 Right So this sounded like an excellent idea when we discussed it in the pub the night before Clearly you all get the joke a Pandora box Now that I'm standing up in front of all of you with lots of line as well It's not quite as funny as I thought it might be And it's got this more disadvantage that I've got no handholds in the box So Lydia you're gonna have to click through the slides Off you go Some of the factors that we think lead to successful innovation Processes in the humanitarian sector and particularly at MSF So the first one we've got is collaborating with others and our first example from MSF comes from a project designed to test the thermo stability of insulin which we're going to hear about later in this session and The project team worked closely with two sets of people firstly with field staff field staff in order to measure the thermo stability of insulin In a real life environment and secondly with you need Which is a university in Geneva and the team found that it was really important for each partner to have a clear and documented set of responsibilities and roles And does anybody know what these little children are looking at Well done So when drones first came along a few years ago everybody thought whoa, that's fun What can we what on earth can we use them for and congratulations to the chat somewhere in the audience who thought let's transport Drug-resistant tuberculosis samples in Papua New Guinea because that takes quite some mind-bending to a thought of that It's a really good effort. So we encourage you to be curious and experiment. Otherwise, you'll never get anywhere So thirdly resourcing the project So for example There was a project designed to test the use of cholera vaccines for outbreak control and in 2012 There was an outbreak of cholera in Guinea ahead of the rainy season and MSF implemented a mass vaccination of 150,000 people So the team had already written a concept note before the cholera outbreak and that included information on what they wanted to do And what resources they would need and that allowed them to quickly resource the project as soon as the outbreak occurred And in particular funding was made available for a project manager to be able to devote a significant amount of time to be in the field Absolutely Okay, next one ethics now. We just spent the whole previous session discussing things linked to this. This is another electronic medical record style idea and for them it was protecting data and I think as medics We grow up with that with this me not because I'm not a medic But as non-medics we don't grow up with ethics and so it's quite important to educate our non-medics about ethics And that's why we build this framework for non-medics about ethics And so I think it's a really important lesson learned over the last few years And I'm glad we've locked it down in a publication which we'll show you later on So organizing the process in 2015 MSF designed and built an Ebola treatment center in Sierra Leone and the project benefited from really strong project management Processes that were taken from MSF's construction policy So technical experts met for four days to work on the design and each member was chosen to bring different expertise With very little overlap And as a result of that the team was able to iterate through eight versions of the design in just four or five days And they had regular check-ins with the field team to ensure that the design would work in the site location Good oak. So these are two. I'm now using words which I got nailed to the wall for using a two years ago business and functional analysis and so MSF's not a business We're an NGO etc. Etc. What what can we learn from the private sector regarding this? Well, business analysis and functional analysis are vital vital steps in the process of innovating in any project, etc And this was a good example for those of you who recognize this was presented a couple of years ago It's the refresh project. It's about Diagnosing breakages and boreholes and repairing them as opposed to digging a new borehole and they really thought hard about what their needs were and then the business analysis and then they really Accompanied the kit to the field and looked really hard about, you know, does it really work? Does it fit into the land cruise that can can local stuff actually use it? So they they tick this box and with excellent results and the project scaling up now So managing risk MSF is currently involved in a large stage three clinical trial of a rate of virus vaccine and the teams managed risks in four ways One by getting strong support from senior management Two by having a very detailed project management plan with Episodra and third by selecting a trial location in which Episodra already had a really significant presence And fourthly by ensuring that funding was flexible enough to meet needs as they changed And so this is last year The message and thank you very much Peter for once again repeating this fantastic fail forward fail fast and learn from it I managed to get this is Arion here in come It's the general director of OCA. So one of the five most powerful people within the MSF movement Standing up And that wasn't a snipe at the international office. It's just reality This is and the fact that he can stand up as a general director and admit failure personal failure He took personal responsibility for a project that failed. I think it's really it's a big deal. And so I Also admitted failure on this. This is the PDA Ebola PDA And I didn't know it would failed until quite a long time afterwards. And so it's quite yeah I think it's important to