In 1855, one single person fundamentally changed the course of medicine for good. By introducing proper hygiene and sanitation to soldiers battling on the frontline in the Crimean war, Florence Nightingale reduced the death rate from diseases such as typhus and cholera from 42% to 2%. Her critical thinking and determination changed medicine forever, for the better.
Lots has changed since 1855. But one thing remains the same. Nurses are still imperative to the delivery of medical care. They stand on the frontline between the life and death of patients. Almost every clinical interaction is bookended by nurses. They are intricately intertwined with almost every system, almost every product rolled out in healthcare.
And yet nurses are very rarely engaged in the decisions or design, despite being best placed to advise what works and what doesn’t. And because of this, every day, nurses are coming up with and implementing workarounds to the system in which they operate, and the equipment they are given. They are so aware of the inefficiencies that they are unconsciously creating innovative ways to get around them – up to 27 times per shift.
What are workarounds?
“Workarounds are observed or described behaviours that may differ from organisationally prescribed or intended procedures. They circumvent or temporarily ‘fix’ an evident or perceived workflow hindrance in order to meet a goal or to achieve it more readily.”
In most modern-day workplaces, when an employee spots an inefficiency – a way of saving time, or money, or a way of producing a higher quality outcome – they are rewarded for it. At Google, employees take part in 24hour “fixits”, where everyone can be wholly dedicated to fixing one specific identified problem.
In healthcare, however, workarounds aren’t seen as a positive thing. Time isn’t set aside for innovation, and innovation doesn’t breed reward or recognition. Instead, those actions are viewed as a potential compromise to protocol, and therefore patient care and safety.
In this way, instead of creating an environment in which those best placed to improve their workplace are encouraged to do so, the healthcare sector as a whole, and the NHS in particular, risks losing its greatest asset, with the disengagement of nursing staff contributing to record staff shortages. 1 in 10 nurses are leaving the NHS each year, and estimations putt staff shortages at 250,000 by 2030 without serious intervention.
Nurses and innovation
But nurses are natural innovators. In the 1940s, it was a nurse, Bessie Blount Griffin, that invented the feeding tube. In the 1950s Sister Jean Ward invented Neonatal Phototherapy. In the 1960s it was ED nurse Anita Dorr who invented the Crash Trolley. These are lifesaving inventions that came from nurses thinking creatively about the problems they faced every day and finding solutions to them. From Florence Nightingale introducing proper hygiene and sanitation in the 1850s through to Teri Barton-Salina introducing colour-coded IV lines in the 2000s, nurses have been revolutionising medical care for centuries.
Innovation from the front line is desperately needed. Nurses must be viewed as a fundamental part of that innovation process. Giving them the opportunity and the environment to put their knowledge into action will help cut costs, reduce inefficiencies, and improve patient outcomes.
With the right tools, it’s possible to cultivate an environment in which innovation and improvement ideas are encouraged. A recent Accenture study, however, showed that though 91% of UK employees want to innovate, only 34% feel empowered to do so. So here are some ideas from us on how to help create an innovative atmosphere in your workplace.
5 tips for creating an innovative workforce
Ask open questions
If you’re looking for improvement ideas on a particular topic, you can get people thinking creatively about the issue by asking open questions. Asking “How do you think we can save 10 minutes each day on the ward” will encourage people to give their ideas far more than asking “Do you think our ward is efficient?” You can use a survey tool to engage with large, diverse groups, gathering a wider range of ideas.
Recognise and reward
One of the best ways to encourage engagement in innovation is to actively recognise those who are coming up with great ideas through an awards scheme. It might be certificates, stickers, incentives or just calling it out in team meetings; it’s important to find a way of rewarding people who are helping to improve their workplace. Doing so will encourage others to follow suit, as well as showing your team that improvement is a priority.
Set aside time
Time is one of the most precious commodities within a hospital setting, and there never seems to be enough of it. It can be difficult to justify taking 10 minutes to ‘be innovative’, much less encouraging the whole team to do so. The benefits of ringfencing that time, though, will become clear quicker than you might think. In a recent study of the use of the ImproveWell platform to encourage ideas in Royal Cornwall Hospitals NHS Trust, it was found that one idea saved 22 hours a week, or around £19,000 a year.
Respond and implement
Asking people to be involved in innovation will only be worthwhile if it results in action. Implementing ideas will boost morale and drive engagement in your change programme. If an idea can’t be put into practice, or will take some time to implement, make sure that you still respond and keep people in the loop. The ImproveWell solution enables you to directly message team members who give you ideas, as well as publish reports about the improvements underway to your whole team.
Don’t bite off more than you can chew
Transformative change doesn’t necessarily come from one big idea. Small, everyday ideas are as valuable as big ones, and by identifying and changing the small things, focused on day to-day operations, you can dramatically impact cost and time efficiencies in a manageable way. Using an idea management tool such as the ImproveWell platform can help you to organise and prioritise the ideas that come in from the frontline, so that you can action the quick wins while freeing up project management resource for the harder to implement ideas.
By cultivating an environment of continuous improvement, healthcare organisations can leverage the knowledge and creativity of one of their most valuable assets; their dedicated and hardworking nursing staff. In turn, this will produce time saving efficiencies, cost benefits, increased morale and engagement, and ultimately better patient outcomes.
To find out how ImproveWell can help you drive change from the frontline, arrange a platform demo today!
 Rebecca Love, Director of Nurse Innovation & Entrepreneurship at Northeastern School of Nursing
 3 Nurses’ workarounds in acute healthcare settings: a scoping review, Debono et al. (2013)