NRG Energy Workshop: Implementing Sustainable Innovations

design that mattersI N N O V A T I O N F O R S O C I A L E N T E R P R I S E

NRG leadeRship meetiNG11 apRil 2013

mEThOdS FOR REAChINg POSITIVE ImPACTelizabeth Johansen, director of product development

ImPLEmENTINg SuSTAINAbLE INNOVATIONS

FAIL EARLY TOSUCCEED SOONER

photo courtesy Drake Goodman, www.flickr.com© elizabeth johansen

THINK VISUALLY, DREAM BIG

photo courtesy Duncan Cumming, www.flickr.com© elizabeth johansen

SUSTAINABLE INNOVATIONSTARTS WITH A DREAM

DTM’S DREAMUSING DESIGN TO MAKE

LIFE BETTER FOR PEOPLE WITH FEW RESOURCES AND

OPPORTUNITIES

WHERE© elizabeth johansen

INNOVATION IS EXPLORATION

THE DESTINATION: YOUR DREAM

WAYFINDING TOOLS

SET THE SIGHTS

CONNECT THE DOTS

SEND OUT THE SCOUTING PARTY

HAVE A DREAM

SKETCH THE MAP

CREATIVE TOOLS

VISUAL THINKING

INSPIRATION SYNTHESIS BRAINSTORMING PROTOTYPING

THE INNOVATION PROCESS

SET THE SIGHTS

CONNECT THE DOTS

HAVE A DREAM

SKETCH THE MAP

VISUAL THINKING

INSPIRATION

SYNTHESISBRAINSTORMING

PROTOTYPING

SET THE SIGHTS

CONNECT THE DOTS

HAVE A DREAM

SKETCH THE MAP

VISUAL THINKING

INSPIRATION

PROTOTYPING

VISUAL THINKING1. DRAW YOUR NEIGHBOR (30 SEC)

DRAW YOUR DREAM1. DRAW YOUR NEIGHBOR 2. VISUALIZE A DAY OF LIFE IN YOUR IDEAL FUTURE (2 MIN)

1. DRAW YOUR NEIGHBOR2. VISUALIZE A DAY OF LIFE IN YOUR IDEAL FUTURE 3. DRAW YOUR DREAM (2 MIN)

DRAW YOUR DREAM +

1. DRAW YOUR NEIGHBOR2. VISUALIZE A DAY OF LIFE IN YOUR IDEAL FUTURE 3. DRAW YOUR DREAM4. SHARE YOUR DREAM WITH YOUR NEIGHBOR (1 MIN)

DRAW YOUR DREAM +

PROJECT FIREFLYnewborn phototherapy

OUR DREAM

From J. Maisels, “Phototherapy for Neonatal Jaundice,” NEJM 358;9, Feb08. Absorbance spectrum of bilirubin shown as white line.

ONE OF NINE ROOMSTREATING 150 INFANTS.

VIETNAM: NATIONAL OBGYN HOSPITAL

INSPIRATION

“WE USED TO USE A PRESSURECOOKER TO STERILIZE OUR EQUIPMENT, BUT IT BROKE. ALL WE HAVE TO USE NOW IS THIS TOASTER OVEN.”

-MIDWIFE IN DELIVERY ROOM

CAMBODIA: TONELBATY HEALTH CLINIC

INSPIRATION

A DUKE UNIVERSITY STUDY FOUND THAT 95% OF ALL DONATED INFANT CARE EQUIPMENT IS BROKEN WITHIN 5 YEARS.

NEPAL: KATHMANDU

INSPIRATION

“ALL OF THE INFANTSWERE JUST DISCHARGED YESTERDAY.”

- NURSEVIETNAM: MAI CHAU DISTRICT HOSPITAL

INSPIRATION

FABELLA IS ONE OF THE FEW (25%) PUBLIC HOSPITALS. THEY CURRENTLY HAVE 6 PHOTOTHERAPY DEVICES TO TREAT A NICU OF 115 INFANTS.

THE PHILIPPINES: FABELLA NATIONAL HOSPITAL

INSPIRATION

VIETNAM: HA NAM DISTRICT HOSPITAL

INSPIRATION

VIETNAM: HA NAM DISTRICT HOSPITAL

INSPIRATION

FABELLA HAS 4 WARDSFOR MOTHERS. DURING THIS VISIT, 1 WARD HAD 185 MOTHERS.

