Evolution of Nurse-Led Hackathons, Incubators, and Accelerators from an Innovation Ecosystem Perspective

  • Olga Kagan, PhD, RN
    Olga Kagan, PhD, RN

    Olga Kagan is an adjunct faculty at CUNY SPS and Molloy College. She holds a Baccalaureate degree in nursing from Hunter-Bellevue School of Nursing, a master’s degree in Nursing Informatics and Administration, and a PhD from Molloy College. She is a founder of OKHCC, a healthcare consulting firm serving individuals, groups, and communities within public and private sectors. Dr. Kagan founded Food Allergy Nursing Interest Professional Group (FANI) on LinkedIn; and received honors and awards for her contributions to nursing research and health policy. Dr. Kagan is a member of the ANA, NYAM, HIMSS-NY, AAAAI, ENRS, and SONSIEL. Currently, she serves as an elected member on the board of ANA-NY, on the CUNY SPS Governing Council; and on the advisory board of the Center for Nursing Research and Evaluation at Molloy College.

  • Joshua Littlejohn, MPH, MSN, RN
    Joshua Littlejohn, MPH, MSN, RN

    Joshua Littlejohn has over ten years of experience across the healthcare ecosystem to create products and experiences that bring value to patients, providers, and communities. He has a particular passion for products that keep us healthy and foster better connections between people. Joshua began his career in healthcare as a bedside nurse at Tulane Hospital in New Orleans and holds two master's degrees from the University of Pennsylvania in Nursing -Healthcare Leadership and Public Health. Since 2015 he has focused on enhancing the delivery of home and community care using technology. His diverse background in bedside nursing, public health, clinical informatics, and technology has provided a solid platform for creating a range of products. These include communication toolkits used by community health workers in rural Africa, cloud-based data visualization products for multi-hospital health systems, and consumer-facing digital healthcare platforms delivering virtual caregiving to families and clinicians under DaaS and SaaS models.

  • Hiyam Nadel, MBA, RN, CCG
    Hiyam Nadel, MBA, RN, CCG

    Hiyam M. Nadel is the director of the Center for Innovations in Care Delivery at Massachusetts General Hospital. In this role, she is both a mentor and incubator of ideas for front-line caregivers, conceiving an idea to prototyping and beyond. She is currently an inaugural Johnson & Johnson Innovation Fellow. She earned a BSN from Northeastern University, Clinical Genetics Certificate from Brandeis University, and an MBA from Babson College, focusing on innovation and entrepreneurship. She is a Founding member of the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders. The most recent award she has received is the 2020 Extraordinary Women Advancing Healthcare Award from the Commonwealth Institute. This award recognizes ten remarkable women in Massachusetts who are emerging and inspiring leaders pioneering advances across healthcare and who demonstrate collaboration, mentor others, and encourage diversity.

  • Marion Leary, MSN, MPH, RN
    Marion Leary, MSN, MPH, RN

    Marion Leary is the Director of Innovation at the University of Pennsylvania School of Nursing. As the Director of Innovation at Penn Nursing, she works to amplify and educate nurses as health and healthcare innovation leaders. Ms. Leary is a member of the American Nurses Association Innovation Advisory Board and a Founding member of the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders (SONSIEL). She is a host of the University of Pennsylvania School of Nursing podcast, Amplify Nursing, and a contributor to the American Nurses Association's official journal, the American Nurse, as part of the My Nurse Influencer's column. In August 2019, she was named an Influencer of Healthcare winner in the category of Excellence in Innovation by the Philadelphia Inquirer.

Abstract

Nurses are continually innovating to fill gaps or inefficiencies within healthcare. This was particularly evident during the COVID-19 pandemic, when a burst in nurse-led innovation in all areas of healthcare and across the lifespan necessitated an innovation ecosystem to realize nurses' full potential. New ways of thinking and leading the future of nursing have been echoed by the National Academy of Medicine’s Future of Nursing Report 2020-2030, the American Nurses Association (ANA) innovation task force, and the American Nurses Credentialing Center (ANCC). Nurse-led hackathons, incubators, and accelerators have emerged to meet the need for a more intentional and formal pathway for nurses to add value to health and healthcare within an innovation and design thinking framework. This article describes a brief historical background of hackathons, innovation incubators, and innovation accelerators and considers their evolution within the nursing profession, including implications for practice and education.

Key Words: innovation; hackathons; incubators; accelerators; healthcare innovation; human-centered design; design thinking; nurse-led innovation

Nurses have been innovating throughout history, often out of necessity...Nurses have been innovating throughout history, often out of necessity, because they encounter gaps or inefficiencies in processes, products, or equipment within the healthcare system. The World Health Organization ([WHO], n.d.a) defines healthcare innovation as developing and delivering new or improved health policies, systems, products, technologies, services, and delivery methods that improve people's health. Innovation responds to unmet needs by employing new ways of thinking and working adding value in improved efficiency, effectiveness, quality, safety, and affordability. It can be preventive, promotive, therapeutic, rehabilitative, and assistive care (WHO, n.d.a).

Nurse-led innovation centers the nurse as the subject matter expert and lead driver...Nurse-led innovation centers the nurse as the subject matter expert and lead driver of the ideation, creation, and implementation of new or existing ideas into practice. This process is best achieved through the human-centered design approach, which focuses on the needs of the individual(s) experiencing a problem to create or collaboratively develop a solution that meets their needs (Chung, 2014; David Kelley, n.d.).

