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Dome - What’s the Big Idea?

Dome November 2014

What’s the Big Idea?

Date: November 6, 2014

Innovation Hub at Sibley Memorial Hospital encourages new ways of thinking to improve health care and the patient experience.


HARD FUN: Joe Sigrin, left, and Nick Dawson of the Innovation Hub loosen up their imaginations with help from Sibley nurse Silvia Ochs. The team often uses techniques from improvisational comedy in brainstorming.
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HARD FUN: Joe Sigrin, left, and Nick Dawson of the Innovation Hub loosen up their imaginations with help from Sibley nurse Silvia Ochs. The team often uses techniques from improvisational comedy in brainstorming.

Maybe it’s the free coffee, bananas and granola bars. Or the knowledge that hospital president Richard “Chip” Davis is on duty at the ideas desk, waiting to hear your thoughts about improving life at Sibley Memorial Hospital.

Or maybe it’s the playful, relaxing atmosphere with its jukebox, Play-Doh and foosball table that has attracted a steady stream of visitors to the Sibley Innovation Hub. Since opening in July, this bright, airy space has inspired hundreds of Post-it suggestions—many of them on display—from clinicians, administrators, patients and community residents. Along with a group of hospital executives, the Hub’s innovation team is available to help define problems, build on ideas and find creative solutions to some of Sibley’s most pressing concerns.

And that’s the plan. “The Hub is going to help us think through what care is going to look like in the next 10 to 15 years,” Davis says. “Sibley has the opportunity to participate in and shape the transformation of health care—and to demonstrate how care should be provided in the community hospital setting.”

Davis knows the power of creative approaches: Before assuming the presidency of Sibley in 2012, he directed the Center for Innovation in Quality Patient Care, now part of the Armstrong Institute for Patient Safety and Quality. When he rededicated the 3,000 square feet that housed Sibley’s Health Information Management Department, he established a home for innovation, Silicon Valley-style.

So far, Hub-assisted projects have led to improvements in multidisciplinary rounding, a prototype for valet parking for patients, a better system to process payments and a poster that aims to reduce central line infections. 

All Ideas Welcome 

When an idea is submitted, the “Hubsters,” as innovation staff members are known, determine if it aligns with the strategic objectives of Sibley and Johns Hopkins Medicine and if it can influence the field of health care. If so, appropriate staff and resources are assigned to help bring the idea to fruition. The idea’s originator remains the champion of the proposal, shepherding it through the development process with lots of support from the innovation and design teams. If an idea is not selected for full development, the originator is still encouraged to develop and implement it independently.

“We often call our work hard fun. We try to dream big, get stuff done and have fun doing it,” says Nick Dawson, Sibley’s executive director of innovation. “When we do it well, we improve care and quality in ways no single person could have thought of alone. We look for big themes, like employee engagement and patient experience. Then we apply a process for change that is very human-centered to look for innovative solutions.”

Dawson has worked in various aspects of health care management, including directing community and physician engagement for Bon Secours Health System in Richmond, Virginia, a system of 14 acute care hospitals. He uses “design thinking,” the same methodology that has led product designers at the fabled IDEO firm in Palo Alto to develop the first mouse pad for Apple, an improved Pringles snack chip, a heart defibrillator that “talks” in emergency situations and better ways for Kaiser Permanente nurses to conduct shift changes.

Design thinking begins with “empathy for the consumer,” Dawson notes, a proven quality improvement approach that calls for problem-solvers to spend time observing how people actually use products or go about work activities before determining how to improve them. 

New Ways of Thinking

Hospitalist Therese O’Donnell, director of Sibley’s hospitalist group and palliative care service, says that the Hub’s approach is already reframing how employees look at their work. “It’s causing people to stop and think in a different way,” she says. “The effect it’s had on our multidisciplinary rounds project is a good example of improvement, collaboration and team-building.”

For that project, hospitalists, nurses, pharmacists, nutritionists, and physical and occupational therapists came together to re-examine the rounding process that had been established with guidance from the hospital’s Lean Sigma quality improvement group.

With Dawson’s help—and some conversational prompts borrowed from improvisational comedy—the group discovered that “the old physician-dominated power dynamic” still needed tweaking in order to ensure a better flow of information.

