Ashley Gambhir is the executive director for healthcare transformation at University of California San Diego Health. Her role involves gathering insights and ideas from more than 14,000 employees, and helping to turn those into concrete innovations within the nonprofit healthcare organization. In 2024, UC San Diego Health was ranked as the top hospital system in San Diego by U.S. News & World Report.
InnoLead spoke with Gambhir about her work harnessing insights from employees, creating a culture of continual innovation, and leveraging innovation management software to drive meaningful organizational change.
This interview is part of our new research initiative, Making Innovation an Enduring Capability.
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My role involves leading a portfolio of significant organizational changes. This includes leading process improvement, innovation management, project management, and operational teams supporting digital enablement, such as telehealth, and improving operational effectiveness. Our focus is on supporting a culture of problem solving through enhanced systems and structures.
It’s been about seven years since we started with more traditional process improvement — incremental changes, standardization, and engaging team members in improving our processes. To embed daily innovation as part of our culture, we created a mission statement: We want to have 14,000 problem solvers that relentlessly improve care while loving their jobs. We started a management system to encourage daily input by asking, “What ideas do you have?”
Harnessing Insights with an Innovation Management Platform
Before joining Health, I worked on the campus side of University of California San Diego (UCSD), where we implemented HYPE’s platform as part of our strategic planning process. After introducing it to Health, we did one pre-COVID campaign where we asked employees why they chose us as their healthcare provider, generating nearly 500 insights. Due to the pandemic, we didn’t start using it again until about two years ago. Since then, we’ve conducted six campaigns.
We recently ran an innovation campaign to improve patient experience, with a focus on noise levels during inpatient stays. In healthcare, we leverage evidence-based best practices, particularly around improving quality and experience, but they don’t necessarily factor in local nuances. We wanted to tap into the collective genius of teams working directly with patients and get their ideas. To collect input from patients, we used HYPE’s platform and a survey.
We wanted to tap into the collective genius of teams working directly with patients and get their ideas.
Given healthcare’s unique environment — where many staff don’t use computers regularly — we also provided paper forms and posters for submitting ideas. We’re now evaluating which ideas to implement.
Advancing Health Equity
Another recent campaign was focused on advancing health equity. It’s really a collective activity. While centralized initiatives are helpful, distributing decision-making throughout the organization can add up to significant impact. We conducted an exciting campaign to get ideas on how to improve health equity, found key themes, and obtained strategic action plans to address major areas that employees across the organization feel would make a difference for our patients.
Evaluation and Implementation
Our evaluation process leverages HYPE’s crowdsourcing feature, incorporating thumbs-up votes and comments, to identify ideas that get the most momentum. We have internal subject matter experts and process owners serve as judges to support implementation. We set criteria before we ask for input, so people know how they’ll be evaluated, and aim for transparency in the evaluation process.
We tend to score on expected impact, complexity, and effort. We try to group what we commit to implementing into two categories: the low-hanging fruit we can do pretty quickly and long-term strategic projects that require more time and resources. We did an innovation campaign focusing on leverage AI to improve healthcare, knowing it would likely require finding a third-party vendor or in-house development. We’re not going to see solutions implemented overnight or even in a month; the level of effort is higher than, say, the noise-reduction campaign.
We work with campaign sponsors to ensure follow-through on input, with agreements from process owners to clarify available resources and commitments. Progress is reported in public venues, including a monthly meeting where sponsors are accountable to the executive team and the organization. Our standard is to track 30, 60, 90, 180, and 360 days. For shorter-term projects, we might turn our attention to something else. If it’s longer range, like with AI, we aren’t going to report quite as frequently, but we’ll report for longer than one year.
Reducing Variation in Care
We extensively research clinical pathways that improve care quality, so we can reduce variation in the care our patients get. Sometimes we’ll ask staff to submit best practices from previous employers. For example, one of our current initiatives is starting up a mission control center. Many institutions have them for financial efficiency or patient flow. We’re initiating ours with patient flow, because we can leverage and adapt those best practices quickly, but we’re trying to build two functions I think are quite innovative: supporting hospitalization avoidance and predicting and preventing quality and safety incidents. Some of our team members have done these on smaller scales in previous organizations.
We’re also looking at the potential for AI to help predict and avoid safety events before they occur.
Ashley Gambhir is the executive director for healthcare transformation at University of California San Diego Health.
