With unpredictability in the health care marketplace, some hospitals may shy away from the risk of innovation. However, questioning the status quo and working to improve outcomes is consistently worth the investment.
As we have found at Nationwide Children's Hospital, we can attract talented faculty and improve patient outcomes when we cultivate an environment that supports innovation. Encouraging curiosity and providing resources allows health care professionals to be the results-driven people they want to be and we need them to be.
A case in point: at Nationwide Children's, years of scientific effort recently reached fruition with a new gene therapy product offering life-saving outcomes for infants born with spinal muscular atrophy.
We invested in basic and clinical research faculty driven by a need to solve this neuromuscular puzzle. We constructed specialized labs, such as a clinical-grade Good Manufacturing Facility, to support viral vector production for gene therapy. We developed the supporting resources, including staff focused on interpreting FDA regulations and a robust office of technology commercialization to protect and promote our intellectual property.
This infrastructure was expensive, and more than a decade in the making, but the investment is paying off. We now utilize these resources in myriad ways to expand our research in gene and cell-based therapies and to establish a comprehensive genomic medicine program.
While prestigious programs like gene therapy are important, innovation can also occur on a smaller scale and still provide a significant impact. For example, consider recent studies examining overprescribed antibiotics in urgent care centers.
A study in JAMA Internal Medicine indicated that nearly half of antibiotic prescriptions written in an urgent-care center were for conditions that did not warrant their use.
A quality improvement project by physician-researchers at Nationwide Children's, published in Pediatrics, demonstrated that implementing a relatively simple protocol in urgent care centers can substantially reduce unnecessary antibiotic exposure, specifically in urinary tract infections.
When planning for this project began in 2013, urgent care centers within the Nationwide Children's system did not have a process for telling patients with presumed UTI to discontinue antibiotic use when urine cultures were negative. There was also little documentation when follow-up did occur. The clinicians designed a simple notification protocol to inform parents to discontinue the medication if warranted.
The protocol saved 3,429 (40 percent) of a possible 8,648 “antibiotic days.” As familiarity with the protocol grew, and a lab nurse position was dedicated to the task of follow-up, 60 percent of days were saved.
To be an innovation leader, faculty and staff must be grounded in accountability and dedicated to the organization's core strategic plan. Within those parameters, they should be given the latitude not only to conduct their work, but to consider broader questions and explore new opportunities, all in the service of creating best outcomes for patients.
The current volatile health care environment may lead many hospitals to back away from supporting innovation. This would be a mistake. Facilitating an atmosphere that encourages forward thinking, asking questions and conducting research is a vital investment. If done strategically well, it will have long-term benefits for the institution and more importantly for our patients.
Learn more about research and innovations at Nationwide Children's Hospital here.