Everyone is talking about innovation in healthcare. In theory, innovation improves care and outcomes and lowers costs but in practice, innovation requires a lot of groundwork. Innovation centers keep popping up and each has its own mission and motive. Clinical Innovation + Technology spoke with the leaders of several U.S. innovation centers to learn more about these organizations. What do they hope to achieve and how, who is involved and is this a trend or an integral part of healthcare going forward? Read on to find out.
The U.S. healthcare industry was facing a crisis with or without the healthcare reform law, says Terry Leach, RN, executive director of the University of California Center for Health Quality and Innovation in Los Angeles, but the legislation “accelerated the conversation."
Leach’s varied experience, from health policy professor to public health nurse to healthcare attorney, showed her that confining the provision of illness care to the four walls of a hospital results in treatment episodes, not a wellness paradigm. The question is how to use hospitals most efficiently, she says. When people use the emergency department as their primary care provider, “that’s a prime example of misallocation of resources contributing to increasing spending of healthcare dollars.”
The 18 percent of U.S. gross domestic product going to healthcare is not sustainable. The upward trending of that percentage was heading for a crisis that “demanded that every stakeholder get involved.”
Getting off the ground
Among its five medical centers, UCLA had expertise in virtually every field and could support a multidisciplinary innovation center and began to do so in October 2010. The bumps in the road have come in cataloging where that expertise lay and learning how to identify and disseminate best practices.
The center does not aim to reward researchers for autonomous behavior, she says. “The only way we’re going to survive as a system is if we inculcate collaboration into our mission. But there is no science of teamwork or collaboration.” The first request for proposals was deliberately written to encourage projects that used interdisciplinary teamwork and where patient centeredness was one of the objectives, she says.
They expected to get about 10 RFPs during that first round but received more than 100. To manage the work, they created an operations committee that included the chief medical officers of all five medical centers and the majority of chief nursing officers.
One of the major questions for all projects is how to work with patients as partners in their healthcare. “That’s a whole new paradigm for academic medical centers,” Leach says. RFPs are geared to rechannel the “vast intellectual capacity at the University of California and help us create a cadre of innovators.” Those that receive funding are expected to mentor others, take advantage of the institution’s leadership training and participate in the center’s annual colloquium to share their work.
“There’s a lot more than money we can give people to help them become a successful change agent. Money is great but it’s not enough.” Very few successful people work in a vacuum, she says, so they now ask that applicants identify a mentor to help them innovate on their home campus.
'Learning is social'
The MacColl Center for Health Care Innovation, part of the GroupHealth Research Institute in Seattle, also focuses on relationships, says Director Michael Parchman, MD, MPH. The center was established 20 years ago by Edward H. Wagner, MD, MPH, considered the father of the chronic care model, as a result of GroupHealth’s nonprofit, consumer-driven culture.
“The natural receptor sites for this kind of work were safety net settings,” says Parchman, where Wagner started off building an evidence base around chronic care. Over the past 20 years, the center has built a lot of strong relationships and ties to safety net organizations across the country. “A lot of what we do is facilitate learning by helping connect these safety net clinics and health centers in a way that they can learn from each other. Learning is a social activity.”
Those safety net providers keep the MacColl team grounded, he adds. “We’ve taken time to visit with them, find out about their challenges.”
The center is very tightly connected to the GroupHealth delivery system. “We have our feet firmly grounded in the operation side of things which serves as a reality check as far as what will or won’t work in the