fail forward fast I think I'm thank you very much for adding Peter the notion of failing fast. It's really key and our final factor is engaging end users so in the last session you heard about two e-care mobile applications and One of the factors that's been really important in the success of those two projects has been regularly engaging with health workers in the design and piloting of those two applications All right, great. And so we can go forward and we've got to bonus. I mean, you know This is just our opinion. We're keen to hear your opinion And so I'm not sure Kim whether it's possible to pull up the the voting thing of a dig now So you might notice next to you in your chairs if you look behind your Sorry on the right hand side, you've got under your right elbow You've got a little keypad a black keypad with that one to nine And we're interested to hear what your experience was of the nine things that we've just listed Which ones were the most important when innovated now? Don't vote yet. I think Are we ready to vote? Yeah, we're ready to vote vote just one Do we have the result Kim give me a thumbs up I could see behind the window Just the number or just the number and enter. I don't know Just the number That's interesting. That's not what I expected at all That's very and then bugger the risk. Let's just pile straight in there and just don't get on with it Nobody cares about the risk Of the ethics by the ethics That's very interesting and in get I'm really happy to engage with end users I'm really strong to have it big shout out to that one as well. I think it's That's that's key. I think if you don't talk to the end users as well. So that that's very interesting However, this is just nine so we wonder whether you might have others but before we go there And if you can hold up one of those pieces. I really am rather restricted I Some of you under your chairs will have a piece like this So everybody look under your chair or look under the nearby chair and if you have a piece hold it up Okay, we got one over there yet. Yeah, so those of you who have a piece of the puzzle Stand up and bring it to the front Come down to the front. I'll have to have the lights on for this To the front here here Here we will Okay, and so can you build your puzzle come around to the front? This is gonna make it a Three-by-three, please a three-by-three. You've got two minutes go This is gonna make obviously an evidently tweetable photo And while they're doing that I want the rest of you to think of other clever things to say that we may or may not have had earlier on I have a pen and more bits of the puzzle so think while they're doing this Missing one so there's one underneath the chair somewhere look around. There's not people in every chair One more bit of the puzzle Somebody's stolen a bit of a Did I see the back man? Oh, yes. Here we go Peter. It's very appropriate Peter that you should find the last one and Let's let's see which one is it Which one is it Peter? I can't see the rest of them. So you put me in a difficult position analysis Well, give them a round of applause. Thanks very much Go ahead and take your photo if we could for the online audience We might have to lift it slightly higher and so they can see what's going on one two three photo two four five tweet Okay, now it's your go What hands raised please if you like to add things to this complex puzzle Yeah, I think we're down there So I have a hand raised at the back there gentlemen in the back shirt I've got another one here in the middle lady in the gray top off to the right a gentleman in the gray shirt So we'll take those three first Starting at the back can't hear you say it again Scaling up scaling up adoption Implementation. Well, that's three Scaling up Okay, thanks very much. Okay, and then we come forward to the lady sitting in the middle there. Does somebody give me your microphone pragmatism practicality Pragmatism, yeah, so there was an interesting presentation I don't know if you saw her outside the pathways chaps. They were talking about Stick to the reality and not the plan Yeah, I think that's their catchphrase and so I think you're absolutely right pragmatism is very very useful when approaching these things And I have to write these in a hurry and can you take over the talking and I'll do the writing Having a strong sponsor sponsor The resources is one thing the money having someone strong enough to defend it in front of people who might not let you go ahead It's very important Okay, and sponsorship, okay So a champion somebody who's kind of a political level and provide you the resources you need to do it Okay, lots of hands over here. So we've got let's take the lady Okay, just there Is there something about not giving up That's very linked to the kind of fail forward if you fail once try try and try again so perseverance excellent Come on down the bottom here wait for a mic before you shout So That's supposed to be come out of the business analysis But I think it's worth reinforcing the notion of clear objective now I saw that several presentations earlier this afternoon and listed that as a key point going forward having a clear objective. Thanks very much What about the cost? cost I know I know this the C word shouldn't be mentioned in MSF, but still We're in this we're spoiled with MSF. Let's admit it money's less of an issue human resources to fill the gaps in the field That's where the real challenge with MSF arrives But I think can I change it slightly and then change it to opportunity cost because if we spend nine million in one thing Then that nine million could be spelled somewhere