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Steve Kelley, Humphrey
Institute of Public Affairs
Civic Caucus, 8301
Creekside Circle #920, Bloomington, MN 55437
October 15, 2010
Present:
Verne Johnson (Chair); David Broden, Janis Clay, Bill Frenzel, Paul Gilje
(phone), Jim Hetland (phone), Sallie Kemper, Dan Loritz, Tim McDonald,
Wayne Popham (phone), Bob White
Summary
of Kelley's comments:
Minnesota needs to establish an innovative culture in both its private and
public industry. A process known as "Design Thinking" may help government
and business organizations to both devise and accept change by bringing
people with backgrounds in the design professions into the mix of in-house
problem-solvers. Two areas greatly in need of innovative efficiencies,
health care and education, are not treated evenly in state budget
discussions. In forecast budget deficits, spending projections correctly
include inflation in health care costs but not in education costs. This
puts K-12 at an unfair funding disadvantage.
A.
Welcome and introductions-Steve
Kelley is a senior fellow at the Humphrey Institute and director of the
Institute's Center for Science, Technology, and Public Policy. He served
in the Minnesota Senate from 1997 through 2006 and the Minnesota House of
Representatives from 1993 through 1996. He was chair of the Senate
Education Committee for four years.
Before
his legislative service Kelley was a public member of the Minnesota Board
of Medical Practice for six years and served one year as its president. He
has been a lawyer practicing commercial litigation at the Minneapolis firm
of Mackall, Crounse, and Moore since 1979.
B.
Comments and discussion-During
Kelley's visit with the Civic Caucus, the following points were raised:
Establish an innovative culture in Minnesota
"Thanks for this opportunity," Kelley said, to the assembled participants
in the Caucus. "I will start by saying that I think it is essential for
Minnesota to do a better job at fostering innovation in a variety of
ways." When businesses talk about innovation, he said, they often talk
about needing people that are trained in math and science-people that
excel in problem solving. That's often a preferred way to start thinking
about innovation.
"But I
think you need to create a whole innovation culture." If our government
and nonprofits are not conveying that need of true innovation-if we're
accepting just incremental improvements-then we will not make substantial
progress." So Kelley said he has been thinking of ways to engage
organizations to embrace a difference approach that goes beyond problem
solving.
Applying 'design thinking' to
Minnesota public life
He
described one method-'design thinking'- that has promise. "Design thinking
starts with an approach developed by professional designers and architects
to find out what people's real needs are." In many cases designers go and
live with people, work with them, and observe them in their environment as
they go about their daily lives. Only then do they begin to envision a
model for improving how those peoples' needs are met.
Kelly
cited a book by Tim Brown titled Change by Design. Find a TED video
of Brown describing design thinking here, as he urges those in the design
industry to think about problems larger than fashions of the day:
http://tinyurl.com/yhwst85.
And
click here to find an article he wrote with Jocelyn Wyatt on design
thinking applied to social innovation for the Stanford Social Innovation
Review:
http://tinyurl.com/y9zh3fd.
The
concept has applications across industries. The Mayo clinic is interested
in innovation, so they created a Center for Innovation a few years ago
(http://tinyurl.com/mkwcps). Their own design staff, consisting of
artists, architects, design professionals and engineers from other
industries, work with doctors and nurses to rethink how they do things.
For
example, in trying to reduce surgical complications the designers drew a
map of the operating room and asked each of the people present during
surgery to draw on the map where they move throughout the course of a
surgery. The surgeon's "map" was a single dot facing the patient; the
anesthesiologist drew a ring around the patient's head. Then designers saw
that the nurses' "map" was a picture of extensive activity all around the
operating room as they were bouncing about performing their assignments.
This illustration made the risks for variability in quality control
vividly apparent; these were the risks that they then sought ways to
address.
A
participant described a similar experience from the defense industry, when
they had to assemble a proposal in a process that involved a large group
of around 40 people. "The facilitator put us in a room, with an
illustrator. 'Let's talk about it,' the illustrator said, and after an
hour he had a cartoon that represented where we wanted to go with the
proposal."
What
is it about the design lab approach, a participant asked, that might make
sense for our public services in the state? Kelley responded that research
shows that having diversity in a group-adding someone who is a right-brain
creative, or has story-telling abilities-makes it more likely there are
innovative solutions. If a group is solely comprised of people that have
risen within their own organizations they may often have very similar ways
of thinking or looking at problems. Often they are 'left-brained', more
analytical than creative. So even if they are diverse on some levels (age,
gender, race, industry), the group may not actually be as diverse as it
could or should be for optimal results.
One of
the reasons why health care professionals took this approach early, Kelley
explained, is that they understood that a person's state of mind affects
their health. And different "states of mind" might logically be expected
to affect the course of a collaborative effort. So by bringing truly
different skills and perceptions to bear on a problem the thinking process
on the whole should be enhanced.
Rapid prototyping
What
is different about this process, a participant asked, from ordinary
"brainstorming"?
One
particularly different component is the research that precedes the work of
re-design-the careful observation of processes, trying to pay attention to
the unvoiced needs people have. It's as Henry Ford said, " If I had
asked my customers what they wanted they would have said 'a faster
horse.'"
"We
need to pay attention to what problems people have and how they might be
solved and then follow that with rapid-prototyping," Kelley said. Some
groups do a 'behavioral prototype,' which changes how the group working on
the problem approaches its solution. When you have a prototype, the
conversation can be about the prototype and not about the disagreements of
people in the room.
Design thinking can help create a public sector open to change
"I see
this technique spreading more and more into government, and moving people
away from being quite so risk-averse."
