On a recent episode of the Knowledge Project podcast, Dr. Atul Gawande compared the relative importance “breakthrough” versus “follow through” innovation:

”We’ve been fantastic at breakthrough innovation, with no real understanding of follow-through innovation… Follow through can seem like it’s about nuts and bolts, and not about new ideas.”

What follows is a discussion about the importance of follow-through and rigor with advances in medicine. A redirection of attention away from the shininess of “breakthroughs” is an interesting idea. It’s not that follow-through doesn’t happen, it’s that it gets backgrounded or treated as less important. It’s not as “cool” as being on the cutting edge.

I was reminded of Clay Christensen’s Innovator’s Dilemma and its notions of “disruptive” versus “sustaining” innovation — really two different names for the same concepts above. It’s become fashionable in business to focus a disproportionate amount of attention on being “disruptive”, perhaps to the exclusion of continued improvement on things you’re already expert at. Staying in front of shifts in the climate of your business sector is certainly important, but so is sharpening the saw and staying competitive in your current space.

As Gawande discusses in the episode, the aggregate good done by simple, sustaining developments like basic sanitation procedures and process improvements far outstrip what most breakthroughs provide.