INSPIRATION

“WECOMPLETELY BANNED USE OF FORMULA IN OUR HOSPITAL. INSTEAD, WE ENCOURAGE ALL MOTHERS TO BREAST FEED AND USE KANGAROO CARE TO KEEP THEIR INFANTS WARM.”

-DOCTOR

INSPIRATION

THREE MOMS, THREEJAUNDICED INFANTS, SHARING ONE ROOM WITH AN UNUSED OVERHEAD PHOTOTHERAPY.

VIETNAM: PHU BINH HEALTH CENTER

INSPIRATION

SYNTHESIS

SET THE SIGHTS

CONNECT THE DOTS

HAVE A DREAM

SKETCH THE MAP

VISUAL THINKING

INSPIRATION

PROTOTYPING

CREATIVE TOOLS

WAYFINDING TOOLS

Project Point of View:In order to reduce the volume of otherwise-healthy

newborns referred to overloaded national-level hospitals, rural district hospitals in Vietnam and Southeast Asia

- NEED -

a trusted, safe, ROBUST tool to provide newborns with blue light therapy in the mothers’ room

SET THE SIGHTS

SKETCH THE MAP

CONNECT THE DOTS

SET THE SIGHTS

CONNECT THE DOTS

HAVE A DREAM

SKETCH THE MAP

VISUAL THINKING

INSPIRATION

PROTOTYPING

CREATIVE TOOLS

WAYFINDING TOOLS

SEND OUT THE SCOUTS

PROTOTYPE -

1. A WAY OF TRYING SOMETHING OUT QUICKLY AND CHEAPLY.

2. ANY ASSET YOU CREATE TO HELP TEST CRITICAL PROGRAM ASSUMPTIONS.

Prototyping: It’s Not Just for Products

SEND OUT THE SCOUTS +

WHAT IS A PROTOTYPE?A TOOL FOR LEARNING AND COMMUNICATION

WHAT IS A PROTOTYPE?A TOOL FOR GETTING RICH FEEDBACK AND ALIGNMENTA TOOL FOR GETTING RICH FEEDBACK AND ALIGNMENT

WHAT IS A PROTOTYPE?A TOOL FOR GETTING RICH FEEDBACK AND ALIGNMENT

WHAT IS A PROTOTYPE?A TOOL FOR THINKING THROUGH AND LEARNING

WHAT IS A PROTOTYPE?A TOOL FOR MAKING COMPARISONS

HOW TO PROTOTYPEBREAK THE PROBLEM INTO PIECES

LOOKS-LIKE

WORKS-LIKE FEELS-LIKE

HOW TO PROTOTYPETHINK THROUGH ALL THE STEPS

HOW TO PROTOTYPEQUICK AND DIRTY

HOW TO PROTOTYPEUSE ROLE-PLAYING

HOW TO PROTOTYPEITERATE, ITERATE, ITERATE

1. READ YOUR CHALLENGE2. MAKE A 1-MIN SKIT (A ROLE-PLAYING PROTOTYPE!) OF HOW

YOU WOULD TEST YOUR ASSUMPTION (10 MIN)3. SHARE

CHALLENGE 2PHASE: DETAILED DESIGN

CHALLENGE 3PHASE: IMPLEMENTATION

CHALLENGE 1 PHASE: CONCEPT DEVELOPMENT

1. READ YOUR CHALLENGE2. MAKE A 1-MIN SKIT (A ROLE-PLAYING PROTOTYPE!) OF HOW

YOU WOULD TEST YOUR ASSUMPTION3. SHARE WITH YOUR NEIGHBOR (1 MIN EACH SKIT)

CHALLENGE 2PHASE: DETAILED DESIGN

CHALLENGE 3PHASE: IMPLEMENTATION

CHALLENGE 1 PHASE: CONCEPT DEVELOPMENT

CHALLENGE #1

SEND OUT THE SCOUTS +CHALLENGE #1

CHALLENGE #1

CHALLENGE #2

SEND OUT THE SCOUTS +CHALLENGE #2

CHALLENGE #3

FIREFLY

MTTS OVERHEAD

HOSPITAL-MADE TOP & BOTTOM PHOTOTHERAPY

MTTS BILIBED

CHALLENGE #3

108INFANTS TREATED TO DATE*

*513 treatment days

December 8, 2011 through January 6, 2012&

April 26, 2012 through February 1, 2013

2FIREFLY CLINICAL DEVICES

*out of three clinical Firefly units total manufactured in December 2011

2NATIONAL HOSPITALS

1DISTRICT HOSPITAL

>1/3REDUCTION IN TREATMENT TIME*

* During 17 infant treatments during December 2011 Clinical Evalat National OBGYN Hospital in Hanoi, Vietnam

