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How Creative Problem-Solving Tactics Become Nursing Innovations

BD Institute for Medication Management Excellence

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How Creative Problem-Solving Tactics Become Nursing Innovations


PUBLISHED: Aug 5, 2019

Kelly Larrabee Robke, RN, MBA, MS


 

Are you an innovator?

As nurses, we tend to be critical thinkers and problem solvers, experts in assessment and prioritization within our practice. Despite these tendencies, nurses have been historically under-represented in the innovation space. Nurses are quick to identify themselves as experts in troubleshooting, but very few will acknowledge their role as innovators.1

Innovation can be thought of as the process by which new ideas are generated that advance, improve or even revolutionize our lives, our work, and in the case of healthcare, how we care for patients. According to the World Health Organization (WHO), “health innovation identifies new or improved health policies, systems, products and technologies, and services and delivery methods that improve people’s health and wellbeing.”2

Over time, the nursing profession has changed its approach to innovation. Today, when thought leaders consider how to generate momentum in the nursing innovation movement, we imagine a comprehensive approach, asking ourselves how to ignite and highlight innovation, and how to cultivate future nurse innovators.

At the recent HIMSS Innovation in Nursing Practice panel sponsored by BD, nurse leaders representing different perspectives shared their approaches to innovation and collaboration.3

Nurse leaders share their experience

Panelist Bonnie Clipper, Vice President of Innovation for the American Nurses Association, opened with statistics: registered nurses in the United States outnumber licensed physicians 4:1, and licensed pharmacists by more than 9:147—ratios which suggest that nurses are exposed to direct, ongoing patient care on a grander scale than their clinician counterparts. Based on her perspective as a nurse leader, Clipper stated that this level of exposure, coupled with the fact that nurses regularly devise creative problem-solving tactics to ensure that patient care continues despite obstacles, means that nurses are already innovators. The challenge that remains, she explained, is to educate the nursing community on their natural abilities as innovators and connect nurses with others who have an interest in cultivating, developing, and promoting innovative ideas. In this way, she believes, nurse innovations have the potential to impact processes and workflows that support positive patient outcomes.7

For Judi Cullinane, Executive Director of Nursing Research, Innovations and Professional Development at Tufts Medical Center, innovation can support four areas of nursing practice: processes, programs, projects and products.9,10,11 Whether innovation brings a new perspective to an existing product or prompts nurses to consider adopting a new process, from Cullinane’s perspective, innovative ideas can emerge in a variety of ways: through necessity, problem-solving, brainstorming or sheer creativity.8

At Mercy Health System, Chief Nursing Optimization Officer Betty Jo Rocchio focuses on elevating clinical practice excellence for front line nurses by making a connection between workarounds (which may have developed informally to save steps or improve safety) and approved organizational processes. Rocchio shared two examples of innovations that emerged this way at her institution: voice-activated charting in the electronic medical record, and the use of dictation software.8

 

A creative approach to collaboration

Healthcare is in a constant state of evolution. The rise of nursing innovation has the potential to support the need to find optimal solutions to issues that impact the care delivery continuum. Possible areas for innovation include tools and technology, but also concepts, workflows and training.

Innovation pathways create opportunities for collaboration in which nurses may lead and support cross-disciplinary efforts. One potential pathway discussed by the panellists is the development of a healthcare innovation center, which may be structured as its own department or part of a broader organization to support research or nursing operations. The panelists indicated that an innovation center could engage nurses in its activities, as well as staff from IT and informatics.

Multiple players in the healthcare space, such as academic centers, professional organizations, and healthcare enterprises are all committing to the benefits of innovation by establishing a variety of pathways to achieve it. Using pathways for process improvement at the University of Pennsylvania Health System, nurses set out to improve medication reconciliation at the time of discharge. They began by demonstrating that patients discharged from the medical surgical units have fewer medication discrepancies, and less likelihood of medication errors, when two RNs reviewed a patient’s discharge instructions as well as their associated prescribed medications.11 As a result of their work, a “discharge time out” process was instituted at their facility.

