SAN DIEGO — A few years ago, Chris Waugh was global marketing manager at an innovative bicycle company. Now, he’s leading innovation at one of the largest health care systems in the U.S.

As the chief design and innovation officer at Sacramento, Calif.-based Sutter Health, Waugh believes the health care field needs to ask questions that are “big and bold,” he said during a Friday afternoon session at the American Hospital Association Leadership Summit.

For Sutter Health, asking those questions has led to five steps that overcome what Waugh terms the “invisible no” to achieving innovation in health care. Here are Waugh's five steps:

Innovation accelerator: Waugh advised against forming committees to make decisions, saying it's best to appoint an individual. "What we need are people [who] make decisions because we observe what we call the “invisible no” in health care. That is that no one explicitly says, 'You can’t do that,' but because ideas bounce around the system from one department to another, nothing gets done. ... We say, 'This is coming down the pipe and looks interesting, what do you think?' and right away we can make a quick decision."

Increase speed: "We wanted to accelerate our speed. Everything we do in our group is 90 days. If we see an interesting company, the goal is to get that into the field and into what we call 'lives touched' within 90 days. Our goal as an innovation team is to touch 1 million lives by 2020 — we’re at about 20,000 right now. If we don’t achieve that goal, we might as well pack it up because, ultimately, unless we’re touching a life with something compelling, we’re not doing our jobs and we’re not transforming care, which is our mission."

The hatchery: "We need sites that can unpack interesting concepts. We said: 'How do we accelerate? How do we not take more risk as an organization, and what do we need to scale it down?' We can do a lot of things in the system for less than 100 patients in less than three months."

Diversity of thought: "The last person I hired on my team is a former architect from Colombia. He is completely foreign to health care, but paired with our lead clinician, sparks are flying in terms of what they are capable of doing, and we can prototype what can be an entire service line very quickly. We wholly celebrate outsiders coming into the system with new and novel ideas. Our external innovation advisory council includes companies outside of healthcare advising on what they've learned about going to market quickly and not just looking within our own industry."

Human-centered design: "We hear a lot about 'patient-centered,' which irritates me because you’re only a patient for a limited time — the rest of the time you’re a person, and you’re navigating your life. We need to respond to you and reflect that you have a whole journey that has a lot to do with your life and very little to do with us. If you unpack that, you could say you are your own doctor 99 percent of the time. What can we do as a health system to enable you as your own best clinician? This has us fundamentally rethinking how we’re talking about the experience patients go through."

As someone originally from outside health care, Waugh believes leadership should  tap into outside ideas to promote innovation.  

"What if a health system partnered with Airbnb?" Waugh asked. Transplant surgery at Sutter requires 30 days of housing in San Francisco, which can affect a patient’s eligibility, Waugh said. “Try finding housing in San Francisco right now,” he said jokingly. The vacation-rental website company could help find homes in the city that are conducive to good health (i.e., with no stairs and appropriate lighting), and collaborate to find lodging with community members willing to provide that housing.

“With these entities, no bets are off, and many of them are outside health care, and they are some of the greatest breakthroughs in health care,” Waugh said.