Written by: Center for Care Innovations

Innovation isn’t the same thing as inspiration. It doesn’t strike you out of the blue—you have to work for it. Often that means that the best innovators are organizations that devote significant time, resources and thought to the processes through which they generate and try out new ideas.

Columbus Regional Health (CRH) in Indiana is one such organization. Since 2005 CRH has spent $2.9 million on innovation, and in 2011 they built a dedicated innovation center to pursue forward-thinking ideas in a systematic way. Since then the center has taken up 84 distinct projects and saved the organization an estimated $1.7 to $3.2 million each year.

Last month a CCI team, along with change makers from the Safety Net Innovation Network, visited CRH to see their innovation center in action. Below is a summary of the top five takeaways the team had following their visit for safety net organizations to consider as they build their innovation infrastructure.

1. A Strategic Process for Continuous Innovation

Too often innovation in an organization will mean convening a one time committee to brainstorm around a single issue. When their work is done, they dissolve. Rinse and repeat for the next issue. CRH sought to create a better cycle that smoothly transitioned an experienced core team from one project to the next, creating a pipeline of continuous innovation.

Five years before creating their innovation center, CRH started by creating a strategic process to drive their innovation work. This process starts by sourcing projects from a variety of sources, from customers to providers to brainstorming sessions. Projects can also develop out of spotting at gaps in performance, finding a best practice to implement, a need to meet external benchmarks, or the dictates of the organization’s larger strategic goals.

These ideas are then iterated with ideation until they are ready to be piloted. For projects that need resources, CRH’s strategy council is the gatekeeper. This group prioritizes projects based on their strategic fit, the organization’s capabilities, and external drivers, and then sets out of a timeline to put priority ideas into action.

Columbus Regional Health


They built this structure based on the Office of Strategy Management (Kaplan & Norton HBR article: https://hbr.org/2005/10/the-office-of-strategy-management) which addressed the challenge between strategy development and strategy execution by centralizing a new unit to oversee all strategy related activites.

2. The 5-P Framework

People, places, projects, processes, partnerships. Together these elements define an organization’s culture, and focus on each one is critical to making that culture innovative. CRH uses the 5-P framework to call out these five distinct spheres and break them into more specific sub-domains. More information about each of the 5 P’s can be found in CRH’s Progress Report on Innovation.

Columbus Regional Health

3. Innovation vs. Quality Improvement

A question we often hear at CCI is, what is the difference between innovation and quality improvement, and what method works best? Rather than focusing on one approach or the other, CRH instead puts significant thought into applying the right tool to the right problem. As part of their strategic process, CRH has three distinct pathways for pursuing new projects: process optimization, project management, and innovation. Each of these uses different resources and methods, as assigned by the strategy council or executive team. Process optimization, similar to quality improvement, uses Six Sigma tools and is lead by a Lean Sigma black belt. Innovation projects, on the other hand, uses design thinking tools and a trained design thinking facilitator. Meanwhile the third set of ideas use business planning and project management techniques, applied by a project manager.

These pathways also reflect a framework CRH uses to categorize projects as either “incremental,” “evolutionary” or “revolutionary.” These three types form a spectrum from process efficiency and effectiveness and extensions of existing services to health system redesign, and, like the three strategies described above, each notch on the spectrum is useful for tackling a particular kind of problem.

Columbus Regional Health

4. Designing a Space that Inspires

For the CCI/SNIN group, one of the biggest draws on the CRH trip was the physical space of their innovation center. For Columbus, having a literal place dedicated to brainstorming and ideation serves as a visual signal to the organization that innovation is meant to be a priority and a part of their culture. As long as employees don’t get stuck on the idea that the center is the only place where innovation happens, this can be a very powerful tool.

The space has its own identity from the rest of the hospital, which changes the flow of how things get done— it’s not “business as usual.” Key design principles of the innovation physical space include: flexibility via moveable furniture that can be easily modified for different teamwork configurations; making the work visual and visible; and co-locating innovation and improvement staff to spark spontaneous collaboration.

Columbus Regional Health
Columbus Regional Health

5. The Healthy Communities Council

This unique institution at CRH is a coalition of dozens of community stakeholders, including health system representatives, county government and court officials, school district leaders, domestic violence advocates, local businesspeople, and more. The council meets every two months at the innovation center, where the CCI visitors got to attend the most recent Healthy Communities meeting where they participated in a collaborative brainstorm around the question: “How might we enhance health impact by creating more opportunities for employment?”

The meetings involve keeping all parties up to date on the status of various projects. Each meeting also includes a brainstorming session focused around a specific wellness issue, such as access to care and domestic violence. Many of CRH’s innovation projects start in these discussions. By including these stakeholders at the start of the innovation process, rather than looping them in later, CRH grounds their work in what the community actually needs.


CCI would like to thank Lynne Maguire, Head of Innovation Strategy at Columbus Regional Health, Julie Abedian, President of Columbus Regional Health Foundation, the CRH team and Columbus community.

For more info on the Columbus Regional Health Innovation Center, please visit: crh.org/innovation



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