Nurses often are practical innovators—they find solutions for their patients in everyday practice. A platform such as MakerNurse documents do-it-yourself improvements of patient care. However, when it comes to more far-reaching innovations, ideas are amiss or don’t prevail. The entrenched way to do things in healthcare institutions may make healthcare innovation seem so “difficult”3.
Previously in this blog I argued that innovation is not a genetic feature but a teachable habit. For nursing education, two recent reports offer clues how to do this. Based on discussions with administrative healthcare leaders, White and co-authors1 drafted a catalog of competencies that can bring about innovation—certain behaviors, such as change management, and cognitive patterns, e.g. design thinking. They then asked nursing leaders how important they find each competency, and how they rate their own competence in each.
Highest mean competence (4.68 on a scale from 1 to 5) of the 347 respondents was reached for Tenacity and perseverance, which ranked fourth in mean importance (4.72), showing no significant gap between both parameters. However, Ability to convey a compelling vision was considered most important (4.76), but came only fifth in mean competence, revealing a significant importance/competence gap. The largest gap (0.5) was found for the Change management questionnaire item.
In which way do nursing leaders think innovation could be taught? They recommended hands-on experiences: Project-based learning in consulting engagements, case studies of failures and field-based experiences were ranked highest among pedagogical approaches. By contrast, the respondents rated traditional lectures lowest.
The authors conclude that nursing courses should include analyzing successful or failed innovation cases studies. Practiced healthcare or nurse leaders could play an active role in teaching students and help them find opportunities for creative solutions within their organizations.
These findings are echoed by the designers2 of the Seminar on Innovations within the University of Iowa College of Nursing’s Doctor of Nursing Practice program. This seminar consists of modules addressing recognition of innovation opportunities and managing their realization. It uses the skills set proposed by Dyer, Gregersen and Christensen3, who pointed out that people who found disruptive innovations learned to question reality, to associate previously unconnected thoughts and to experiment with novel ideas.
Importantly, Joseph and co-authors2 emphasize that disruptive innovations in healthcare require from future nursing leaders to collect experiences outside their home turf. Thus they assigned the seminar participants to businesses characterized by comprehensive success—companies that are successful product and service innovators, show how to exert resilience and to adapt to changes in the environment, and contribute to their community.
The students were asked to behave like anthropologists, to document what they encountered and to connect it with their own healthcare environment. Outside of their own field, they would see how company managements solve problems with a creative mindset. While students expressed fear before their field practice, support by faculty helped them overcome this initial hurdle and keep what Joseph and co-authors call “creative courage”.
Three examples from the article may be enough for illustration: One student, visiting a manufacturing plant with a strong reputation of employee welfare, came up with a new idea how to evaluate health and wellness of employees in healthcare. Another student, assigned to a software sales and marketing company, collected experiences with customer care and developed a new method how to timely follow up patients after clinic visits. A third student went to a global financial company and learned about data analytics. Afterwards, s/he developed a model for analyzing a system of care in a predictive way.
Hospitals and other care institutions strongly rely on defined workflows and often operate on tight budgets. To incite innovations within healthcare institutions, professionals need to learn to recognize and realize opportunities before they start their career and become absorbed by daily routines. Both reports show how this can achieved for nurses and nursing leaders5. I am sure the ideas can also be applied in other areas of healthcare.
Mirko von Elstermann
Read more:  White KR, Pillay R, Huang X. Nurse leaders and the innovation competence gap. Nurs Outlook 2015 Dec 17. http://dx.doi.org/10.1016/j.outlook.2015.12.007
 Joseph ML, Rhodes A, Watson CA. Preparing Nurse Leaders to Innovate: Iowa’s Innovation Seminar. J Nurs Educ. 2016;55(2):113-117. http://dx.doi.org/10.3928/01484834-20160114-11
See also:  Herzlinger R. Why innovation in health care is so hard. Harvard Business Review 2006;85(6):58-67. https://hbr.org/2006/05/why-innovation-in-health-care-is-so-hard
 Dyer J, Gregersen H, Christensen HM. The innovator’s DNA: mastering the five skills of disruptive innovators. Boston MA: Harvard Business School Publishing, 2011.
 Institute of Medicine. The future of nursing: leading change, advocating health. Washington, DC: National Academies Press, 2010. http://iom.nationalacademies.org/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx