As told by Keith Jackson, Professor of Medical Engineering at the University of Sheffield, Entrepreneur and Medtech Executive.
Culture, as is commonly referred to in business, is the operating environment within an organization. It speaks to the leadership, interpersonal relationships, expectations and values that drive a company toward its goals.
Creating the right culture is one of the most important aspects of being a capable leader. As new talent is brought in, some employees leave and the world changes, the culture will inevitably evolve. The trick for leaders is to shape the culture in the direction you want it to go, in order to reinforce the desirable behaviors, both current and aspirational.
As businesses in the orthopedic space, you want to foster a culture that champions innovation. But how do you achieve that environment?
The truth is it takes very deliberate activities and interventions.
It’s Never Too Late to Innovate
Creating an innovative culture is undoubtedly easier when a company is small and first established, but that’s not the only time to do it. If you are trying to change an existing culture in a more mature company, you may need to engage in dismantling and rearranging.
But ultimately, the time to adjust and move toward a more innovative culture...is now. No matter where you are in the evolution of your business.
Whether you are large, medium, small; it does not matter — the time to do it is now. All businesses can become stale, to a greater or lesser extent. They all need an injection of energy from time to time, or maybe a recalibration of what the business seeks to accomplish in response to shifting customer needs and market dynamics. So, just as you might refresh your company strategy regularly, the same is true of your culture.
It is always helpful though, if perhaps, there is an external imperative to change. We’ve had a very big one with COVID-19, which has led to rethinking about future strategy, particularly in orthopedics. COVID is a crisis. It is an actual seismic event and unprecedented, really, in a number of ways. I think, when you have that external influence, that catalyst, it can really help to galvanize a team to get behind accelerated change. You have a shared challenge that you are trying to overcome or navigate through and that is tremendously potent.
External dynamics are always helpful as a catalyst to create a sense of urgency, explain to employees and to get them to buy into doing things differently. A change of leadership is another example, whether that be the CEO or others in the senior team. That is also a good time to advance the culture.
Regardless of an external force or internal shakeup, it is best to look at your culture regularly and at least annually, similar to your strategy, and decide whether you need to make some changes. What’s working? What do we need to change? How do we go about that? How do you get people to buy into it and to make that change happen?
In order to innovate, a company must come up with different ways of doing things that ultimately creates value and enhances competitive advantage. One of the first steps is identifying where there may be opportunities to innovate. To start, it goes beyond just making a better product or an advanced technology. In fact, the more disruptive innovations do not pursue ever better product performance in the hope of realizing higher prices. They seek to help customers to do their jobs easier and more cost effectively.
To create a strong culture of innovation, it’s helpful to think of the many opportunities for innovation across the company, including technology and product performance, the interfaces between products and how they work together as product systems, business and manufacturing processes, the profit model, your brand, customer engagement and employee engagement.
Each of these areas presents an avenue for improvement using creative thinking. Begin by looking beyond the obvious of the next new, shiny product and into ways that you can innovate internally as an organization.
Learn to Innovate Together
Innovating is not a natural process, even in engineering businesses. As an engineer, I can speak to the fact that we apply a lot of operational thinking. We’re comfortable with repeatability, consistency, rules, routines and procedures. We operate rationally.
Engineering and manufacturing businesses will benefit from a leader making deliberate space for creativity and innovative thinking. Rather than approach everything with an operational mindset, encourage expansive thinking where the team is on a quest for what might be possible. Give employees a chance to explore ideas and try not to evaluate them too early — the more reductive thinking, analysis and evaluation can come later. You do not want to criticize or say it has been tried before; you do not want to slow the flow of new ideas.
When an organization is learning to innovate, it is imperative to go through that phase as part of that growth cycle involving everyone, not just the leaders. That releases tremendous diversity of thinking with different goals, different experiences and different perspectives, which is healthy for surfacing new ideas. Counsel individuals to share the airtime, try to deliberately slow down, be inquisitive, explore and look expansively at the opportunities, ideas and options available and do not race to a solution.
Clearly, you’ve got a commercial imperative to get new products to market, or to improve your processes, to reduce cost and add value, or to have a stronger engagement with your customer base. All of those commercial imperatives are still there. However, if you want to get to the really good ideas, deliberately create a safe space to have free thinking.
Get Team Buy-In
As with most things in business, making things happen requires getting buy-in from your people. If it is about people, it is really about communication. This needs to be two-way, which is what senior teams sometimes miss. I’m not a great fan of the tablets of stone from the mountain top, saying, “This is the way forward. This is what we’re going to do. Everybody needs to get in line. Everybody’s got a part to play.” I think there can be times for that, but it is not very often.
