In a very interesting TED talk entitled “Where Do Good Ideas Come From,” Steven Johnson gives example after example of how individual moments of epiphany are more likely to be the product of group discussion and process than the sudden “eureka” moment of an isolated inventor or innovator. If you want to see Johnson’s TED talk (it has more than 2,000,000 viewers) it will cost you a mere 17 minutes and is probably a better investment of your time than an equal number of minutes watching an NFL game.
http://www.ted.com/talks/steven_johnson_where_good_ideas_come_from/transcript?language=en
Lean, more than other continuous improvement methodologies, is built on people interacting with other people. Collective activities draw people into a conversation where there are no ideas that are bad. The process is fueled by the sharing of ideas until the right idea comes to the top, is deployed and is confirmed by results which demonstrate that improvement has emerged.
I have mentioned to friends that over the last decade or so it is possible to sense movement in healthcare by attending conferences and watching the evolution of the programs of these conferences. A decade ago you had to go to the meetings of the Institute for Healthcare Improvement or the Group Practice Improvement Network to find any significant number of people talking about the evolution of practice driven by focus on the patient and delivering quality, safety, equity, and the better use of resources. Ten years ago even the conversations at the meetings of organizations like AMGA, the American Medical Group Association, were still about little more than how to survive in the old world. Over the last few years the conversations at most meetings have radically changed to a discussion of what is emerging in the new world of healthcare. It is not all about the Affordable Care Act, although that reality has been a major stimulus to the process. Now I am bombarded on the Internet by information about change in healthcare. There are almost daily notices of discussions of ACOs, various new payment methodologies and how to successfully acquire the competencies to succeed in this new environment. That is emergence!
Conversations everywhere have evolved and what is emerging is good. I have been to many meetings where economists state that the pace of improvement or the observations on the fall of costs seem faster than can be explained. I do not know how long this trend will last or where it will go ultimately but our industry is changing and is being redesigned by emergence. My guess is that as more and more people step away from the isolation and silos of the status quo and begin to interact about how their world is changing, we will see emergence and acceleration toward new and better healthcare. We have something over the ants and the termites that excite E. O. Wilson; we actually do think and we do have consciousness and the ability to will better outcomes. Our Lean-driven ability to think together can only speed up the process.
Two big takeaway questions emerge quickly for me from considering “emergence” as an active process. The first is whether or not there are ways of “catalyzing” the process to accelerate the emergence of new structures and innovations. I think the answer is yes, and my next thought is that emergence is what occurs in a Lean activity. The philosophy and tools of Lean may be the catalyst. The second question is the role of leadership in a leaderless process, and again, the description of the Lean leader seems to be a step in the right direction. The Lean leader is responsible for the environment. Leadership asks the questions that direct attention toward what might be important. Lean leaders ensure that the learning cycle will be energized by measurement and that the politics of change do not block the process of emergence. Leaders can be “connectors and protectors” within an emergent environment. What leadership is not responsible for is being the single source of good ideas. Leadership may be responsible for providing sustenance to emerging ideas and for expanding the reach of the ones that really have potential. That kind of leadership gives us an advantage over Wilson’s ants.
Emergence does not require an explainer anymore than it requires a traditional leader. What it requires is engagement and the courage to just try and the curiosity to see what could be done if you open up to others who share your goal of the Triple Aim.
Johnson’s TED talk ends with hope. He spends the last five minutes telling the story of the evolution of the GPS systems that started out as the core of Reagan’s Star Wars and now gives us driving directions, allows us to find the nearest Starbucks, and continues to direct the world’s traffic on earth from satellites in space. It is a story of emergence beginning with an idea born out of the curiosity of a couple of engineers and mathematicians that was stimulated by Russia’s launch of the first Sputnik in 1957. To get the idea really going they needed the help of a leader. He ends the talk with the most practical of all reasons for the collaboration that produces emergent results:
Chance favors the connected mind.