*an expensive, high-risk treatment of last resort for patients with severe jaundice, where all the newborn’s blood is removed and replaced by

donor blood

EXCHANGE TRANSFUSIONS* AVERTED BY FIREFLY

SET THE SIGHTS

CONNECT THE DOTS

HAVE A DREAM

SKETCH THE MAP

VISUAL THINKING

INSPIRATION

PROTOTYPING

CREATIVE TOOLS

WAYFINDING TOOLS

SET THE SIGHTS

CONNECT THE DOTS

HAVE A DREAM

SKETCH THE MAP

VISUAL THINKING

INSPIRATION

PROTOTYPING

CREATIVE TOOLS

WAYFINDING TOOLS

THINK VISUALLY, DREAM BIG

FAIL EARLY TOSUCCEED SOONER

photo courtesy Duncan Cumming, www.flickr.com

OVERHEAD PHOTOTHERAPY FIREFLY PHOTOTHERAPY

THANK YOU!

During field research, you found that phototherapy was often ineffective in rural hospitals because staff with little training use classic overhead phototherapy incorrectly, leading newborns to be transferred to higher level hospitals and receive life-threatening exchange blood transfusions. Specifically, the problems are: • the light bulbs become too dim to be effective• the distance from light to infant is too far or too close • low power setting is always used to conserve energy You have just created a “looks-like” prototype of a top and bottom lighting device to take to Vietnam (left). The final device will use high-power LEDs that last 5 years.

Create a skit (a role-playing prototype!) demonstrating an activity to do with doctors, nurses, and parents that will cheaply test whether the device is hard to use wrong for users with little training. Think specifically about: power setting, top light height, and warning when the lights bulbs become too dim.

ChALLENgE #1 +PhASE: CONCEPT dEVELOPmENT FIREFLy IS ThE ONLy PhOTOThERAPy TOOL ThAT CAN gO INTO dISTRICT/PRImARy hOSPITALS

ChALLENgE #2• At the end of a successful trip to Vietnam with your

“looks-like” phototherapy prototype, you are now beginning the detailed engineering design phase.

• The design must be completed in 3 months to ensure it is ready for clinical evaluation this year.

• You have recruited six engineers representing four companies to complete the detailed engineering design: two mechanical, two electrical, one optical, one thermal.

• All four companies have agreed to give DtM a major price break since it’s for a good cause.

Create a skit (a role-playing prototype!) demonstrating an activity you could do at the kick-off meeting to assess the engineering team’s ability to work well together.

+PhASE: dETAILEd dESIgNENgINEERINg CONTRACTORS wILL COLLAbORATE EFFICIENTLy

A manufacturing analysis and a one-month clinical evaluation of your fully-functional phototherapy found:• The device’s double-sided lighting reduces treatment

time by more than 1/3 compared to typical mono-direction devices, treating 1.5x as many infants.

• Typical overhead devices are often used incorrectly, decreasing effectiveness. Issues include setting the height of the light incorrectly and placing multiple infants under one light source risking cross-infection.

• Estimated manufacturing costs put the device price slightly higher than bare-bones overheads, but still less than all other alternatives.

You have seen at least 20 different brands in use in the field, with at least five configurations. You are about to visit purchasing stakeholders in Southeast Asia.

Create a skit (a role-playing prototype!) demonstrating an activity that would allow you to gauge price sensitivity among the various purchasing stakeholders.

PhASE: ImPLEmENTATIONFIREFLy PuRChASINg STAkEhOLdERS CARE NOT juST AbOuT COST, buT COST-EFFECTIVENESS

ChALLENgE #3 +

LEFT TO RIghT, TOP TO bOTTOm: FIREFLy, mTTS OVERhEAd, mTTS bILIbEd, Pgh hOSPITAL-mAdE dEVICE

NRG Energy Workshop: Implementing Sustainable Innovations

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