Fresh Eyes - Seek Out and Use the Wisdom of Others

What is it and how can it help me?

We instinctively view situations from our own personal perspective. However, looking at things in different ways can help us make new connections and lateral leaps. We often describe ‘not being able to see the wood for the trees' when we are stuck in our thinking. A ‘fresh pair of eyes' brings a new perspective to a situation when we may believe that we have exhausted all the options. The fresh eyes tool is based on these principles, and seeks to generate new ideas by anticipating how others might view a situation.

When does it work best?

It's easy to follow the same routines and do things the way that they've always been done. But how often do you stop and consider whether there is an alternative - something that might work a little better? If you feel that something just isn't working, you could try the fresh eyes approach. A different perspective or a fresh attitude can generate a range of ideas for solving a long term problem that has been baffling you and your team.

How to use it

A summary of the steps

Firstly, define the problem or issue.
Then, randomly select alternative viewpoints (see below for examples), and predict how people might respond to the following questions:
What would be important to them here?
What aspect of the topic would they focus on?
What ideas and approaches might they have?

Reflect on the possible responses and ask yourself / challenge yourself - might this work in healthcare?

Ask ‘why?' repeatedly

Why do we have to come to this place?
Why do we have to wait?
Why do we have to have this done?
Why do we need to see lots of different people?
Why do we have to see this person again?

Below is a random list of perspectives you could explore: give it a go and see the problem from a completely different perspective...

Manager of a fast food restaurant
Six year old child
Librarian
Sales and marketing representative
Leisure centre manager
Parents of small children
Airline flight attendant
Stand-up comedian
Politician
Accountant
Retired person

Facilitator tips

The whole process need only take an hour of your time: 30-40 minutes to gather all the ideas, 20 minutes to decide what to do next. You should aim to use at least four to five different perspectives and record the combined results so that you can review the ideas later. It will also help if you are able to give lots of examples from healthcare so people can see how the tool is connected and applied.

Lean techniques have come from the production industry
Luton & Dunstable Hospital have installed an idea capture scheme that British Telecom first used
Hotels provide a good set of fresh eyes for bed management
‘McDonalds drive through' provided inspiration for a ‘flu jab drive through' and ‘pharmacy drive through' in the US. The ‘pharmacy drive through' is now coming to the UK

The list of perspectives can be added to, changed or modified. You could set the group a warm up task of identifying a list of different job roles and then use these in the session. Try not to censor the choice of perspectives, some will work better than others but all are valid. Even if you can't see an immediate connection, others probably will.

When you have identified some of the challenges, you can also use the ‘Simple Rules' tool to help make the change.

Examples

Example 1
Issue: John is once again waiting for 3- 4 hours in the orthopaedic follow-up clinic. He thinks he should have an x-ray but no one has given him a form. Last time he waited to see the doctor, who then wrote the form for the x-ray, after which he had to queue again to see the doctor. John can now book his outpatient appointment, but no matter what is done, waiting times always seem to be the same.

Look at this issue through the fresh eyes of a child, who might ask:

Why do we have to come to this place?
Why do we have to wait?
Why do we have to have the test?
Why do we have to see the doctor again?

By looking at this issue through fresh eyes, we might ask ‘How would a supermarket manager reduce waiting at checkouts during peak times?'. Subsequently, we might think of the following approaches:

Encourage internet shopping with home delivery
Have flexible opening times
Open smaller stores in office districts so that people can drop in on their way home from work

This encourages us to make lateral connections we might not otherwise have made. In the healthcare context we could consider:

Does all follow-up have to be face-to-face or could we telephone patients?
Can we run follow-up clinics at different times to reduce demand?
Can we form partnerships or agree protocols with our local GP practices to assess the viability of patients being followed up elsewhere?
Can we plan the process so that it runs more smoothly?

Example 2
A great example of creative thinking: Prof Elliot connected car racing to heart surgery and used the learning of a pit stop to improve their transfer processes at the end of heart surgery.

Example Phrases
‘Problems cannot be solved by thinking within the framework that created them.'
Albert Einstein

‘An idea is a feat of association.'
Robert Frost (American Poet)

‘New ideas come from differences.'
Nicholas Negroponte

What next?

Review all the ideas - try using ‘Six Thinking Hats' as a refining tool
Decide what can be realistically tested
Run several small scale tests with volunteers (PDSA)
Share the findings
Implement the best ideas

Other useful tools and techniques on this website:

Brainstorming tool.
Simple rules tool.
Introduction to creativity.
Productive wards
PDSA
Six thinking hats

Additional resources

Books:
Plsek, P (1997) ‘Creativity, Innovation and Quality' ASQ Quality Press.

Allen, D. Kingdon, M. Murrin, K. Rudkin, D (1999) ‘What If: How to Start a Creative Revolution' Capstone Press.

Websites:

Also on our website, you can access a toolkit on creativity and innovation, which has been designed specifically for the NHS

Background

This approach features regularly within literature on creativity under a number of different names such as ‘other people's views', ‘freshness' and ‘river jumping'.