Nurses devise their own innovations

If necessity is the mother of invention, Massachusetts Institute of Technology researchers Anna Young and José Gómez-Márquez figured they would find cheap, practical innovations in the small Nicaraguan town of Ocotal, 3,000 miles from Cambridge. The object of their 2011 search was to find creative doctors delivering quality care at low cost by using locally procured fabrics, electronics and other supplies.

“We thought we were going to find MacGyver-like doctors coming up with their own medical devices,” Young said. But after more than five months of searching, “we couldn't find said doctors anywhere.”

What they found were nurses.

From IV alarms made from parts of deconstructed electronic toys to goggles to protect the eyes of neonatal patients undergoing phototherapy treatments, they found nurses “MacGyvering” ideas left and right.

That finding led to funding from the Robert Wood Johnson Foundation and others for a project to investigate whether the nurse-innovator phenomenon could be honed in the U.S. In September 2013, Young and Gómez-Márquez co-founded MakerNurse and launched a study that set up temporary do-it-yourself medical-device workspaces in six U.S. hospitals.

The “maker” spaces function as a cross between a science lab and a builder's workshop. They are stocked with adhesives, fasteners, electronics, pliers, sewing needles, laser cutters and even 3-D printers. Nurses with bright ideas can use the spaces to create objects that improve patient care.

Innovations often rise out of practical issues, said David Marshall, chief nursing officer of the University of Texas Medical Branch at Galveston, a U.S. test site for MakerNurse. Based on the results of the pilot, UTMB unveiled the first permanent space for its providers last month.

Even before the pilot, a nurse at UTMB made weekend trips to Home Depot to create a device for the cardiac catheter lab that elevates and secures patients' wrists during procedures. It used to be done by using a stack of towels. Another nurse created a medication belt so she could remain hands-free while delivering prescriptions to imprisoned patients.

Nurses' innovations don't always get the limelight and are often overshadowed by bigger, more expensive technologies, Marshall said. “But if what they make helps patients to be more comfortable or assist with providing care, we're happy to support them.”

Seeing an idea they conceived materialize and put to good use is satisfying and taps staffers' full potential, said Dr. Mark Smith, director of the MedStar Institute for Innovation, Washington, D.C.

MedStar has been creating an “ecosystem for innovation” that includes an inventor program for creative health information technology ideas, simulation laboratories to test sophisticated medical equipment and human factor and usability testing to prevent safety mishaps from newly introduced medical devices.

Though not a participant in the MakerNurse project, Smith said he finds the concept “definitely intriguing. It fits into the broader construct of trying to deliver the tools, systems and assistance that enables staff to be the best they can be.”

Young said the MakerNurse concept thrives in places where the review process lasts weeks, not months. Any creation made by hospitals in the study is submitted for an internal review before being used on actual patients. Meeting Food and Drug Administration requirements can also be a factor.

The labs in the study are stationed at Bon Secours St. Mary's Hospital in Richmond, Va.; Driscoll Children's Hospital of Corpus Christi, Texas; Maimonides Medical Center in New York City; the Mayo Clinic in Rochester, Minn.; South Shore Hospital in South Weymouth, Mass.; and the Sierra Providence Health Network and the Texas Tech University Health System, both in El Paso.

Young and Gómez-Márquez expect to publish findings by early 2016. Their goal is to create a national network for sharing maker space innovations. Although the initial project focused on nurses, the do-it-yourself concept can be used by any hospital staffers.

Healthcare works best when people share ideas collaboratively, said Young, one of a few people selected to speak at the annual TEDMED conference in November. “There is this stealth community of innovators in healthcare. But they are not connected and are not sharing what they are making.”