RT Journal Article SR Electronic T1 Innovating at pace during crisis—military lessons for the COVID environment JF BMJ Leader JO BMJ Leader FD BMJ Publishing Group Ltd SP 105 OP 108 DO 10.1136/leader-2020-000267 VO 4 IS 3 A1 Brigadier Tim Hodgetts YR 2020 UL http://bmjleader.bmj.com/content/4/3/105.abstract AB The challenges of innovating at pace in recent conflicts has encouraged military medical lessons to be codified into an integrated model of innovation, with generic application for the wider healthcare sector and the COVID environment specifically. This ‘Toolset for innovation and change’ emphasises the need to first understand and frame the problem using external (STEEPLE) and internal (TEPID COIL) factor analysis. The conditions that support exemplar innovation adoption by an organisation are described (ADOPTER—Agile, Decisive, Outcome focused, Politically aware, Tolerant of Risk, Empowered and Rewarded) as are the conditions that are necessary for successful innovation translation to another organisation (TRANSL8—Transformational leadership, Relevance, Adaptability/Acceptability, Networks, Simplicity, Life enhancing change, 8-steps of complex change). The obstructions to innovation, or ‘innovation constipation’, are highlighted and remembered as B-OWELS. The toolset was first developed by the author in 2015 from sustained experience of innovation at pace and has been successfully applied to messy problems requiring complex change in both the military and civilian healthcare sectors.