Episode 13 : Innovate for Impact:

SCTS_Marion Leary: Audio automatically transcribed by Sonix

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Marion Leary:
Welcome to the Smart Care Team Spotlight, presented by Care.ai, the Smart Care Facility platform company and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CMO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
So too often, technology makes caregivers' lives harder, not easier. It's time for smart technology to empower care with a more human touch. I'm so excited to have a luminary, nursing innovator, educator, and thought leader, Dr. Marion Leary, as our guest on the Smart Care Team Spotlight today. Dr. Leary currently serves as the inaugural Director of Innovation at the University of Pennsylvania School of Nursing. She is also a co-founder and on the board of SONSIEL, the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders. In addition, she serves on the board at the American Nurses Association Innovation Advisory Board. During these turbulent times in healthcare, we're excited to have a conversation that will help us paint a clearer picture of the current state and transformational future of the nursing profession. Welcome, Marion, and thank you so much for joining the Smart Care Team Spotlight today.

Marion Leary:
Thank you for having me, Molly. I'm really excited to talk with you.

Molly McCarthy:
Well, I know you're coming off of another nurse hack over the weekend, so I appreciate your time and time away from your students. And I wanted to actually talk a little bit about nursing students as we think about the nursing profession. And I know there's no shortage of statistics that point to the shortage and the continuation of nurses throughout their career. And I'm wondering, as you think about nurses applying to school today, what are their motivations and expectations and maybe bringing in some examples of what you're hearing in the classroom, and how does the reality they are facing regarding the practice of the nursing profession compare or contrast with what originally inspired them to go to nursing school in the first place? That's a long question.

Marion Leary:
So it's funny because I was just talking about this today on another sort of advisory board that I sit on. And yes, I think there is a disconnect between potentially what nurses are learning in their nursing school programs and what they're experiencing once they start to practice in the healthcare setting. And so, there is a retention issue for new grads, and the expectations of what sort of support, mentorship, guidance that they are going to get at the bedside and what it means to be a clinical bedside nurse potentially is not matching the reality. And so I think one of the biggest things that I'm hearing from nurse leaders and from students and new grads is that there is a retention issue, and we need to try and figure out how to have students understand better what it is that nurses are doing at the bedside. I think part of this has to do with the pandemic, right? During the pandemic, it was really hard for nursing students to have clinical experiences or as rigorous of clinical experiences as had happened in the past. And so without those clinical experiences, it's hard to know what you don't know until you graduate and you start working, and you really are in the bed, at the bedside, in the trenches. And so a lot of I do a lot of work around innovation and helping nurses and nurse leaders figure out how to address these problems in an innovative and creative way, so that we can keep our new grads, like students are going into nursing for a reason, right? They want to be in this profession, and so we need to match their expectations, but we also need them to be prepared for the realities. And if that's not happening right now in the way that the new grads need it, we need to figure out ways to meet their needs.

Molly McCarthy:
Right, I know there's a focus, even with the hack this past weekend, on the retention piece, so important. And I'm just curious around the students that you see every day, and first of all, I would love to hear a little bit more about what you're teaching this semester and how you're incorporating the reality of nursing, perhaps, into those courses.

Marion Leary:
Yeah, I am so lucky. So I get to teach a class called Innovation in Health: Foundations of Design Thinking. And so, it is a course that is open to upper-level undergrad students at Penn Nursing, but open to all upper-level undergrad and grad students across the university. So it's an interdisciplinary, flipped classroom approach where the students are solving problems for real health and healthcare problems that they're seeing and working with community members, other healthcare providers, depending on the topic that they're trying to address. And so the course is great because they're unable to teach them these skills, like the innovation methodology, so that they can look at the problems differently and come up with creative solutions to those problems that they can then take and implement in their clinical practice.

Molly McCarthy:
I love that. It reminds me of the MacGyver approach, but I think it's important as nurses, as you mentioned, just to understand that methodology as well as that they have the capabilities and thought processes to come up with strong solutions to their, to the challenges that they face at the bedside.

Marion Leary:
And, well, and to that point, we know that nurses are innovating every day in all the places where they work, right? And so it's, in this class, the point is to expose students earlier to the methodologies and the rigorous way that they can take those ideas, the things that they are MacGyvering and actually implement it, test it, and scale it up in a way that can benefit not just them during one shift, but everyone who is experiencing the same problems. We know that nurses are solving the same problems all the time and creating one-off solutions. That doesn't help anybody except the nurse at that time. So if we can educate students and nurses using this rigorous methodological approach, then hopefully, more nurses will be able to scale up their ideas and help more nurses when they experience the same problems.

Molly McCarthy:
Yeah, and I also think, to your point, with these newer nurses coming in and understanding that methodology that you've taught them, that they can question, why is the workflow a certain way, and could we potentially improve it through different, including different care team members or technology? Of course, I've got the technology background, so I just have to throw that in there. I do want to touch on that. And I started the podcast today with a statement, and I'll just reiterate it, that healthcare technology has too often failed our caregivers. I know this well, whether it be in different point solution, and EMR, etc. I'm just wondering, from your perspective and your tenure within healthcare, your thoughts on that statement, and how do you see it manifesting itself as your students start their careers? And really, what are the consequences of the tech?

