Sharon Levine

Sharon Levine, BSN, RN
Clinical Nurse, Cardiac Intensive Care Unit

Innovation is becoming a popular subject of nursing research. Though many nurses think of innovation as simply coming up with creative inventions, it is a process for developing and testing new ideas that has distinct stages.

I first learned about the innovation process at an Organization of Nurse Leaders (ONL) meeting this past fall. One of the speakers, Naomi Fried, PhD, chief innovation officer at Boston Children’s Hospital, developed the idea of an innovation “lifecycle,” which is comprised of six predictable stages with a gap in the middle referred to as the O-gap, or the operationalization gap. The six stages are: initiate, ideate, pilot, operationalize, optimize, and obsolete or repeat. The lifecycle begins with the identification of an idea, which is then evaluated and filtered to meet the innovator’s vision. Innovators must then build and test a prototype of the idea during the pilot phase.

Fried describes the O-gap as the challenge of diffusing a new idea across an organization. Once the organization realizes the value of the innovation, operationalization begins. The innovation is then improved during the optimize stage. Once tested by participants, the innovation is evaluated for its effect on the problem. It is determined to either be worth keeping, or it becomes obsolete.

What does nursing innovation look like at BWH? As a member of the Department of Nursing Practice Committee for six years, I have listened to many ideas nurses have for improving patient care outcomes and nursing practice. BWH nurses are proficient at recognizing patients’ needs and identifying problems. At Research Day on Nov. 20, 2014, the discussions and posters presented by nurses showed the depth of innovation that nurses are transitioning into practice.

Nurses are ideal innovators because we do not accept the “status quo.” Nurses find ways to help patients deal with stress and changes in their health, for example, choosing a meditation app to help with relaxation or finding a music selection that the patient enjoys. Some ideas are more complicated, such as having a bedside wedding ceremony for a patient who cannot leave the hospital or facilitating mother and baby time when both are critically ill.

Here are a few ideas for nurses who want to learn how to cultivate innovation on their units and transition their ideas into practice:

First, present your idea to your nurse director and clinical nurse educator. They can advise you on the best approach to begin the innovation process.  For example, presenting your idea to your unit-based Nurse Practice Council can create a project that becomes a collaborative journey for the group. On the Cardiac Intensive Care Unit (CCU), our Nurse Practice Council implemented two research projects called “The Patient’s Perspective of the ICU Diary in the CCU” and “Use of a Blog for Nursing Peer-to-Peer Sharing of Educational Information.” The principal investigators and co-investigators are all members of the council.

Ideas can also become funded projects that support teams of nurses who are exploring innovative solutions to improve patient care and clinical issues. The Lily Kravitz Studies Award and the Mary Fay Enrichment Award both support several teams of nurses involved in implementing their projects.

There is also an annual BWH Hackathon that is hosted by Brigham Innovation Hub (iHub) and MIT H@cking Medicine. This event gives clinicians, engineers, designers and entrepreneurs a chance to pitch projects that seek to improve health care delivery. One of the features of the Hackathon is an “Idea Share Wall” where participants can post different health care challenges. Teams are formed to develop solutions and then compete for prizes awarded on the last day of the event.

Professional nursing organizations also provide innovation support. The American Association of Critical-Care Nurses (AACN) has a Clinical Scene Investigator (CSI) Academy program that is designed to apply a staff nurse’s expertise in enhancing patient care while decreasing expenses. Teams of nurses from hospitals apply to work with AACN CSI Academy faculty and an internal mentor to identify issues and develop and implement solutions. Hospitals selected to participate receive a grant to support the team’s learning journey. The MICU at BWH participated in the CSI Academy by developing a project titled “Under Pressure: Reducing Hospital-Acquired Pressure Ulcers in the MICU.”

There are several opportunities and resources available for nurses to apply innovation to nursing practice. Whether you are a first-time innovator or an experienced one, you can turn your idea into a project that will make a difference in patient outcomes and nursing practice.