Revolutionising Support for Severely Injured

This information was sourced from "Revolutionising support for severely injured" by Observatory of Public Sector Innovation (OECD), https://oecd-opsi.org/innovations/revolutionising-support-for-severely-injured/. Licensed under Creative Commons Attribution-ShareAlike 3.0 IGO (CC BY-SA 3.0 IGO).

Innovation Overview

The National Injury Insurance Scheme, Queensland, provides comprehensive care and support for those with serious injuries from Queensland traffic accidents, regardless of fault. We cover a spectrum of serious injuries, aiming to deliver effective support promptly. Each year, we welcome about 100 new individuals needing sustained care and support. By focusing on participant-centred care and engaging in co-design processes with participants & stakeholders, we ensure our services are adaptable and responsive. This commitment to evolution and improvement led to our collaboration with QUT and the initiation of the MyNIISQ initiative.

Opportunity MyNIISQ is a user-centric digital dashboard initiative that enhances the autonomy and empowerment of injured participants. It aims to improve user experience with round-the-clock access to information, streamline the agency's administrative processes, and bolster the participant-support planner relationship for increased trust within the scheme.

Approach The innovation journey began with the Agency team gaining an in-depth understanding of participant needs, developing personas for both participants and key stakeholders, and embracing the Desirability, Feasibility & Viability (DVF) framework. A global environment scan was conducted, examining trends in self-service and digital automation across healthcare, insurance, lifetime schemes, government, and research institutions, culminating in the integration of a co-design methodology.
Collaboration with QUT's Chair in Digital Economy followed, leading to an Innovation Research Sprint. This sprint comprised four phases: incubation and research, design and ideation, validation and refinement, and implementation and integration, all underpinned by extensive stakeholder consultations.

This collaborative effort resulted in solutions rooted in proactive and benevolent organizational concepts, aligning with the OECD’s Anticipatory Governance. The six-week sprint's output was the MyNIISQ Solution Report, detailing a user-centric dashboard concept accompanied by an in-depth implementation plan, segmented into immediate actions, mid-term incremental projects, and long-term comprehensive transformations. This strategic plan includes regular participant and stakeholder consultation sessions to garner feedback and genuinely capture the participant voice.
Early iterations, such as paper-based prototypes, were developed and presented to a participant reference group for detailed feedback. This process ensured that the most valuable features were prioritized. The pilot sought to assess the desirability, feasibility, and viability of a digital portal that enhances participant interaction with the Agency and offers various communication modes based on participant preference.
Our future vision is to explore how the portal will support other key stakeholders, including case managers, allied health and attendant care service providers, service providers and legal representatives.

What Makes Your Project Innovative?

NIISQ is among the first Government Agencies to adopt QUT’s 6-week innovation research sprint (https://theconversation.com/we-solve-problems-in-30-days-through-research-sprints-other-academics-can-do-this-too-204373). This is a highly interactive, co-designed process that rapidly investigates opportunities and provides actionable recommendations.
The participant engagement model is an innovation in our Scheme because we are using lean and agile techniques to rapidly test with participants and to build trust through co-design.
By engaging with Participants from the very inception, MyNIISQ is showing tangible value for our participants. It is also proving to be rewarding for our staff. The project demonstrates the practical applicability of the Anticipatory Governance framework (https://www.oecd.org/strategic-foresight/ourwork/Foresight_and_Anticipatory_Governance.pdf), as we embarked on designing our organisation’s future, and not simply responding to the current needs.

What is the current status of your innovation?

As of 30th of January 2024 we have built our first pilot, with further pilots planned for the future. We have tested our Participant Portal with a core group of participants and completed our initial evaluation report, with plans to scale. We are now about to go live with our SMART cards pilot to test how they might enable a more meaningful goal-planning conversation for MyPlan. We have started work on each recommendation in the MyNIISQ recommended 12-month implementation plan, and the direction and commitment it has given the Agency cannot be understated.
Our pilot has been considered a success in both terms of the positive feedback and also the strength of the feedback. The uplift in trust in the Agency and requiring a bolder uplift in subsequent innovation sprints had led to increased momentum and experimentation, and the innovation culture is snowballing. Innovation capability in the Agency is growing as a result, with the participant front and centre of each project we touch.

