The Surprising Power of Liberating Structures: Simple Rules to Unleash A Culture of Innovation (34 page)

• Use
  TRIZ
  -like questions instead of the first three, namely: (1) What can you do to make sure that problem X becomes much worse? (2) Is there anything you are doing that in any way, shape, or form looks like any of the practices you just listed? (3) What is preventing you from stopping these practices?
  
• Use insights and barriers that surface to develop scripts for
  Improv Prototyping
  scenes and organize Improv sessions
  
• Use the same sequence and type of questions to guide one-on-one conversations
  
• With virtual groups, use the chat function to share answers to each question, then select powerful stories/behaviors/actions to be vocalized with the whole group
  

• For reducing harm to patients experiencing safety lapses (e.g., wrong-side surgery, patient falls, medication errors, iatrogenic infections) with cross-functional groups
  
• For use as an ethnographic data-collection tool within a multisite research project
  
• For eliminating practices that keep professionals from helping clients change unproductive behaviors
  
• For
  a series of local dialogues to help community members discover solutions to a chronic problem (e.g., disruptive children in a classroom, a cycle of violence that is not solved only by punishing offenders)
  
• For researching and unleashing action to build professional competencies (e.g., in medical schools and social-service agencies). See “
  Developing Competencies for Physician Education
  ” in
  Part Three: Stories from the Field
  .
  
• For use in a one-on-one conversation to find approaches to a tough challenge
  

Below: presentation materials to introduce DAD

“Reality is only a consensual hunch.” Lily Tomlin

•
  
Invite participants to think big and bold and discover the most attractive of their ideas together by asking, “If you were ten times bolder, what big idea would you recommend? What first step would you take to get started?”

• Open space without chairs or tables
  
• Participants will be standing and milling about
  
• Index cards, one for each participant
  

• Everyone is included and participates at the same time
  
• Everyone has an equal opportunity to contribute
  

• Individually to generate bold idea and first step and write on index card
  
• Everyone standing to pass cards around
  
• Pairs to exchange thoughts
  
• Individually to score the card participants have in their hand
  
• Whole group for sharing highest final scores and ideas
  

• Explain the process. First, every participant writes on an index card his or her bold idea and first step. Then people mill around and cards are passed
  from person to person to quickly review. When the bell rings, people stop passing cards and pair up to exchange thoughts on the cards in their hands. Then participants individually rate the idea/step on their card with a score of 1 to 5 (1 for low and 5 for high) and write it on the back of the card. When the bell rings, cards are passed around a second time until the bell rings and the scoring cycle repeats. This is done for a total of five scoring rounds. At the end of cycle five, participants add the five scores on the back of the last card they are holding. Finally, the ideas with the top ten scores are identified and shared with the whole group. 3 min.
  
• Demonstrate one exchange-and-scoring interaction using a sample index card to clarify what is expected during the milling, namely no reading aloud of the cards, only passing the cards from person to person so that each person has one and only one card in hand. The process can be confusing for some people. 2 min.
  
• Invite each participant to write a big idea and first step on his or her card. 5 min.
  
• Conduct five 3-minute exchange-and-scoring rounds with time for milling (and laughing) in between. 15 min.
  
• Ask participants to add the 5 scores on the back of the card they are holding
  
• Find the best-scoring ideas with the whole group by conducting a countdown. Ask, “Who has a 25?” Invite each participant, if any, holding a card scored 25 to read out the idea and action step. Continue with “Who has a 24?,” “Who has a 23”…. Stop when the top ten ideas have been identified and shared. 5 min.
  
• End by asking, “What caught your attention about 25/10?” 2 min.
  

• Develop a group’s ability to quickly tap their own sources of wisdom
  
• Obtain results that are more likely to endure because they were generated transparently from within and without imported advice
  
• Spark synergy among diverse views while building coherence
  
• Encourage novice innovators to think boldly and come up with practical first steps
  
• Create an environment in which good ideas can bubble up
  

• Some of the scoring may be erratic. If a participant at the end of round five has a card with more or less than five scores, ask the participant to calculate the average of the scores and multiply this average by 5.
  
• Invite the group to choose one big idea and first-action step and revise it so that it is expressed even more clearly and compellingly
  
• Suggest a seriously fun but clear rating scale, for example: 1 = not your cup of tea to 5 = sends me over the moon. The crowd needs to understand and agree with the rating system if it is to be used for decisions.
  
• As you start and demonstrate one exchange-and-scoring interaction, take your time and ask for feedback, particularly if it is a large group.
  
• To make it hard to peek at scoring from earlier rounds, cover the back of the card with a Post-it note
  
• Post all the cards on a wall or on tapestry paper, with the highest-scoring cards on the top
  

Below: workshop participant in Italy posting the top-performing bold ideas

• Move to developing action plans or to
  Open Space
  with your Top 10
  
• Do a second round
  of 25/10 Crowd Sourcing
  that includes others not in the present group (aka Cloud Sourcing!)
  
• Include
  25/10 Crowd Sourcing
  at the beginning and end of a meeting
  
• Array your Top 10 in an
  Agreement-Certainty Matrix
  
• Instead of asking for bold ideas, ask, “If you could unmake one decision that is holding you back, what would it be? What is your first step to unmake it?”
  
• Instead of bold ideas, ask, “What courageous conversation are you not having? What first step could spark your courage?”
  
• Instead of bold ideas, ask, “What do you hope can happen in the future? What practical first step can you take now to tip the balance in this direction?”
  

• For prioritizing ideas and galvanizing the community after an
  Open Space
  Technology or “Unconference” (participant-driven) meeting
  
• For illuminating bold ideas at the start of a conference or task-force meeting
  
• For wrapping up an important meeting
  
• For a closing circle to share ideas and reinforce bonds among group members. See “
  Developing Competencies for Physician Education
  ” in
  Part Three: Stories from the Field
  

•
  
Invite participants to visit several innovators who will share something new or innovative they are doing and that may be of value to them

• A large space where 5 to 8 stations can be set up far enough from each other to minimize interference with one another
  
• A suitable number of chairs to accommodate the small groups at each station
  
• Space for a display as needed by presenters
  

• A few members of the group, the presenters, share their work
  
• Everyone else in the small groups has an equal opportunity to participate and contribute
  

• Presenters set up their individual stations
  
• The whole group is split into the same number of small groups as there are presenters, for instance, 7 small groups if there are 7 presenters
  
• Groups
  stay together while they rotate through all the innovation stations