A conversation with Dr. Zayna Khayat, Future Strategist of SE Health

Zayna Khayat, a Ph.D. trained biomedical scientist, is the Future Strategist at one of Canada’s largest and oldest non-profit health organizations, SE Health. She describes her job title as “a fancy word for Chief Innovation Officer.” Outside of SE Health, Zayna holds faculty positions at Singularity University and the Health Innovation School, as well as an Adjunct Professor position at Rotman School of Management. Her work is creating a better future for senior citizens and aging adults.

Dr. Zayna Khayat

I had the pleasure of speaking with Zayna about disruption gurus, Kaiser Permanente, and why she tries to ban the word innovation with her team at SE Health.

Banning the Word ‘Innovation’

According to Zayna, true “Big I” Innovation in healthcare is sluggish at best and barely existent at worst. “It’s steeped in tradition,” she told me. “It’s a business model that hasn’t evolved in 150 years…There’s many forces in place to keep things the way they are.” Her trick for generating real, substantial innovation from her team? Ban the word from their lexicon.

“I don’t like the word innovation and have banned it from my team’s work,” she said. “Healthcare is desperate for a lot of new, so many use the word innovation to describe any change or improvement. It could be just having a good meeting is innovation. Doing something that you should be doing anyway is innovation. And then of course digital, anything digital. I needed language to distinguish our purpose of modernizing and future-proofing our health system and our own org. Hence, we are called the Futures team.”

Zayna especially dislikes the concept of having a dedicated unit to support sustaining innovations in the core; she says it should be an expected piece of every business line. “We will not touch continuous innovation,” she told me. “It’s the easiest thing for any org who’s been operating a certain way forever to assign to the innovation team…because it’s somewhat safe, and you’re so risk-averse, you’re never going to do the big thing that your org and system really need.” Zayna says that for her team, continuous innovation draws away time and resources that should be going towards the work that no one in the core organization could own – remodeling and reinventing Healthcare’s business model.

“The unfinished business [in healthcare] is business model innovation, which is re-architecting the patient value proposition, who does what, and how you get paid. That hasn’t changed, like I said, for decades…we’re called the Futures team because we’re trying to build the next business models and future patient spaces  we need to be in instead of trying to only optimize the current things we do.”

More specifically, Zayna’s team is changing the way seniors receive healthcare in their homes. According to Zayna, healthcare services are moving away from facilities and into the home. “We work on creating future models to keep seniors healthy or to restore their health in the home setting,” she said. “We have two focus areas. One is designing new housing models…The other area is new ways to keep people healthy in their home. I call that the Home-spital…Most activities and procedures are done in a hospital or clinic can now be done in a home setting, it’s just that few are doing it at scale yet.”

Explicitly defining the two areas her team works in has been key to their ability to focus. Zayna says that focus not only directs the efforts of team members but also makes it easy to say “no” to multiple demands and ideas that cross their desks daily.

“Declare your priorities and be ruthlessly focused on those. Otherwise, stuff will come at you in every direction. As soon as you declare you’re the innovation team, it all comes to you because people don’t fully understand what you do or do not do. If you don’t have focus areas, you’ll dilute your resources and move slowly. I’ve seen that over and over again with innovation teams.”

Disruption Gurus: Getting Teeth in the Org

SE Health may be supportive of Zayna’s team creating disruptive breakthroughs in healthcare, but not all organizations can make innovation stick. This may be why so many struggle to maintain their innovation units.

“I see a lot of organizations start an innovation unit or center with ambitious and exciting plans, and then within a year the lead quits and the unit goes away…and then they start again a couple years later. I also see a lot of innovation theatre.”

Zayna defines innovation theatre as “having the shop or unit, with a fancy website or space [to work in], but no real teeth, methodology, or accountability to transform the patient experience, org or sector” She says in order for an innovation team to create impact, a vital requirement is sponsorship by the organization’s top executives.

“[Innovation teams] often report too many layers down in the org, and often to IT, Strategy, or Research & Development instead of the CEO…or the mandate is not commensurate with the quality of the talent or the resources provided; that is, people are part of innovation teams who don’t have the needed tools and methodologies.”

Zayna’s solution? She has heard an idea but rarely seen it in practice: the innovation team is lead by a second CEO – a Chief Entrepreneurship Officer, whose job is to continuously renew the organization’s business model. She says such a CEO can balance out the important work of the Chief Executive Officer, whose job is to keep the org’s current business model running flawlessly. The two would integrate at the board level.

The board, Zayna says, is often what saves a struggling innovation team – “it sometimes just takes one visionary board member who gets it and has enough influence and power to bring everybody else along and challenge the CEO and management team.”  

Nurses & Cockpits: The Kaiser Permanente Story

When I asked Zayna about her favorite innovation story, she told me that she’s particularly fond of the way Kaiser Permanente went about improving the safety of their hospital wards.

“I don’t know if you’ve ever been in a hospital ward, but in the middle of all the chaos, a nurse is dealing with the patient and there are buzzers going off and constant interruptions, yet they also have to administer meds. And sometimes those meds can be lethal if not dosed properly. It’s a dangerous time…but they’re so distracted that medication reconciliation errors can occur. Their numbers were a concern at Kaiser before they took an innovation lens to the problem.”

Kaiser Permanente knew something had to change, so they reached out to their in-house innovation consultancy for help. The innovation team sought out other industries in which professionals had to perform potentially dangerous tasks in distracting environments. Among the places they observed was the cockpit of airplanes.

“There are these few minutes of take-off that nobody is allowed in [the cockpit]. It’s called a sterile cockpit. No one is allowed to enter the sterile cockpit because that’s when all the action could go down in terms of risk to the flight. They took that concept and introduced it [as a sash worn over the shoulder] when a nurse is administering meds. That means you do not touch them, you don’t talk to them, you don’t interrupt her because they’re administering meds.”

The innovation team had incredible results with their sash concept. “They fixed the problem and it stuck,” Zayna said. She told me that she loves this story because it encapsulates what it is that she finds so powerful about human-centered design.

“It starts with no assumptions about anything. If you would have given [the medication reconciliation numbers] to a tech person they would have found a tech solution. If you would have given it to the performance management quality people, they would have found a quality improvement solution…business people would have gotten the data and then just made some change management program and forced it down the throat of the ward nurses…The way [this innovation team] got to that insight about the nurses being so distracted wasn’t from data, it was from observing people interacting with people.”