Collaborations & Partnerships

The project was a partnership between NIISQ and QUT. The QUT team comprised of facilitators, designers and researchers who were joined by NIISQ subject matter experts. Several stakeholder workshops involved NIISQ participants, staff, service providers and legal representatives.
We continue collaborating closely with participants through our Participant Reference Group (PRG) and planned pilots. This ensures we get regular feedback on each idea, improving the user experience and creating trust.

Users, Stakeholders & Beneficiaries

PRG members have expressed positive feedback having seen their suggestions incorporated into new iterations, and our pilot participants are enjoying more streamlined processes in their interactions with the Agency. Staff will continue to see improved workflows, reduced admin burden and improved participant interactions. Our service providers and legal partners will be able to have the information they require in a more timely manner, reducing the need for participants to relive their trauma.

Results, Outcomes & Impacts

The impact of our pilot evaluation has been significant. The pilot was evaluated against Desirability, Feasibility and Viability criteria decided by the pilot team before its launch. The pilot achieved well beyond the majority of criteria, with participants enjoying significantly easier processes and shorter timeframes. This was especially impactful for our reimbursement process: vulnerable participants were not left out of pocket for longer than necessary.
The only target not reached was the number of logins to the portal. The pilot was with a small number of participants and fell over the Christmas and New Year period. It is expected that as the pilot is rolled out to a larger group, we will see greater login behaviour from our users.

Challenges and Failures

The main challenge for NIISQ, being a relatively young and still evolving Scheme, has been “where to start?” The MyNIISQ project allowed the Agency to really focus on what is important to the Agency and to ask our stakeholders what it is they value and need from us.
The next challenge was setting up an agile, cross-functional team made up of innovation leads, subject matter experts, delivery team members and developers to work together towards the common purpose of developing our first-ever participant portal pilot.
To date, there have not been any failures. However, we are very conscious that solutions must not treated as ‘silver bullets’ or ‘one size fits all’. We may not always get the balance right in this regard.

Conditions for Success

Support from our senior leadership team has been integral to this project. Resources had to be taken offline to focus purely on the sprint, and leaders had to trust the process and help ‘hold the line’ as we worked through what a new future for NIISQ participants could look like. Really key is a shared vision to put the participant at the centre of all we do and partner with organisations that share and support our values.
Participants can see their recommendations and feedback morph into features and functionality, making them feel valued. Strong collaboration with local thought leaders who challenged the status quo and brought global research to the sprint really allowed us to explore a diversity of perspectives to ensure success.

Replication

This approach and solution could be replicated by other organisations and countries. Many of the concepts and approaches were sourced from international organisations, the novel aspect is applying it to a government organisation. Subsequent projects are already scheduled to follow a similar approach, while larger innovation themes are about to launch following a similar approach. A sister organisation is already in the early stages of adopting this approach based on the success of this innovation initiative.
The innovation culture has permeated into the organisation and has resulted in a broad uplift in innovation ways of working such as encouraging collaboration and codesign, Lean experimentation, and iterative and agile delivery.

Lessons Learned

Building a participant-focussed innovation culture takes considerable dedication, openness for experimentation & learning, listening to the voice of the customer and leadership. Innovation often requires allowing the space and time to test, learn and fail.
But the real lesson is how co-designing with the people that matter most can help get the most out of innovation initiatives. Involving end users as often as possible creates a better chance for success. Having an amazing delivery team can also see you through from initial concept to real product ready to scale in a short timeframe. Great partnerships are also so important, so always choose those whose values align with yours to get the best outcomes.

Anything Else?

The hardest part is deciding where to start. This partnership has allowed us to filter out the noise and really listen to those that matter most. It has given us clear direction and an excitement for the future. Having clear direction and a plan has been integral to the success of our subsequent pilots. Working closely with our participants, partners, and stakeholders has only reinforced the importance of co-design. Advocates for disability often say, “Nothing for us without us,”; our work has shown that nothing successful can be without the voices of those you serve. Hold that voice dear, and really listen, as it has the power to transform not only your organisation but the lives of those who follow in their footsteps.

Budget: Not disclosed