As natural problem-solvers with hands-on patient experience, nurses and nurse leaders are integral in advancing innovation and driving improvements in the quality, safety and sustainability of healthcare.

That’s the foundational idea behind the Johnson & Johnson Nurse Innovation Fellowship Program (JJNIF) powered by Penn Nursing and the Wharton School, which brings together twenty nursing leaders representing ten health systems, immersing participants in the innovation process by focusing on human-centered design, equity-centered design, and design thinking methodologies to address a real-world challenge their health systems are facing.

This ground-breaking, one-year, team-based fellowship launched in June 2023, and participants are halfway through the process and developing solutions for their specific challenge area, through a combination of in-person and virtual sessions. At the conclusion of the fellowship, fellows will pitch their innovative solutions with the goal of bringing that solution back to their healthcare system to implement.

But what does human-centered design, equity-centered design and design thinking mean? And why is it so relevant for nursing and healthcare challenges? We talked to Marion Leary, PhD, MPH, RN, Director of Innovation at the University of Pennsylvania School of Nursing, to find out.

Marion Leary: To put it simply, human centered design is a methodology that can be used to create solutions to problems, through a process called design thinking, which helps people work through the process in a rigorous way.

You start with the ‘empathy,’ stage, which allows you to gain a deeper understanding of the people or population for whom you are designing. Then you progress through the ‘define’ stage, where designers use the insights gained during the empathy phase to clearly define the problem they are solving for and develop a problem statement. In the ‘ideate’ stage, designers use brainstorming activities to generate a wide variety of ideas that could help tackle their problem, and then test these ideas during the ’prototype’ stage. In the iterative ‘test’ process, designers test and retest their solution on users, and continually refine the solution based on user feedback and further insights.

One of the benefits for clinicians, providers, researchers, and designers is that we aren’t telling people what we think their problem is; we’re allowing them to show us what they know their problem is, so we can have a more human-centered solution.

ML: Innovation and design thinking are the nursing process. In design thinking you move through ‘empathy,’ ‘define,’ ‘ideate,’ ‘prototype,’ ‘test.’ In nursing, you assess, understand, identify, or define, and come up with solutions. It runs the exact path of the design thinking process. Nurses are doing these things at the bedside; they just don’t know that they’re working through the innovation process, but that's exactly what you're taught to do as a nurse. It’s why nurses are such great innovators!

ML: At the beginning of this program, the Fellows identified an area within their institution that they wanted to address. They spent time at their respective institutions, interviewing and observing the specific population relevant to their focus area, and brought all that data and context to the first virtual session, where we worked through different ‘empathy’ and ‘define’ activities, so that when they left that session, they were ready to move on to and come up with creative solutions.

The next session was all about ideating and prototyping. They defined their problem and created a potential solution. We pressure test that solution, we push them to think a little bit more creatively, and then we talked about creating low-fidelity prototypes, so they can test their solution at their institution with their end-users. Each of these sessions are a workshop of design thinking, with mentorship and guidance.

The 10 teams that form the 2023 Johnson & Johnson Nurse Innovation Fellowship cohort represent geographically diverse areas across the US and come from large and small health systems as well as stand-alone hospitals and public health systems in urban and rural locations. You can meet the teams here, and find out what a few of them are working on below.

Dr. Lya Stroupe, DNP, APRN, CPNP, NEA-BC, Director of Nursing Professional Practice and Education, and Melanie M. Heuston, DNP, RN, NEA-BC, Inaugural Chief Nurse Executive, are focused finding an innovative answer to a longstanding question – how to generate interest in bedside clinical care among the new generation.

Through the design thinking and human-centered design, the WVU team identified a key insight – prospective nurses don’t just need to know what RNs do, they need to experience what working as an RN feels like.

“That’s where our innovation is sitting,” said Stroupe. “We’re leveraging technology for a real experience and reaching people who hadn’t considered the nursing profession. What does it feel like to be a nurse? What does it look like when there’s a code going on? How does a nurse react when a patient says, ‘I’m scared’?”

It’s a feeling that inspires people toward nursing, and Heuston says the Fellowship is providing the support and structure needed to turn that insight into a solution.

“Without the fellowship, we might have had this idea, but it would have sat on the shelf,” she said. “But going through the classes, networking with organizations around the country, and being connected with even more people to help us design and develop our idea – we’re prototyping, and now I can begin to see the end product, and it’s really exciting.”

At Corewell Health, Dr. Natalie Baggio, DNP, MBA, BSN, RN, Senior Vice President of Clinical Operations and Chief Nursing Executive, South Region, and Dr. Sandi Plank, DNP, CNOR, NPD-BC, Senior Director Clinical Education, Talent Development & Resiliency, are also focused on building a technology solution to address a key nursing challenge.

“The main problem we identified is the gap in communication, specifically bidirectional communication, between frontline nurses and their direct leaders,” said Baggio.

It’s a complex problem – nurses and managers often work different shifts and schedules, and nurses may work for several days straight and then take long stretches of time off, while managers tend to work Monday through Friday. Further, nurses are often inundated with patient information throughout their shifts, and communication from leaders may get lost.

“We started our focus on the nurse, because we really felt like they were the ones having this communication barrier,” Plank said. But through the Fellowship’s design thinking curriculum, the Corewell Health team widened their lens and shifted their focus.

“We realized that to affect change we really needed to bring in the manager,” Plank said. “Initially, our solution was not as innovative, because we were thinking in our healthcare bubble. And that realization really turned it around for us, and we were able to envision what we could create that was truly innovative.”

Their solution is an AI-driven app that assists nurse managers with tasks such as scheduling, staffing, and communication with staff. The chatbot can interact with nurses via text, voice, or even video, and can be geofenced, so information is provided at the most relevant and actionable moment.

“As nursing leaders, we get so focused and solving today's issues,” Baggio said. “The Fellowship pushes you to think about the problems you can solve in a much more creative and innovative way.”

Stay tuned for more details on the Johnson & Johnson Nurse Innovation Fellowship as the 10 teams present their final solutions in May 2024, and learn more about Johnson & Johnson’s commitment to the nursing profession here.