Hubsters meet with individuals as well as groups. Dawson recalls that nurse Maria Roberts, who was concerned about a slight increase in central line infections, sought help in devising an effective reminder to more carefully “scrub the hub” portion of the catheter. Such brainstorming resulted in “Do the Twist,” a poster of an alcohol twist pad dancing with the hub that promotes a 15-second cleaning.

Silvia Ochs, manager of lactation services at Sibley, received guidance on developing a better system of renting and billing breast pumps to women who deliver babies at Sibley. Flaws built into the “antiquated and cumbersome system” caused staff to spend too much time on paperwork, led to errors in billing and raised potential credit card security problems.

With the help of Sibley executives and the Hub team, Ochs now uses a credit card reader that can easily handle rental transactions and a secure online billing system that is now used by other groups at Sibley. 

“And the story doesn’t end there,” Ochs says. “The new system will also help us to expand our services and do more outpatient consults.” On the integration front, she’s now sharing her knowledge with a lactation consultant at Howard County General Hospital who wants to start a similar program.   

People-Centered Innovation

“Sibley is encouraging people to think about innovation as people and process as well as technology,” says Christy Wyskiel, The Johns Hopkins University’s senior adviser to the president for enterprise development. “It’s not unlike what Peter Pronovost and the Armstrong Institute are doing: questioning every process that can happen in a hospital setting. The Innovation Hub is serving as a testing ground for nurses and physicians to make sure they’re giving the patient the best care.”

How will Davis measure the impact of the space he describes as feeling like “a cross between Starbucks, Google and an airport lounge”?

“A successful first year will mean that this innovative way of thinking is adopted by our culture at Sibley: by our patients, physicians, community doctors and staff, as well as those of us in leadership who are really trying to challenge our mental model of how to solve problems.” 

—Linell Smith and Gary Stephenson

Read more about the strategic priority for people online at hopkinsmedicine.org/strategic_plan.

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A SAMPLE OF A DESIGN-THINKING APPROACH

“Take a simple problem—say the patient arrival experience. We say, ‘Let’s think of everything we’ve felt when we take our grandmother to the hospital, or when we’ve been hospitalized ourselves.’ We name those emotions and map out the journey based on them. That redefines the problem: We’re no longer talking about arriving at the hospital; we’re talking about removing the anxiety and stress and fear of the unknown. So we’ll do an improvisation exercise, and I’ll tee it up with a weird idea like: ‘What if we did Uber for health care and you could call a nurse to your house the night before to explain the procedure to you?’ And someone will say, ‘Amazon does something like that.’ Then, we say, ‘Work in teams and put together your idea, even if it’s really wild.’ Now we’re going to implement a prototype for valet parking that came out of one of those teams.”

Nick Dawson

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DEVELOPING POTENTIAL

Sibley’s Innovation Hub is one of many teams throughout Johns Hopkins Medicine dedicated to encouraging innovative ideas and helping to implement them. A partial list includes: 

  • Johns Hopkins Technology Transfer is the university’s intellectual property administration center, serving Johns Hopkins researchers and inventors as a licensing, patent and technology commercialization office and acting as a liaison to parties interested in leveraging university research or materials for academic or corporate endeavors.
  • FastForward, a catalyst for the advancement and commercialization of Johns Hopkins innovations linked to Tech Transfer, provides early-stage office and meeting spaces and labs for university startups. FastForward is located in the Stieff Silver Building, and another space will open early next year in the Rangos Building.
  • The Johns Hopkins Medicine Technology Innovation Center works with physicians and nurses to jointly develop applications using a Web-based, clinically integrated development platform.
  • Johns Hopkins HealthCare Solutions connects the marketplace to research-based products and services derived from the work of Johns Hopkins’ medical, public health and nursing faculty, clinicians, staff and students.
  • The Armstrong Institute for Patient Safety and Quality promotes initiatives such as Project Emerge, a program to redesign the intensive care unit to better meet the needs of patients and their families. 
  • Howard County General Hospital’s Office of Innovation and Continuous Improvement promotes the development of new tools such as a surgical scheduling app that helps reduce surgery cancellations and delays for patients.