else and so I'd like to nuance that slightly I think everything's gonna cost time everything's gonna cost money. That's normal But we very rarely look at the opportunity cost We very rarely look at what where we could have spent that money perhaps more efficiently or more effectively to have a higher impact So there we go, but I think you're absolutely right To I've got objective here imagination Does that go together with be curious and experiment? To have to think they're really related I guess but Imagination is a step beyond is a step beyond to dream and I liked The presentation I think it was them from the Amman hospital when you said nothing is impossible It's just a question of time and money so that you imagine the world and your new dream. Absolutely Patient sense patient or beneficiary or population centered we have the end user center But I think that was more aimed at the at the health Personnel absolutely Absolutely right so when we thought about end users essentially we were thinking about the people who are going to use these tools And they are the MSF personnel and you want to focus on on the beneficiaries at the end and so the impact for the beneficiaries That's it we've run out of things to think but the fact that there are still hands up Shows that there's no one answer for all of this. It's just a this is this I mean, there's no one way of doing this. There's no prescription for this and And But now considering the microphone is near you Estrella Well, if you can come back again, I'd like you to ask again the question that you asked earlier and I'd like somebody in the audience to Give their opinion on how we might be able to solve it. Please. Could you ask again the question you asked earlier? Do I ask it to you? Do I okay? So that the question was how much how many of these projects Actually know about each other before they're presented at scientific day and how much of that conversation is ongoing During the product or the project development so that there's if there's any synergies or if there's any Anything that can be discussed. It is actually discussed while the product part product is being developed Okay, and so and the honest answer to that would have been that many of the people here today Hadn't heard of the initiatives the very similar very parallel initiatives going on So I'd like to challenge The audience and if that you could have followed from that Sarah go ahead Yeah, I just wanted to note that we held a meeting on research issues in MSF today So looking at how well research in MSF does collaborating separately to innovation and Nathan Ford had done a quick analysis and found that we are much more likely to collaborate with external Organizations than with between operating centers in MSF So here comes the dilemma a Christopher Stokes our outgoing general director. He summed up neatly We are asked to collaborate, but we're set up to compete with five operational centers And is this good is this healthy? Should we change the business model of MSF and go ICRC or UNHCR? We're one ring to rule them all and in the darkness bind them or should we allow things to continue and a slightly chaotic Se fritter as they say in French this healthy tension between the different operational centers So what do we think I open it to the floor? It's possibly the most Permanent question asked so thank you for that It's a fun I'm asking really quite serious questions here Maya Hi, I think we should still continue to suffer it as you said because I think the diversity and The perhaps the the competition is good. I I strongly believe in that However, I think we should be aware of what's going on To be able to at some point and I think especially in the innovation projects. We're trying to move towards that. There's a small kind of club, we're not a working group and We try and talk to each other and to try and make each other aware of what's going on in in the different operational centers to know the project so although it's very much in its early days I don't know Australia asked the question of how many projects were aware I think within a small group of people some of the people were aware of the other projects But it's clear that it has to be widened out and I think we're perhaps moving towards that way But I strongly believe in having a bit of the competition the diversity. Okay, that's very clear Maya Thanks very much any other opinions conflicting opinions or further thoughts to that right in the back there Clotilde Yes, I agree with Maya and that there needs to be room for maybe competition in early phases But then also we sometimes get frustrated not being able to more collaborate. I think that when we talk about risk-taking Set up so that we can innovate. I mean taking the risk of sharing our work is something I think would bring a lot of Positive impacting to the projects and that's something that now we would like to to set up some intersection collaboration around the project that we are we are currently Leading in OCG because there are a lot of resources outside that could help us to get easier or faster at scale and I think that I would love to put you to get I Mean the input from the e-heals unit that was settled in in in Brussels And I know that there's a lot of work done there and I think we would be much more powerful if we managed to share When you're in your little project room you can tell each other everything's going alright But when you stand up in front of an audience like this and you really expose yourself and then you really challenge yourself I really enjoyed watching Megan McGuire and her team are from the e-health unit