This
kind of thinking can inform policy makers, helping them construct systems
that are more open to change. In health care, given how much more
pervasive government's role is going to be, government will need to be
open to this sort of innovation or else significant improvement will be
impeded.
In
education, Kelley described a neuroscientist at the
University
of Minnesota who trains teachers to teach a brain science unit in middle
school in a way that adheres to the latest research on the neuroscience of
learning. In another example of the design thinking approach,, the Nueva
School in the Bay Area of California became much more project-based in how
they teach students. These students are learning new, project-based
problem-solving skills that appear to increase learning.
A
participant asked how a school could redesign to be more personalized
without the additional cost of adding teachers?
"I
don't know about how it affects cost," Kelley replied, "but if you're
teaching in a way that motivates kids, productivity should go up." It is
clear, he added, that personal relationships are essential to learning.
This is the real key to the technology question-if technology is used to
replace the teacher, it can be harmful. If technology is used to offload
rote tasks, such as drilling multiplication tables, it may be very helpful
in freeing the teacher to do the important work of establishing that
personal connection.
State budget projections include inflation for health care costs, but not
for education
"I
just want to say something about the cost of education," he continued.
"The mantra is we don't include inflation in the costs of the state
budget. We don't-but
when
we forecast what we're going to spend in health care, we add up the
benefit set we said we'd deliver to people, and then we project how much
it will cost to provide that benefit set, based on health insurance
estimates that do include an inflation component."
He
explained that $2.2 billion of the coming budget deficit is the inflation
in health care and human services. "Why is it okay to say we're going to
inflate the cost of health care and the cost of other services, but not
inflate the cost of education?"
Systems evolve
"I
think you can work on issues of tenure and school processes without
saying, 'let's throw out the whole organization.' Kelley said. "I was at a
school in
Stillwater that was going to provide every student with a laptop computer.
I went to the parent information night, and met a 58 year old teacher who
said how rejuvenated he was by this experience of rethinking how to teach
in a room where every student would have a laptop. His whole outlook as
an educator was re-inspired."
Incentives matter. Investment banks have to use incentive plans, he said
because it's really hard to hire a lot of people willing to call firms up
and ask them to buy loans. "But I can't think of anything about a monetary
incentive plan that would get teachers to like working with their students
more. If teaching is really about the relationships, I think our focus
should be put there."
"As we
think about how we drive toward these innovation opportunities, we have to
think about the balance of innovation and effectiveness. We don't want to
kill an innovative culture by restricting efforts only to those that have
already been tried and deemed safe."
The
budget will not be resolved without innovation in health care
If you
were to solve the budget problem in a meaningful way, Kelley said, instead
of simply cutting spending, you would have to find ways to cut health care
inflation. That's where the real solution is.
We
can't solve this health care problem unless we have innovation in patient
services. Up until now our payment structures have not encouraged that
kind of innovation. Park Nicollet had a program where they expanded
personal contacts with people with congestive heart failure, following up
with them regularly to assure that they took their medication-that cost
them $600,000 in additional personnel expense but saved the government
around a million dollars by improving health outcomes with less
hospitalizations.
"I
think that what government must do is rethink our processes so that we get
people to want to change their behavior. We've done all the
preaching, we've done all the logical and rational arguments, so now we
have to find out how to connect with people at an emotional level."
There
is a lot of poorly done technology-enabled service. It is important to
think past the hardware, and toward what the technology can do to solve
real needs of real people. Apple's iPhone for example unleashes human
capacity in its wide-open "applications" marketing. The key is the use of
technology as an enabler, to facilitate the communication and foster
creativity.
Early childhood improvements require a broader view of community
"A lot
of the education reform efforts have focused on school. And I'm convinced
they need to take a wider view of things. You look at generational
poverty, and education, and health disparities, and these things are
obviously connected."
He
described Geoffry
Canada
and the Harlem Children's Zone, working to take a whole-family,
whole-neighborhood approach. "What
Canada
is trying to do is cut off the effects of poverty for the next generation.
Ideally we would start with very good prenatal care, so that children do
not start out badly because they were born to a poor family.
We
have to understand that we can't do this during 6-7 hours a day at school,
then not pay attention to what happens in the hours outside of school, and
in the years before school. At the Humphrey Institute, Kelley said, they
are trying to connect a network of science and math teachers, and
community institutions to work toward enrichment activities after regular
school hours. "If we're really going to have an impact on students we need
to be there all along the way."
C.
Closing
To
close a participant asked Kelley for his thoughts on the governor's race,
in light of his message on innovation.
"My
personal feeling is that Representative Emmer's slash-and-burn approach
will be anathema to innovation. I think both Senator Dayton and Tom Horner
are open to innovative solutions, and I take real encouragement that
toward the end of
Dayton's 11-point education plan there is reference to freeing up teachers
to innovate. I hope that's a sign that Mark, across a range of things,
would be more open."
Kelley
also said he is raising money to create a "design thinking" center at the
Humphrey Institute for smaller businesses as well as public sector groups
who might lack the resources of a Mayo Clinic to engage in this type of
research in-house. "I think having a well-designed place to help people
think about innovating-really innovating-would be very valuable in
spurring the kind of creativity we are going to need."
One
last thought: IBM does a survey every few years of CEO's at top companies.
They ask them their views on a variety of topics, and the 2010 survey
asked them for the top thing on their agendas. The most common response
was
innovation/creativity; the second was how to improve relationships and get
closer to their customer.
It
would be a good thing if government were to put that at the top of its
agenda as well.
Thanks
to Steve Kelley for a good conversation.
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