There is a joke shared by statisticians, scrap dealers, and emergency medicine professionals about drivers. Despite the distribution curves of driving skill, the daily admissions to the emergency department, and the clear evidence to the contrary in the scrap business, the average driver strongly believes that they are far better drivers than average. Some truly abysmal drivers feel highly confident that they are, in fact, very good drivers.

So, too, does the average organization harbor images of themselves as highly innovative, while, by some accounts, fewer than 3% of them are. In truth, the other 97% of organizations range from pretty pedestrian to so terrible at innovation that it brings tears to one’s eyes. Being un-innovative is not really the problem, though, and unlike being a terrible driver, being horrible at innovation is only a problem if one has mismatched aspirations.

How do you tell if your organization is truly innovative, or if it is just a bad driver with poor self-awareness? There are several online surveys, but here are three questions taken from an instrument I developed for organizational learning and knowledge behaviors. Score your organization on a 1-5 scale, in which one is “Never” and five is “Always.”

  1. There are places at work I can go to quietly think things through.
  2. I regard networking with other staff members and exchanging knowledge as part of my job.
  3. This organization treats mistakes as valuable learning experiences rather than as a reason to punish somebody.

Here is my informal rating scale:

  • 14-15: Yes, your organization probably has a string of copyrights, patents, and inventions to its name, or soon will. Staff probably get out of bed on weekdays smiling. Well done; smirk it up and thumb your nose at the rest of us.
  • 13: Oh, so close, but no. There is a good chance that you can develop into an innovator if you want to. On the other hand, maybe you rather want to become a great high reliability organization (HRO). You are likely to stay in business a long time and have really happy staff and customers.
  • 10-12: No, but you are a really good candidate to improve your quality and be loved by your patients and clients if you try hard.
  • 7-9: No, seriously. Survival should be the main focus of this organization, not innovation. You may need help to get your processes in order and aligned with business priorities, and you may have a toxic CEO and board.
  • 3-6: Haha, no way! Your organization is that driver who causes most of the accidents, raises everyone’s premiums, and makes safety engineers grind their teeth at night. Please rather consider moving out of healthcare.

Let’s discuss three reasons why innovation is bad for the 97%, and what they can aspire to instead.

The Harm Level

Most innovations are harmful to the organism in which they occur. If a cell suddenly starts marching to the beat of its own drum, it is likely to be cancerous, not a nascent superpower. Some innovations bestow a little benefit, and may become a real breakthrough, but at least initially, they are almost always going to seem like a bad mistake. For example, sickle cell provides a little benefit against malaria at the cost of somewhat debilitating anemia. One the other hand, being able to walk upright has been a pretty good innovation for us, and co-opting the mitochondrion was a roaring success, but these took a while to bear fruit.

Most organizations simply aren’t geared up to do the hazardous job of increasing these “errors,” firewalling them from the institutional immune system, and carefully sifting out the dead-end or virulent innovations from ones that will eventually be incorporated into how they do business. No matter how much they thump their chests that they are “innovation leaders,” most organizations simply lack the optics to tell a cancer from an emergent differentiator, or an error from a good idea. And most do not have the Biosafety Level 4 maturity to handle innovation without blowing up the entire business.

The Waste Surprise

Very few people are ready for the astounding level of waste involved in innovation. Most organizations will try something twice—maybe three times—before concluding it a bad idea, but most innovations take several hundred attempts to get a working model, let alone a commercial product. Edison claimed that he had 1,000 duds before his first bench-ready lightbulb.

While the media repeatedly trumpet the image of the lone genius whipping up an innovation after Sunday lunch, the truth is that it typically takes masses of people collaborating over extended periods, sometimes longer than the lifespan of the originators. New drugs often take 12 years from idea to market, and reportedly, only one in 5,000 potential drugs make the journey to become a product.

Very few organizations have the patience, resources, and vision to pull off more than the most trivial of innovations, due to the enormous waste and time involved.

Process Mastery

A lot of the creative part of innovation is that freewheeling, brainstorming, walking in nature, playing nerf-ball stuff we see in the movies, but that is only a very tiny part of innovation. Once a clever idea pops up, it has to be guided through a very rugged and precise industrial process, to clean it up, remove the burs, refine it, combine it, and figure out how it would be implemented, tested, monitored, and scaled up to production levels.

The development of an idea into a process or product requires inordinate levels of discipline, process maturity, and laboratory-grade levels of conceptual cleanliness. Only those organizations that have repeatable and mature processes for handling the idea to innovation development lifecycle, will be able to do this well.

Realism and Emancipation

Does this mean that organizations should abandon innovation? No, but it does mean that if you are not one of those 3% who do regularly innovate, you need a different approach to innovation: copycatting. There is no shame in copying a good idea, and it takes great skill, determination, and situational awareness to do it well.

You need to develop highly effective and quality-controlled processes for copying what the innovative organizations have already brought to market, and to liberate your organization from the false-consciousness of trying to be an innovator. The effective copycat can often improve on the innovations that hit the market, can pick those that are showing evidence of success, and scale them to meet demand. Accepting the mantle of being a copycat is emancipatory, and your staff and patients will be far happier.

To be an effective copycat, you need to master some things, including:


  • Identifying needs: Getting close to the people you serve, and seeing what their needs are in reality. Not what the marketing department thought was slick, but what the customer experienced. Get into their lives and find out what life is like for them. Solve the problems that they have, not the ones you would prefer to solve.
  • Recognizing a fit: Match deep knowledge of your customers with a high degree of situational awareness. Regularly visit other healthcare and other service organizations, and watch the industry and allied industries closely. Be alert for solutions from other industries that may be adapted to solve a problem your customers feel strongly about.
  • Adapting to customer needs: Work with your customers to tailor innovations to the lived experience of their situations. Iteratively improve the innovation until it is STEEEPA – safe, timely, effective, efficient, equitable, patient-centric, and affordable.
  • Scaling up adoption/production: Gear up to deploy it with low risk and high adoption. Develop the documentation and training materials that make it easy to adopt. Ensure that you have the customer-support processes to match the innovation/customer profile.
  • Monitoring & evaluation and quality improvement: Before any innovation is launched, it is necessary to understand how performance, stability, and interference will be monitored, and processes to routinely monitor it and make adjustments must be embedded in the organization’s operations. The monitoring process must be able to detect leading indicators that it is working as expected, that it is behaving in a stable fashion, and that it is not causing harm to any other processes.
    The organization also needs to conduct periodic reviews; to initiate process improvement actions to address risks, issues, or missed opportunities; and to look for ways to continually improve the quality.
  • Preparing for retirement and replacement: All good things end, and so do innovations. The best time to start planning for the retirement of an outdated innovation is before it is launched. Over time, this retirement process will track the innovation and enable the organization to repeal and replace it with something better when the time comes.