Getting buy-in takes more listening than talking. That’s why it’s really important to involve everyone, not just in trying to stimulate innovation and ideas, but also in terms of shaping that culture. Innovation should become part of everyone’s job.
A great groundbreaker is the employee attitude survey, in which you ask employees, what is working well, what is not working so well or holding us back? Include some very deliberate questions, posed as part of that, about how good are we at being innovative? Where is it working? How could we be better?
You start to draw people in, to have a voice and be listened to. That plays to one of the critical components of creating a more innovative culture, which is not just involving everybody, but encouraging everybody. You encourage them to experiment, to try it out.
There’s a phrase I’ve used a number of times, which is, “Just try it,” rather than “Just do it.” Just try it and then, when you have tried out new things, share the learning across the organization. What went well? What can we do better? How might we adapt or develop that idea, rather than kill it? A lot comes back to the way that leaders communicate.
It involves encouraging people to better articulate their ideas and their thinking. Help them and support them to develop those ideas. Involve the originators to test their ideas out with some simple experimentation — your prototypes, trials, beta models, minimal viable products. Sound them out with customers, or even better with potential customers. Ultimately, share the learnings across the company so that you do not just get better ideas: you all get better at innovating.
Innovating in Orthopedics
The challenge in orthopedics, historically, is often with major joint surgery. Today, we know what works. We’ve got good solid clinical evidence. We know what design attributes work. We know what materials work. We have been so successful over the last 50 years, we are now chasing diminishing returns in order to further refine those implant designs to provide very limited enhancements in patient outcomes.
There is great work that is being done, absolutely. However, I think there is a lot more that could be done, like successful collaboration outside of orthopedic companies and their vendors. What about patients in that equation? What about garnering their views and experiences to develop something that reduces cost, reduces complexity, increases value, perhaps reduces time? Time is a precious commodity, especially when you have a huge backlog of patients to be treated, as well as an aging population. I think there is a lot more that can be done.
What we have seen in orthopedics is a decreasing influence by engineering (materials, design, production techniques) and an increasing influence of human factors. Including clinical practice, by looking at the whole care pathway − not just the 30 minutes of surgery where the implants are used − into how we might improve outcomes. We have also seen a move toward outpatient surgery, with value stream thinking on the patient treatment pathway, that will be very useful post-COVID and to manage costs of healthcare provision.
Orthopedic innovation can address how we support surgeons to have better implant positioning accuracy, to give more reliable, repeatable results and patient-reported outcome measures. For example, there are opportunities to empower patients with more bespoke post-operative regimes, to monitor their own progress and report this remotely using their smartphone, rather than attending an in-person clinic.
There are many ways in which we can innovate, but perhaps the innovation is orientating itself more around the clinical aspects and patient experience of joint replacement surgery. I think this is one area where a smaller orthopedic company can very much differentiate themselves from the bigger companies.
To find that differentiator for your company though, you need to nurture a culture of innovation that actively encourages new ideas, listens to everyone and gains team buy-in.
Culture Change Steps:
Look at Your Culture at Least Annually
Similar to your company strategy, decide whether you need to make changes. Ask: What’s working? What do we need to change? How do we go about that? How do you get people to buy into it and to make that change happen?
Consider the Opportunities for Innovation
There are numerous avenues for a company to innovate. Allow your thinking to consider technology and product performance, the interfaces between products and how they work together as product systems, business and manufacturing processes,
the profit model, your brand, customer engagement and employee engagement.
Encourage Expansive Team Thinking
Adopting a culture of innovation, requires everyone's input, not just leadership's. As you collect responses, counsel individuals to share the airtime, try to deliberately slow down, be inquisitive, explore and look expansively at the opportunities, ideas and options available. Do not race to a solution.
Once you listen to ideas, support the development of those ideas in order to ensure buy-in. Say “Just try it." Then, when you have tried out new things, share the learning across the organization. A lot comes back to the way that leaders communicate shared learnings.
Professor Keith Jackson has 30 years of experience in medtech, leading change as a CEO, Director and Advisor. He has worked with, visited and learned from some of the most innovative organizations, from San Francisco to Shanghai, including Salesforce, Jaguar Cars and Alibaba. He studied disruptive strategy with Harvard Business School and helps organizations create a much more innovative culture, enhancing competitive advantage.