Dynamics of innovation at the point of care: An interview with Dr. Bonnie Clipper
Dr. Clipper is the VP, Innovation for the American Nurses Association Enterprise. Prior to this role she served as a chief nurse executive for 20 years. She is a Robert Wood Johnson Foundation Executive Nurse alumna and an ASU/AONE Executive Fellow in Health Innovation Leadership alumna. She is also a fellow in the American College of Health Care Executives, as well as certified in Executive Nursing Practice. She has recently served on the advisory panel for Improving Health Systems and Reducing Disparities for the Patient Centered Outcomes Research Institute. Bonnie is a strong advocate for bringing nurses into the innovation space and was responsible for building the ANA’s Innovation Framework, which includes celebrating nursing innovation, developing innovation competencies among nurses and facilitating nurses in creation and invention.
Kelly Robke (KR): Nurses represent the largest group of clinicians in the US Healthcare workforce, serving as leaders in care execution, as well as advocates for patients and their families throughout their care experience. From this unique vantage point, nurses have the potential to act as problem solvers, skilled at identifying breakdowns in processes and workarounds to address issues that impact care delivery. How are nurses evolving that unique skillset and operating as influencers and leaders who drive healthcare innovation?
Dr. Bonnie Clipper (BC): First, as leaders, nurses should be part of any innovation/technology committee, integral to their organization’s exploration, evaluation and implementation of new innovations and technologies. Nurses can be natural and collaborative influencers and as such need to learn as much as they can about emerging innovations and technologies. It is important for nurses to understand how these products, solutions, and systems are going to be 1) incorporated into patient care and 2) how they will inform how and where we provide care. Nurses also need to engage earlier in the technology innovation process by participating in product design and evaluation and through engagement in activities on how products are implemented, education is provided, and how new products are branded and promoted, so that nursing can share strategic insights into innovation needs.
KR: A number of factors are driving current and future changes to care delivery management at the point of care. One way care delivery appears to be evolving is through a renewed effort to increase time spent delivering value added nursing activities (those that impact positive patient outcomes, e.g. preparing and dispensing medication or patient education) and decreasing time spent on non-value added activities (e.g. searching, or waiting for, medication). With nurses taking a more active role and voice in driving products, process and policy around these changes, how do you see care delivery expectations evolving?
BC: Nurses must become tech savvy and understand emerging innovations, whether in new technologies, models of care, or care continuum alternatives. This will require us to be nimble in order to educate 4 million existing nurses and make the strategic changes to nursing school curricula that will allow nurses to pivot quickly into a higher tech world where they leverage more technologies even faster in their nursing practice. The ultimate goal is to improve patient safety and care outcomes, with an eye toward reducing escalating costs. Our challenge as nurses is to continue to be the compassionate, trusted, empathetic caregivers that we are, while incorporating more technology into the patient care space. We must be mindful to balance our pursuit of the science of nursing with the critical need to sustain our craft of caring. We must not lose the human touch, connection and personal aspect of patient care.
KR: What innovation trends are you excited about in nursing?
BC: The American Nurses Association (ANA) conducted an internal member poll during this year’s National Nurses Week and learned that nurses expect to see near-term opportunities for innovation that impact nursing, including artificial intelligence, VR, big data/predictive analytics and wearables.
The combined poll results of nurses who responded mirrors the innovation trends identified by an environmental scan. At present, it appears that a combination of artificial intelligence (AI) and predictive analytics could make the most “sizable” impact to patient care. Successful implementation of these systems includes the use of embedded and “behind the scenes” analytics, as they “over-lay” our monitoring systems. Through the use of deep learning algorithms, AI is designed to identify patterns and emerging trends that are otherwise imperceptible to humans. Through predictive analytics these patterns and trends will be analyzed for their predicted outcome, a process which can happen in nanoseconds and occur continuously. These data-driven trends may be evident through lab results, EMR documentation or physiologic monitoring data. While any one change may be “insignificant” in and of itself, AI and predictive analytics will not only pick up the individual results and the pattern that they form, but also be able to project what the trend will look like in its final state—whether good or bad. For those trends with a negative end point, AI and predictive analytics could do the “thinking” and alert the humans (i.e. nurses) to intervene and act upon the prediction. Prevention of negative events through early identification and prediction may have the potential to positively impact the delivery of healthcare. AI and predictive analytics are also being used to predict patients who are likely to be readmitted, and those who will have a longer-than-average hospital stay.