Another example of a nursing innovation pathway is the American Nurses Association’s ANA Innovation Awards, sponsored by BD. This recently launched competition allows individual and nurse-led teams to apply for a monetary award to help develop innovative ideas, with the goal of transforming patient safety and outcomes. Nurse applicants are able to submit innovations related to translational research, development, prototyping, production, testing, and implementation efforts.13

Based on their experience in supporting nursing innovation, the HIMSS Innovation in Nursing Practice panelists considered hackathons, shark tank events and pitch sessions to be important opportunities for nurses to work with members of other groups and disciplines such as physicians, pharmacists and nutritionists.8 Judi Cullinane described collaboration as foundational—through collaboration, innovative ideas for nursing might be discovered or generated by anyone, at any level of an organization. In her opinion, nurses can lead a team along one of these pathways or participate as an essential member.8

Betty Jo Rocchio identified analytics as a significant area for collaboration in which nursing should be part of an overall strategy, but not the sole driver. She explained that, in her experience, a first step to innovate in this arena is for nurses—as the primary data collectors—to gather data to be analyzed. Beyond clinical insights, Rocchio believes there is a need for nurse innovators to have access to those with expertise in business, financial and strategic planning and future commercialization, as well.8

Support for nursing innovation

Based on my experience, nurses serve two primary and essential roles within healthcare: first, as leaders in care delivery execution, and second as advocates for patients and families. Quality of nursing care is regarded as the single largest determinant for patient ratings of a health systems’ overall quality of care and services14,15 underscoring the necessity to support the panelists’ goals for nursing innovation and nursing practice excellence.

 

Learn more

Each month on the BD Institute for Medication Management Excellence blog, thought leaders explore topics of critical importance to medication management, and provide additional ways to learn.

Now that you’ve read about opportunities for nursing innovation, dig deeper by reading an interview with Dr. Bonnie Clipper on AI, predictive analytics and other innovation trends that may impact future nursing and patient care. Then, consider the latest thinking on optimized workflows and value-added care activity—critical needs for nursing practice.

 

References

  1. Unleashing Nurse-Led Innovation. BDO. https://www.bdo.com/insights/industries/healthcare/unleashing-nurse-led-innovation. Published 2019. Accessed May 9, 2019.
  2. Health topics: Innovation. World Health Organization. https://www.who.int/topics/innovation/en/. Published 2019. Accessed July 17, 2019.
  3. Disrupting Healthcare with Nursing-Led Innovation at HIMSS19. The HIMSS Innovation Center. https://www.himssinnovationcenter.org/disrupting-healthcare-nursing-led-innovation-himss19. Published 2019. Accessed May 9, 2019.
  4. KLAS study finds nurses more likely to be happy with EHR than docs – Health News. 9zp.info. http://9zp.info/klas-study-finds-nurses-more-likely-to-be-happy-with-ehr-than-docs.php. Published 2019. Accessed May 9, 2019.
  5. ANA Celebrates Contributions of Nation’s 4 Million Nurses During National Nurses Week, May 6-12. nursingworld.org. https://www.nursingworld.org/news/news-releases/2019-news-releases/ana-celebrates-contributions-of-nations-4-million-registered-nurses-during-national-nurses-week/. Published 2019. Accessed May 9, 2019.
  6. United States Department of Labor. Occupational Outlook Handbook: Pharmacists. Bureau of Labor Statistics; 2019.
  7. United States Department of Labor. Occupational Outlook Handbook: Registered Nurses. Bureau of Labor Statistics; 2019.
  8. Clipper B, Cullinan J, Robke K, Rocchio B. Innovation in Nursing Practice: A Discussion with Leadership. HIMSS Global Conference & Exhibition, Luncheon Panel. February 2019.
  9. Cullinane J. Innovation in Nursing, Parts One and Two. Lecture series presented at the BD Institute for Medication Management Excellence, 2019. https://www.bd.com/en-us/clinical-excellence/innovation-in-nursing-part-one-the-possibilities
  10. Thomas T, Seifert P, Joyner J. Registered Nurses Leading Innovative Changes. The Online Journal of Issues in Nursing. 2016;21(3). doi:10.3912/OJIN.Vol21No03Man03
  11. Blakeney B, Carleton P, McCarthy C, Coakley E. (May 31, 2009) "Unlocking the Power of Innovation" OJIN: The Online Journal of Issues in Nursing Vol. 14, No. 2, Manuscript 1.
  12. Ruggerio J, Smth J, Copeland J, Boxer B. Discharge Time Out: An Innovative Nurse-Driven Protocol for Medication Reconciliation. MedSurg Nursing. 2015; 24(3) 165-72.
  13. ANA Innovation Award. Nursingworld.org. Published 2019. Accessed June 27, 2019. https://www.nursingworld.org/practice-policy/innovation/ana-innovation-award/
  14. Otani K, Kurz R. The impact of nursing care and other healthcare attributes on hospitalized patient satisfaction and behavioral indicators. Journal of Healthcare Management 2004: 49 (3): 180-196.
  15. Otani K, Waterman B, Dunagan W. Patient Satisfaction: How patient health conditions influence their satisfaction. 2012: Journal of Healthcare Management 57 (4).
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