Why Innovation Thrives at the Mayo Clinic

by Uri Neren

Start listening for guidance on innovation and you tend to hear a lot about Apple, Google, and other high-tech pioneers in Silicon Valley, Boston, or Seattle. You rarely hear about hospitals, especially those that operate closer to farm fields than oceans.

Yet in the extensive research my team has done to uncover the mystery of successful innovation, we've found few track records to rival that of The Mayo Clinic, in decidedly non-urban Rochester, Minnesota. The World Database of Innovation we are compiling, as a collaborative effort between my firm, Generate Companies, and several universities, represents over 20,000 hours of work to date. As well as over 200 in-depth case studies, it compiles the ideas of 4,500 or so innovation experts and consultancies.
Innovation is a multi-dimensional challenge; we have identified more than 105 areas in which it would be valuable to arrive at a definition of best practice. But one of the most fruitful areas has been "Conditions Needed for Innovation to Occur." As is the practice in each area of the database, we first pored over accounts of innovative environments (corporate, nonprofit, and public sector), many of them provided by our partners at some of the top innovation consultancies. Scanning for every mention of a workplace condition, we found 128 conditions we could put a distinct name to — and when we boiled the list down to common conditions, there were no less than 17. Our conclusion is not that all 17 are "must-haves", but that all should be considered by any large organization hoping to create a setting where innovation will flourish.

In the case of The Mayo Clinic, the right conditions were in place at the very beginning. While the word "innovation" has not always been attached to its work, the habit of developing better ways of treating patients and running its operations has been a signature trait since its founding in 1889 by brothers William and Charles Mayo. Three conditions in particular formed the climate that endures today:

Limited Resources. The hospital was born of tragedy, a result of a devastating tornado in 1883 that left much of Rochester in ruins. The town was only an outpost when Mayo began and today, as a world-renowned provider, it is still situated in the midst of cornfields in this town of 30,000. Interestingly, scarcity of resources shows up in our database as the single strongest driver of innovation in organizations in general.


Connectedness. The brothers established a place where teamwork was paramount yet where "cooperative individualism" would thrive. Early on they created an atmosphere open to new ideas and engaged in world travel to observe other physicians and spread the Mayo name. Mayo created the Surgeons Club in 1906 to allow doctors to watch surgical procedures in Rochester, anticipating by a hundred years the "open innovation" approach that has captured imaginations in the past decade. Today, Mayo's graduate school maintains the open door tradition.

Internally, Mayo has achieved a high level of connectedness among employees with systems and processes that enable — and oblige — everyone across the organization to find and connect with the expertise they need at any moment. Such systems are often associated with excellence in service and outcomes. Our research underscores that they also enhance innovation, by focusing attention, from multiple perspectives, on new problems and ideas.

Diversity. The brothers established and promoted the country's first real "group practice" concept where physicians in different disciplines would collaborate on the care of patients. The combined wisdom of practitioners, they believed, would result in better, more integrated care and better results. Their approach is sometimes called cross-functional teaming, and is now common in health care and corporate innovation practices. 

Just as important as these initial conditions was the Mayo brother's resolve to constantly re-invent their enterprise. They were dedicated to being the best in their field and, more importantly, to moving the entire field of medicine forward. Perhaps the best example was their decision to place doctors on salary, which would allow them to focus on health outcomes rather than volumes of health-related transactions, and give them the space for creativity, education, and research. This was a decision so controversial it nearly shattered the Mayo family, but one that helped to create one of the world's greatest medical centers.

More than a century old now, the Mayo Clinic enjoys brand recognition at nearly the level of The Coca-Cola Company. Its culture is known for collaboration, knowledge sharing, communication, and teamwork, and it takes pride in a legacy of important innovation. Many, many people have shared responsibility for building its practices and processes, but all had the advantage of the fertile conditions the Mayo brothers worked with at the start.