the Clinical Leadership programme, you will probably be aware that the term ‘innovation’ can be used to describe a wide range of phenomena in healthcare and elsewhere. However, as in other courses, we recommend that you keep in mind two features as absolutely core to your claim that something is an innovation (Williams et al., 2009, p. 5):

• It needs to involve something happening in practice that improves some aspects of performance. Coming up with a concept or invention is not enough; it needs to be implemented and working effectively.
• This thing or practice being implemented needs to be something novel, breaking with or departing from current practices, behaviours or equipment.

So innovation in the way a service is delivered goes beyond improvement of established process and practices and involves challenging and even replacing some aspects of them. Innovations do not simply follow from improving what is already there. This break with established practice may be limited in scope or comprehensive and far reaching, so the service becomes transformed completely, as with the replacement of a great deal of cardiac surgery with the use of stents by cardiologists. But moving beyond what is already in place, even on a limited front, implies two further things:

• There will be risks involved – the results cannot be totally predictable, and not all attempts to innovate actually succeed in bringing about improvement. However, as long as patient safety is not compromised, they may still be worth trying.
• Investment of resources of some form will be required in order to get the benefits, whether in the form of staff time, new equipment or perhaps education and training, or keeping an existing service going while a new one is piloted.

These two features of innovation are the fundamental reasons why planning and leading innovation can be difficult as well as rewarding.