Marion Leary:
Well, I mean, it's, I totally, 100%, think that is a true statement, but it doesn't have to be a true statement. It's only a true statement because a lot of technologies are not developed and designed for the people who are going to be using them and with the people who are going to be using them. Again, my background is human-centered design, right? So that means that we are trying to understand the problem from the point of view of the people who are experiencing it. So us as designers, clinicians, researchers, engineers aren't going out and telling people what we think their problem is, but allowing them to show us and tell us what their problem is, and then co collaboratively creating a solution together. And I think that's where technology, especially in healthcare, fails a lot. I used to be a resuscitation science researcher, and I worked a lot with engineers from some of the defibrillator companies, and we would go to these engineers, and they would have never set foot in a hospital, would never have tested their designs with healthcare providers, and then wondered why the healthcare providers weren't using their devices or didn't know how to use their devices because they weren't working with the people who needed these devices. And so I think one of the things that I teach my students is that you have to have an interdisciplinary team working on the solution. Everybody brings a different background, experience, and knowledge to the problem and to the solution. And if you don't have the team members who you need, especially the end users, whoever that is, whether that's clinicians, patients, community members, you're not going to develop the right solution, and you're not going to develop a solution that people are going to use. And so regardless of the setting, if you're developing a new technology, you have to include the stakeholders, and especially in healthcare nurses. Like nurses, my colleague, Doctor Terry Richmond, says this all the time. Every product or process that touches a patient goes through a nurse, so you have to have a nurse on your team. And I'm sorry, I keep talking, if you want to follow up question, but every engineering student, every design student that I talk to, I tell them if you are starting a company or creating an innovation around healthcare, you have to have a nurse on your team, not just as like a consultant, not just somebody you're talking to and gaining information from, but have a nurse on your founding team. You have to.

Molly McCarthy:
I love it. And I did not, I wanted you to keep going, because it's so important that our listeners hear that and really embrace it and understand what that means for us and for product development. It's so key. So that interdisciplinary team, having a nurse at the table throughout the design and development, and deployment process, will end up in a win-win.

Marion Leary:
But it's up to nursing programs to get nursing students ready for that too. They, we have to be educating our students around innovation methodologies so that they feel comfortable being a part of these types of teams. This is the future. This is the future of healthcare. We need to be educating students in an innovation and entrepreneurship mindset so that they can participate.

Molly McCarthy:
That's wonderful. I know that your program there reaches; doesn't it reach more than just the Penn students?

Marion Leary:
Which program?

Molly McCarthy:
The innovation program. I had a friend who said she saw the design thinking, I'm sorry.

Marion Leary:
Yes, so we have a grant through the Rita Hillman Foundation, where we created an online open-access platform that nurses can use to learn about human-centered design and innovation in nursing. And so it's sort of an asynchronous platform that's laid out like the design thinking methodology, which is a five-step process. And so we have read, watch, listen, and activities that you can do if you want to use this methodology, either in your institution or in your academic setting. And I'll just put a plug in since you mentioned it, we are updating that website now, and we're going to be redesigning it with an equity-centered design focus. And so I'm hoping that will launch in early 2024. But that website, the Design Thinking for Health Platform, will now have an equity-centered design framework built into it, because having an equity-centered lens is just more important than just a human-centered design lens, but they go together.

Molly McCarthy:
Thank you. I wanted to make sure that our listeners heard about that, because I know some of my friends have, across the country, have actually seen it. Just building on that last couple of points you made, obviously, you've worked with different emerging technologies, from 3D printing to virtual reality. I know, I think you did some virtual reality in the heart resuscitation program, from what I recall, and we talked about this, but we know to innovate anything, you must first deeply understand the problems that you want to solve. And obviously, nurses know those problems more than everyone, I think I heard you mention that a couple of different times. So something that we've talked about before is just ensuring that our nurses are at the table so that they have a voice. And I just heard you say that you just told someone this morning that you have to have a nurse on your team. So with that in mind, what are your thoughts around incorporating competencies into, around these areas, into your curriculum for new nurses? And have you been able to also scale that with ANA or SONSIEL to really help advance innovation? As you mentioned, we have to be teaching our students about this process in school. Yeah, I've done guest lectures, and I know that their idea of technology might just be an EMR. So tell me a little bit more about your thinking around this.