in Paris Doing regular Demonstrations of what they're doing is to go down the line so they expose themselves not just once but as often as possible Megan if you're in the audience somewhere you can comment on that Are you there? I'm how did it feel Megan to stand up and expose yourself not in the literal sense of the term but To to to share on a regular basis what you're doing and take the hits because you've taken hits I know I've held your hand at times when it's been tough. Yeah I mean, I don't think it's just our team that state is doing us. I think there's a collective group who are attached to e-health and health information systems that Where we meet on a quarterly basis and we share intersectionally a lot and it's happened organically and I think it's There's quite a few people in this room that have participated in that process over the last several years where we have been able to collectively both make some successes and and share and and work across sections and we've also been able to Identify where we've messed up And so I I think there's I mean there's there's a good 10 15 people in this room who have at different times collaborated on this platform and We've all together have taken different chances and risks Of figuring out how far we can push each other and also how far we can support each other And so I I don't necessarily think we need to set up formal Arrangements, but it is nice when you have a collective group of people who can come together and and and share and and Want to share and and engage and I would say, you know The NTB project there was a little bit of push because it was funded by unit aid But we were we've been able to work across four sections and and also through two other organizations In a very short period of time and so we can do this and and we are doing some collaborations With our health information systems as well. So I I don't think it's it's happening It's just not happening in a formal or public way good. Okay Pete to take things further just down here at the front There's a microphone kicking around I Think maybe it does need to be formalized slightly I think a lot of the collaborations that happen happen because people have personal relationships Hmm, and if you don't have that network to start with you don't know where to go so we ran a workshop on On Thursday about commercial innovation partnerships And there were people there that didn't know that other people in MSF met and talked about innovation issues Even though they're working on innovative projects So I think it does need to be formalized and there needs to be those access points into a wider network People and not just projects absolutely I think that was one of the founding reasons to creating this day and here I look at Sarah and Keira and we wanted to get people together and it's not for nothing that there's it's over two days And so there's a possibility of beers and dinner between the two days because that's where these formal connections is made Hence the lunchtime as well. I don't know whether you'd like to further comment on that or any other thoughts Yeah, when this day was first suggested and It made sense to put it after the scientific day and to not try to silo innovation because there was a lot of Crossover and we all learned in the editorial committee a lot from the research There's a lot of innovation the innovation learned a lot from research and it's a continuum So it doesn't make sense to create further silos, but to build on those networks good Okay, and so leading on to our I mean just to show you that What we did we need to just make it up if you can bring the other slides Back up so there's three publications which you feel free to read which summarizes a lot of what's being said today And I have to say that it's really reassuring that I've watched this day for three years now and this year. I was really impressed by Almost all of the projects I could see really following this kind of advice that you see here And it kind of almost feels like job done and move on and so Here's an here's an option for moving on next year Another live vote question. I look up to Kim to see whether this is going to be possible If not, I'll just do it with raised hands It's going to be possible and so I'm guessing Kim keep your fingers up or down It's going to be yet number one for yes and number two for no and really the statement is if we run a failure fair The idea of celebrating failure as a mark of innovation a risk-taking and learning at the side is 2018 Would you come and this audience this this question has been asked to the online audience as well So I'll share the result after us and so voting is open press one for yes and two for no off you go Okay, that's pretty clear And that's very similar online online. It was even stronger. It was 95% Said they would come to a failure fair of five percent. They wouldn't I'm wondering the next question is is Would you personally stand up here in front of And I don't have the voting thing So you are just raise your hands if you'd feel comfortable because it's about we talked about creating a comfort zone A kind of a space where we can actually share without being cut down to the pieces Can you raise your hands if you would feel comfortable standing where I am admitting failure? That's reassuring So we'll get people next year. So I well, we'll see nothing decided but that might be a fun Direction to take as I agree with Peter Innovation has been a bit done to death the word innovation. And so let's move on and Learning organization. Let's explore some other words Great. Okay. Thank you. Thank you. Time to move on