Supporting a Culture of Innovation and Entrepreneurship (I&E) in Nursing

Ryan J. Shaw, PhD, RN | Associate Professor

Director, Health Innovation Lab, Duke University School of Nursing

The Future of Nursing report from the Institute of Medicine, called on health care organizations to support and help nurses take the lead in developing and adopting innovative, patient-centered care models and to engage nurses and other front-line staff in the design, development, implementation, and evaluation of medical and health devices, health information technology products, and entrepreneurial opportunities. It emphasized the need for nurses to “lead in diffuse collaborative improvement efforts”. For this culture of innovation to transpire, radical transformation is needed. Because health and health care delivery are increasingly complex, solutions must come from both within and outside the traditional healthcare enterprise. Thus, partnerships are needed across disciplines including nursing, medicine, engineering, computer science, business, and many others. Moreover, nursing is in an opportune role to assume leadership in fostering a culture of innovation that can create solutions to the complex demands of today’s healthcare environment.

Since that 2010 report was released, a new report in 2021 has since come out. A review of the landscape shows that the profession of nursing has made some progress. Yet, it’s clear radical change has yet to come. A 2021 study highlights seven colleges with centers for innovation in nursing. While not an exhaustive list, it demonstrates that a culture of innovation is still transpiring. Across most schools of nursing, innovation is more commonly used as a term as part of nursing education rather than a term to describe entrepreneurial endeavors such as the creation of new products and testing new care delivery models.

Momentum in innovation and entrepreneurship (I&E) is accelerating as universities increasingly invest in the I&E space. A 2017 report shows 158 US allopathic medical school websites with innovation and I&E programs. This change is seen in the funding landscape as well, as demonstrated by NIH investing over $1 billion per year into health life science companies that are creating innovative technologies. Nursing schools which invest in I&E are likely to be more successful in these contemporary funding opportunities. This requires investment in human capital, physical infrastructure and strong partnerships with university and academic health system endeavors. With the end goal of delivering exceptional care to patients and promoting health equity, it is necessary that Nursing invests in innovative infrastructure and frameworks accessible to nurses to find more effective and efficient methods of delivering care.

Structure and Frameworks

Nurses, an underrepresented group in innovation, need opportunity to innovate. Leadership must demonstrate that they value nurses as having ideas and knowledge that should be shared and acted upon to address unmet needs in healthcare and society. This includes dedicated time and space that allows the curious to ideate, prototype and iterate. Partnerships with professions such as engineering and business can provide the skills to design and build new products. Nurses need access to funding, capital, and representatives with knowledge about licensing, regulations, institutional review boards (IRBs), product development, business models, and conducting clinical trials.

To lead and embrace a culture of innovation in healthcare requires learning approaches that develop knowledge and skills to operate in complex 21st century organizations. Nursing can embrace frameworks such as design thinking for example which provides a human-centered framework to identify and solve complex unmet needs in nursing and healthcare. Design thinking is an approach that exposes learners to knowledge and skills beyond their own discipline in a safe learning environment. By breaking down the process into iterative steps, this approach strengthens the potential for innovation.

When Nurses are Provided with Opportunity, they Innovate!

If you build it (and support it), they will come. I present a few examples that demonstrate how when Nursing invests in structure to support I&E, innovation transpires. One example is the Line Snuggler®. This design-patented and proven nursing product keeps central lines and connected IV tubing covered and contained, thus reducing costs and apprehension, increasing patient comfort and decreasing the number of line contamination protocols. Invented by a clinical nurse, this product was made possible by access to resources that could provide guidance on how to take an idea and usher it through the pipeline to be a manufactured product that was evaluated in a clinical trial and receive FDA clearance. A second example is EasyShift™. This product is a one caregiver solution for turning and boosting patients of size in bed. EasyShift was created when biomedical engineers came together with nurses to create a better solution for patient repositioning. By providing access to nurses and an environment to collect data and iteratively test, the product went from engineering to field testing. And finally, the I-Drape®, a disposable intubation drape was invented by a nurse anesthetist and a PhD nursing student. As a result of the COVID-19 pandemic, this product was invented to address the need for an adaptable product that protects providers from respiratory droplets during airway manipulation.

When afforded with structure and opportunity nurses can take the lead in developing and adopting innovative, patient-centered care models, new products and entrepreneurship. Nurses are at the forefront of patient care and as the largest healthcare workforce in the nation, we should be empowered to address unmet needs in healthcare. Now is the time to invest in our profession and for nursing leaders to step forward to accelerate building and sustaining a culture of innovation and entrepreneurship.

September 2021