Wharton@Work

July 2024 | Innovation

Front-Line Innovation: Empowered Nurses Improve Care

Health care might not be the first industry that comes to mind when you’re thinking about cutting-edge innovation. But innovation is the driving force behind transforming patient care, streamlining processes — and ultimately saving lives. Creating and adopting new ideas, though, is often obstructed by health care’s traditional, entrenched mindsets and outdated systems. That’s where a new program from Johnson & Johnson, Penn Nursing, and the Wharton School comes in.

The one-year, team-based Nurse Innovation Fellowship Program is aimed at advancing health care by equipping chief nursing officers (CNO), nurse executives, and senior nurse leaders with the knowledge, tools, and guidance they need to create change within health systems. At the forefront of patient care, nurse leaders are uniquely positioned to understand both patient needs and operational nuances. They are also able to understand and influence industry disruptions, a key to developing and accelerating the adoption of more effective, efficient, and patient-centered innovations.

Moving Beyond Traditional Nursing Pathways

Jill Wegener, Blythedale Children's Hospital's senior vice president, chief nursing officer and patient care services, was part of the first cohort in the fellowship. “I am the CNO in a small standalone children's hospital,” she says. “We are not affiliated with an academic medical center or a university; our access to health care leaders with varying degrees of expertise is limited. Often, it’s our small but ‘mighty’ team trying to figure things out. We recognized that the Nurse Innovation Fellowship Program was an opportunity to connect with nurse leaders and executives from across the nation and to learn from the top academic advisory team from Penn Nursing and the Wharton School. We were eager to tap into resources that we don't typically have access to.”

“Nurses typically enter the profession to heal, to care for people,” she continues. “We often don’t recognize the impact and influence nurses can have on designing health care systems; policies and practices that optimize care for our patients and families; and creating a healthy, innovative work environment for the staff we are charged to lead. Nurse leaders of the future need to have an influential presence within hospital senior leadership teams, within hospital governance boards, and in the political arena. Sticking to only the typical nursing educational pathways is not enough. We need to expand our typical educational training and explore opportunities that will enhance our knowledge of the business side of health care, innovation design, and political advocacy pathways. This is exactly what the fellowship invested in us this past year. The business knowledge we gained from Wharton in the program really complements our existing skills and will enable the nurse fellows to be more successful in advocating for healthcare change or reform at the state level, the federal level, and within our own organizations or professional bodies.”

Wegener explains that during the fellowship application process, prospective teams are asked to share a current challenge on which they want to focus their innovation efforts. “We had been working internally for eight years on enhancing the transitions of medically complex children from our hospital facility into the home community. It’s one of our core missions and a major strategic initiative. Yet we still have significant barriers to overcome to ensure this transition home is a successful one. We selected this as our fellowship innovation problem.”

As Wegener and her colleagues explored ways to support their patients and their families after discharge, they conducted wide-ranging discussions with various stakeholders. “The explorative inquiries with our stakeholders enlightened us and allowed us to understand the depth of how broken and inefficient the community system is that we're handing these kids over to. There's no safety net for them once they leave our hospital,” Wegener says.

In addition to sessions on the theory and practice of innovation, finance, and other business-related topics, the program provides the time, resources, and mentorship needed to work on the challenges presented by the participants. Over the course of the year-long fellowship, they get assignments designed to move their projects forward and to obtain buy-in and support from other leaders in their organizations. For the team from Blythedale Children’s Hospital, that meant designing an innovative app that would support medically complex patients and their families as they transition to their community care providers.

From Theory to Practice

“Our project was designing a HIPAA-compliant application that would keep us connected with our families post-discharge,” says Wegener. “When we got to the prototyping, we were connected with a mentor for eight weeks who met with us regularly to take us through the application design, the build, our options, what we needed to think about, and what the legal aspects were that we had to explore.”

In the classroom, she learned about potential opportunities for scaling the app, thinking about the hospital’s market influence, and creating a return on investment. “All of these topics were covered during the sessions with Wharton professors and in 1:1 brainstorming sessions with our mentor,” says Wegener. “In nurse exec programs, you learn about finance and budgeting, but little about how the real business of health care operates. Every component of the Wharton educational curriculum this past year was extremely enlightening and of significant educational value to our nurse-leader fellowship cohort.”

Beyond work on the app, Wegener and her CEO are partnering with another children's hospital for the next phase of creating a safety net for their patients. “We are exploring opportunities to advocate for them at the New York state level. Through our advocacy work, we seek to educate politicians on the challenges, barriers, and limited competent health-care providers families face once they transition home to their communities. We seek to enlighten them and help them understand how ‘broken’ the system is and how it is failing families across the state. Our goal is to create legislation that supports access to competent community health-care providers for all medically complex children across the state,” Wegener says. “This is not only a New York state problem, but also a national problem. One of the Nurse Innovation Fellowship Program instructors has expressed interest in joining our efforts if/when we take this nationally. She’s offering her connections with people at Penn and CHOP [the Children’s Hospital of Philadelphia] who might sign on and be able to help. So even though we have graduated from our Nurse Innovation Fellowship Program, our partnership and collaboration with our innovation team and business experts will be ongoing.”

“When we were accepted into the Nurse Innovation Fellowship Program, we never anticipated, even in our wildest dreams, how professionally career enhancing and career changing the program would be,” says Wegener. “It wasn’t just the knowledge that we learned within the formal course of study, but the networking with innovative nurse leaders across the nation has really been substantial for us. It taught us theories, skills, and processes that we are now able to bring back to our organization, taking our teams through the innovative design process that Penn Nursing and Wharton instilled in us. This program is worth the return on the investment of dedicating yourself for a year. It's a gift, an amazing investment, and an incredible opportunity for nurse leaders to participate in this experience.”