Maybe the business of health care has always been a juggling act, but in this age of uncertainty it seems to me those of you who run hospitals have a lot more flaming torches to keep spinning in the air. Even as hospitals struggle to maintain a viable bottom line so they can continue to serve their communities, many are engaged in an unending process of rethinking and improving the way they deliver care. The motivation isn't entirely altruistic; let's face it, whatever becomes of health care reform by the time the courts have finished vetting it, the horse is already out of the barn — how you are measured for what you do and how you are paid for it are changing dramatically. You better learn to do it more efficiently and more collaboratively or there'll be trouble ahead.

Nevertheless, I've found in talking with executives at many hospitals that their process of transformation is not driven nearly as much by financial or regulatory pressures as by a deep-seated desire to make care better for the patient. That's why they chose the profession to begin with. Happily, leading-edge hospitals are finding ways to do both.

A few weeks ago I wrote about Columbus Regional Hospital in Indiana, whose new Innovation Center is destined to be a model for other community hospitals intent on experimenting with care delivery. Less surprising, perhaps, is another organization with a long and distinguished history of innovation: the Mayo Clinic in Minnesota. I recently spoke with Barbara Spurrier, administrative director of Mayo's Center for Innovation, which opened in June 2008.

The CFI is housed in a 15,000-square-foot space with about 50 professionals, ranging from designers, anthropologists, clinicians and more, and is intended to be what Mayo folks call “a giant incubator” of ideas. It includes an outpatient lab that allows for the observation of patients while they interact with providers in the clinical setting; the Healthy Aging and Independent Living (HAIL) Lab; and spaces for prototyping, workshops and classes.

Spurrier says the overarching goals are to better understand human needs; make care delivery more accessible, affordable and value-driven; foster collaboration; and demonstrate economic value. The philosophy is simple: Think big, start small and move fast.
Currently, the CFI is focusing on three “platforms”:

1. Redesign the medical office to reduce outpatient costs 30 percent while improving the patient experience and outcomes.

2. Transform community health using the Triple Aim model: improve the health of the population, enhance the patient experience, and reduce the per capita cost of care.

3. Improve “care at a distance” by developing three sustainable models that extend specialty care beyond the clinic and hospital to nontraditional settings.According to Mayo, it's doing so by “providing adequate resources and giving intellectual freedom with minimal initial oversight and short timelines to a small team of unconventional thinkers and change agents. This allows the team to explore new spaces that have the potential to radically alter the health care landscape.”

As someone who writes frequently about issues around the aging of our population, I find one of the most intriguing aspects of innovation at Mayo is the HAIL Lab, a "living lab" in the Charter House, a continuing care retirement community with 400 residents connected to Mayo Clinic. A collaboration among Mayo, Charter House and the Kogod Center for Aging, the lab is working on ways to support “aging in place,” helping seniors remain at home, healthy and independent. I'll be eager to learn what they come up with and help get the word out.

Like Columbus Regional Hospital, Mayo wants to spread the gospel of innovation. One way it's doing that is through its annual Transform symposium currently underway. Organized like the famous T.E.D. conferences, the meeting brings speakers from a wide variety of disciplines together to talk about new and exciting ideas. My colleague Haydn Bush is in Rochester, Minn., now and will be sharing what he learns in H&HN Daily tomorrow and Wednesday. Look for his blogs in this space.

Bill Santamour is managing editor of Hospitals & Health Networks magazine. Follow his tweets at