Operationalizing Innovation: A Q&A with Jim Macrae

The notion of innovating in government is a cool thing to say and think about these days (I mean we are talking about it so…) But what does that actually mean for leadership and managers seeking to operationalize and spread this vision? photo of Acting Administrator for HRSA Jim MacraeWe were lucky enough to sit down with Jim Macrae, Acting Administrator for the Health Resources and Services Administration (HRSA), to hear directly from a leader who is trying to grow innovation to solve real problems. HRSA is an agency under the umbrella of the U.S. Department of Health and Human Services that serves economically and medically vulnerable populations and those that are geographically-isolated like rural communities. They award over $10 billion annually to community-based organizations, state and local governments as well as academic institutions to increase and improve access to health care across the country.

Given your time and experiences at HRSA, is there a particular story that sticks with you that speaks to the impact of your work?

A few years ago I gave a speech in California and provided an update on the community health center program. I shared that the program had increased by over 5 million patients in the last several years. After I gave my speech, a woman came up to me from audience and said, “I just want you to know that I was one of those 5 million people you talked about, and you saved my life because I was able to get access to care.” She told me that she found out that she had an issue with her heart and was able to have it corrected because of her local health center. Because of this experience, she also shared that her new life’s purpose was to work in her local health center. Stories like these are great reminders of the importance of our work at HRSA and the direct impact that it can make.

Why is innovation important at HRSA and how do you expect your leaders to promote it?

I think it’s important for two reasons. One is, to paraphrase Albert Einstein, if you keep on doing the same thing over and over again, and you get the same result, you shouldn’t be surprised. So if we want different results, if we want better results, then we ought to try something different and new. The second reason is that innovation engages employees, and a lot of the answers to organizational challenges exist within the staff of the organization. The job of leaders is to figure out how to surface, encourage and foster the staff’s talent to solve the problems that need to be solved. Most of the time, the answers are within the room itself. It’s just about how you create the environment to share or think in different ways.

What do you think the key components are to building a culture of innovation?

First, having some champions is very important. Supporting individuals in your leadership team who are willing to take risks or promote innovation within their organizations is also critical. And leadership support is not just saying that you’re supportive of innovation. But it’s actually demonstrating that through your actions. Primarily it’s creating the time and the space to be able to do it. That’s minimal resources, but it’s giving people the time and space to look at a problem differently, think about what potential solutions are, do a bit of research and then test and try out the new ideas to see if they work. Initial successes are also very helpful as success builds on itself. And then, how do you “institutionalize” innovation? How do you make it part of the culture and the way we do business, as opposed to something new or outside of what we normally do? So how do you incorporate, integrate innovation into how we look at and how we do our jobs everyday?

What do you think the barriers are to innovating more at HRSA?

Adequate time and space always seem to be the primary barriers but it is also changing attitudes – the we “can’t” do it differently, that’s the way we always have done it attitude. Rules and regulations can also sometimes prevent us from doing it. But it’s important to look at whether those rules and regulations really do prevent you from doing something different or if they have just become the reason why we don’t do something. Sometimes there is mythology created and when you go back and look at the rules and regulations, you realize that you actually have more flexibility than you may have thought. So it’s important to ask the question – do we always have to do it this way, or can we potentially do it differently? The other thing with innovation is that we have a fear of making mistakes that sometimes gets in the way of people wanting to try something new or different. One of the things that I’ve tried to do here is promote the idea of learning from mistakes. It’s not that we want to continue to make the same mistakes but how do we learn from those mistakes to prevent them in the future or to actually learn and grow from those mistakes to improve what it is that we’re doing.

What practical tips would you offer to managers seeking to try new things, to solve problems and encourage their teams to do so?

Use Innovation to Address Pain Points One of the best things I think we can do as an organization is to identify our key pain points, and then get a group of people with fresh eyes and perspectives together to see what they can do to fix it. Use innovation as a management tool to address organizational pain points, creating the time and space for significant breakthroughs that can improve the entire organization and its morale. Resist the Urge to Say – Been There Done That When you have been around for a long time, you have a lot of the scar tissue from having tried different things and you can get to a place where you say we’ve tried that before and it didn’t work. That can be a barrier to moving your organization forward. I think it’s important to recognize that within yourself. Even though you’ve experienced it, it doesn’t mean that you don’t share that struggle, but don’t use it as a barrier. You can challenge people and say – I’ve struggled with this, and I haven’t been able to come up with an answer but it would be great if you or your group can come up with an answer to this question. Bottom line: Don’t let your experience stop you from promoting innovation. It’s hard because you’ve been there and done that, but people who haven’t been there as long may have a lot of better ideas than you do. Try New Things as a Pilot A pilot allows you to test something out on a smaller scale and see if it works. If it doesn’t work, you stop. If it does work, you try and figure out how to make it broader. Start in a small place, start in a particular part of your organization or in a branch, in a particular area and then test a proposed solution to see if works. Instead of having to redesign everything, focus on a small area and small part of the problem and see if you can fix that and then work your way from there. And if it works, the trick is – how do you broaden it and get more people to adopt it?   Sometimes we get so overwhelmed with the idea that we have to change the whole entire thing, that it stops us. Make it Part of the Culture You have to make it part of your culture. One of things we have decided to do was make the creativity and innovation measure from the Federal Employee Viewpoint Survey one of the measures that we would track over time. We’ve also incorporated innovation into our strategic plan as one of our subgoals – promoting innovation and creativity. So to the extent that you can, build it into everything from your strategic plan to your performance plans and make it part of what you do.


Special thanks to Jim Macrae for taking the time to share his insights with us and to Sabrina Matoff-Stepp – another champion of innovation at HRSA – for her assistance.