Marion Leary:
Yeah, so many different responses to that. So at Penn Nursing, I'll speak locally first. In Penn nursing, we are infusing innovation into the curriculum in multiple different ways. So not just the course that I teach, but we are talking about human-centered design and design thinking in undergrad, like pediatric classes, all the way through to doctoral level classes. We have our DNP executive leadership program, which kicked off a couple years ago. And as part of that, for the past two cohorts, we've had a design thinking session as part of the framework for that, the AMP program. So every sort of semester, they learn a new phase of the design thinking process so that they can use that to inform how they're coming up with solutions for their DNP projects. And so we see this as starting early but reinforcing throughout the entire trajectory of a student at Penn Nursing. But it's curricular but it's also extracurricular. We have an innovation accelerator program where our students and faculty can apply for funding, mentorship, and education, to learn about how to create an idea and then scale an idea up. There's, you mentioned the nurse hackathon. We encourage our students and faculty to participate in these types of innovation events so that they can learn these skills and then not only learn the skills, but use them to implement an idea that they have created. Nurses have no shortage of ideas, and so it's really up to us, and to your point, organizations like ANA and SONSIEL, to help support and encourage nurses to be able to take their ideas and create them, and implement them. And both of those organizations are doing that in a variety of different ways. So I sit on the ANA's Innovation Advisory Board, I was a founding member and was on the board of SONSIEL, so there no lack of ways for nurses as individuals to get involved in this space. But to your point, we need nursing schools and nursing programs and health systems to support nurses to learn these things. In the Future of Nursing 2020 report, in there, it does recommend that nurses be educated in these things. I think it's slowly going to happen. I know it's, not all nursing schools are teaching this yet, but I think it will get there because, again, technology, innovation, that's the present and the future, and so, if we want nurses to keep up with all of this, we have to be dedicated to educating them.

Molly McCarthy:
Yeah, I couldn't agree more. And I really like your approach at Penn. You mentioned really infusing it throughout the program, regardless of where they might be in their journey, which is critical. Also, we know technology is changing so quickly, so I think having that throughout their time at Penn is just critical. And speaking of tech, I'm just going to close with one more question around technology before we wrap up. But obviously a lot of enthusiasm around artificial wearable biometric sensors, ambient monitoring, and their potential role to create smart care teams, hopefully smart interdisciplinary teams. And just wanted to get your thoughts on the vision for these technologies in nursing practice currently and then in the future.

Marion Leary:
Yeah, and I think again, a couple of things. I think we have to, as a profession, embrace these technologies and be open to their potential uses. Again, I don't work in a hospital or health system, so it's hard for me to sit here and say what nurses at the bedside should be doing, or health system leaders should be doing. I can only say what I hear and see every day when I talk to nurses and nurse leaders. These technologies aren't going away, and I think we really need to think about how to incorporate nurses who are at the bedside, who are in clinical settings, who are seeing the problems, and then incorporate them into how these technologies are being deployed and used. I know that individuals can sometimes be wary of technologies they don't understand, which is why nurses should be involved early on in the creation and implementation of these types of technologies, and why they should be being taught in nursing school how to use them. I think it goes full circle right back to that retention issue and what new grads are going to see and what they expect if we don't teach them about all these different technologies being used in the healthcare setting, and then they get out, and all these technologies are there, and they don't know how to use them. It can be sort of a culture shock. And so there's a lot of ways that we could mitigate this. Again, don't work in the healthcare setting, so I am sure smarter people than I have thought about these things. But it just goes back to the human-centered approach for me, that we need to have anyone who is going to be affected by new solutions involved in the creation and deployment of them.

Molly McCarthy:
Right, I think that's a great point. As these technologies evolve and enter the marketplace to your earlier points, incorporate nurses into the process.

Marion Leary:
Yeah.

Molly McCarthy:
It's pretty, pretty easy, especially the bedside nurses, because we know they'll have solutions, they'll have problems, and they'll be hopefully willing to participate in voice. Just one final question. Our listeners are CNOs, CNIOs, and their respective teams, I'm hoping also that some nursing schools will tune in. But given your unique lens of knowing what your new graduates bring in terms of talent and expectations coming into the workforce, what is your single most important and practical piece of advice for our listeners today?

Marion Leary:
This is a good one. So as you know, I just finished my dissertation and what I found, I think is really important for nurse leaders and health systems to understand that if you support innovation, if you offer innovation activities, and if you allow your clinical nurses to engage in different innovation workshops and education sessions, they are not only more innovative, but they are more satisfied at their institutions. And so I think in order to reinforce nurses being engaged and innovative, you have to support nurses to be engaged and innovative. And that could mean time away from the bedside to participate in innovation events. But, you know, I think it is a pay-it-forward sort of thing. If you want your institution to be at the forefront of health and healthcare innovation, it starts with nurses and it starts by supporting nurses to be innovative.

Molly McCarthy:
Well, thank you, Marion. I think some great words of wisdom here. Pay it forward, include the nurses in that process, and to your point, they will feel more satisfied, and it goes to what we started the discussion with around retention. So thank you so much for your time and your advice today and your sharing your experience. And we wish you the best of luck in your semester.

Marion Leary:
Thank you, Molly. Thanks for having me on.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight. For best practices in AI and ambient intelligence, and ways your organization can help lead the era of smart care teams, visit us at VirtualNursing.com, and for information on the leading Smart Care Facility platform, visit Care.ai.

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