Using Little Bets to Uncover Breakthrough Ideas

By Rose O. Sherman, EdD, RN, FAAN

There is an interesting book by Peter Sims that examines how small bets can lead to very innovative, breakthrough ideas. At the core of this experimental approach, little bets are described as concrete actions taken to discover, test, and develop ideas that are achievable and affordable. They begin as creative possibilities that get refined over time. Sims points out that taking these little bets are particularly valuable when trying to navigate amid uncertainty, create something new, or attend to open-ended problems. As nurse leaders, we often focus on wide-spread systems changes to solve problems. Sims makes a strong case that taking small bets to test out new ideas is often more effective in leading to the type of innovation that is needed in healthcare and other industries today.

Examples of Small Bets Outside of Healthcare

Sometimes, what we see as remarkable innovations or incredible individual talent actually have been built taking very small bets. Sims offers an interesting glimpse into how the comedian Chris Rock develops a one hour performance. When beginning work on a new show, Rock chooses a very small venue close to his home to begin testing and refining his material. His early performances can be painful to watch, but he develops his material over time by taking small bets on what the audience may respond to. He tries out hundreds, if not thousands of ideas before putting together a performance that reaches what his fans refer to as his “full preacher effect”. Sims says that Rock like other innovators begins doing small things to discover what he should do. In developing the store concept for Starbucks, founder Howard Schultz initially began with one store in Seattle modeled after Italian coffee houses and tweaked his model many times until it evolved into the store concept we see today. Many technology innovators such as Steve Jobs of Apple, Jeff Bezos of Amazon and Bill Hewlett, founder of H&P, took small bets with a willingness to fail but the recognition that they could evolve into something important.

Some Key Steps in the Small Bets Approach

1. Be Willing to Experiment

Sims recommends that we must have a willingness to experiment with new ideas and to fail quickly to learn fast. If you are a nurse leader in healthcare trying to tackle perennial problems such as patient falls, pressure ulcers or customer service score problems – why not be willing to look at a different approach to tackling these problems. If an intervention fails then you learn from the experience.

2. Value an Atmosphere that Promotes Creativity

To promote creativity, you must create and value an atmosphere of innovation. You want to avoid snuffing out or prematurely judging creative ideas. Much of what we currently do in healthcare today is not achieving our intended goals so we desperately need disruptive innovation BUT we have to be willing not to shut new ideas.

3. Take Time to Gather Fresh Ideas and Insights

From my perspective, this step is one of the most important that Sims discusses in his book. New insights and ideas are all around us but not always obvious. In a previous blog, I described how a nurse observing the use of scanners at a car rental agency while on vacation developed the idea of medication bar coding. Nurse leaders need to take the time to get out into the world to gather fresh ideas and insights. This means talking with staff, housekeepers, patients and leaders in other industries. It involves reading outside your own professional literature to spot trends and environmental changes. The goal is to both develop a deeper insight into human motivations and desires, and absorbing how things work at the front-line level.

4. Implement, Refine and Retest

Very rarely is a first draft of a book or the initial design of a new process or business – the final product. By arming ourselves with new insights through implementation and refinement, innovations are perfected. We have to develop a willingness to see things as works in progress before abandoning new ideas too quickly.

A key lesson in this book is that leaders often fear failure, because they believe that innovation needs to be unleashed on a very big scale to have meaning. Sims contents that the practice of smallifying problems and taking small bets can be quite liberating and result in unexpected innovation. Most change, he contends, happens in small, achievable ways. This will be important advice for nurse leaders to consider as we move into the new era of healthcare reform.

Read to Lead

Sims, P. (2011). Little Bets: How Breakthrough Ideas Emerge from Small Discoveries. New York: Free Press.

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