...instead, there has been a deficit in recognizing nurses as innovators within healthcare.Nurse-led innovation is not a new concept; instead, there has been a deficit in recognizing nurses as innovators within healthcare. However, that is starting to change. Recently innovation has been recognized as a competency and imperative for the profession by several organizations, including the American Nurses Credentialing Center (ANCC) Magnet status designation and the American Nurses Association (ANA). Most recently, the National Academies of Sciences, Engineering and Medicine Future of Nursing 2020-2030 report underscored the need for nurses to be innovators, stating that it will take an innovative mindset infused with the knowledge and application of human-centered design to do so. (ANA, n.d.; ANCC, n.d.; NASEM, 2021). Healthcare institutions have an opportunity to leverage nurses and their allied colleagues to address some of the most challenging issues today by systematically supporting their involvement in open innovation efforts, including hackathons, incubators, and accelerators.

Background

For this article, nurse-led innovation is defined as an act of creating or improving an existing product, system, process, or service that adds value where nurses lead the effort. Two recent events have highlighted nurses’ contributions in this area: the global COVID-19 pandemic and the International Year of the Nurse and Midwife designation by WHO. Since the start of the COVID-19 pandemic nurses have played an integral role in multidisciplinary teams and have contributed their expertise to the development of services and products to meet the needs of populations around the globe (WHO, n.d.b)

Unfortunately, nurses do not often see themselves as innovators.Unfortunately, nurses do not often see themselves as innovators. This can be explained by gaps in nursing curricula and the absence of nurse-centered innovation in the workplace. Lacking knowledge of innovation methodology, nurses engage in one-off problem solving, leading to the same problem being addressed repeatedly in silos, with nurses’ innovations lost over time. To encourage nurses as innovators and provide active learning environments where nurses can collaborate with other interdisciplinary professionals, we will describe three essential innovation experiences: hackathons, incubators, and accelerators (see Figure 1).

Figure 1. Key Means of Accelerating Nurse-Led Innovation: Hackathons, Incubators, and Accelerators

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(Bone et al., 2017; HackerEarth, 2021; Richards, 2021)

...no single stakeholder has all the resources necessary within its own institution to create the best solution...Literature outside of the nursing discipline highlights open innovation (OI), a term coined by Chesbrough (2003) to describe a collection of innovation methods used in many industries today, including healthcare. OI is a collective, collaborative approach to innovation that starts with the understanding that no single stakeholder has all the resources necessary within its own institution to create the best solution to any given problem. In OI, organizations use both external and internal ideas. Making organizational boundaries become more porous allows greater mobility of ideas (see Figure 2) (Chesbrough, 2003; Durmusoglu, 2004).

Figure 2. The Open Innovation Model

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(Chesbrough, 2003; Used with permission)

Most nurse-led hackathons, incubators, and accelerators were created to respond to this need and to increase intentional collaboration with stakeholders from other industries. These opportunities empower and connect nurses with resources and professionals with diverse skill sets, thereby helping to bring their innovation to fruition.

Hackathons

Hackathon events were pioneered by engineering and computer science but have found their way into healthcare...The term "hackathon" is a blending of the words "hacking" — the identification of a simpler and more efficient way to achieve a goal, and "marathon" — a test of endurance, of extended periods of time and effort (Merriam-Webster, n.d.). Hackathon events were pioneered by engineering and computer science but have found their way into healthcare as a way to bring together stakeholders who understand common problems with people who have the knowledge and experience to build solutions that can address them. Hackathons are time-limited design sprints, typically completed over a weekend, which provide highly focused pathways to reconstruct (i.e., hack) new and effective changes in patient care and system needs (Chowdhury, 2012; Briscoe, & Mulligan, 2014).

These teams include patients, nurses, doctors, engineers, developers, designers, and business, insurance, and policy experts.One of the more well-known and longest-running healthcare hackathon organizations is Massachusetts Institute of Technology (MIT) Hacking Medicine, which has run over 175 events across 29 countries and five continents since 2011 (MIT Hacking Medicine, n.d.). MIT Hacking Medicine-led hackathons bring together diverse multidisciplinary teams that span the entire healthcare ecosystem. These teams include patients, nurses, doctors, engineers, developers, designers, and business, insurance, and policy experts (MIT Hacking Medicine, n.d.). These hackathons have resulted in the creation of 50 companies, and over $240 million has been raised in venture capital.

During the early stages of the COVID-19 pandemic, the MIT COVID-19 Challenge series of events was implemented by this organization to address the changing needs of populations around the globe as the pandemic progressed. Due to the central role of nurses during the pandemic and the International Year of the Nurse and Midwife, (WHO, n.d.b) nursing expertise was actively sought and highly valued at these events. Despite this, nursing representation remained low, highlighting the challenges of including nursing voices within innovation initiatives (Koszalinski et al., 2021).

The lack of nurse representation is now being addressed through nurse-led hackathons.The lack of nurse representation is now being addressed through nurse-led hackathons. The first nurse-led hackathon was held at Northeastern University School of Nursing in 2016, with over 200 nurses in attendance (O'Connell, 2016). The goal was to flip traditional technology-focused events and center the hackathon around nurses and other front-line clinicians to address real-world problems and create innovative solutions. In response to the COVID-19 pandemic, the NurseHack4Health (NH4H) hackathon series was launched, addressing the needs of nurses nationally and internationally (SONSIEL, 2019). The NH4H virtual hackathon is an outgroup of an in-person event in collaboration with the Society of Nurse Scientists, Innovations, Entrepreneurs, and Leaders (SONSIEL) and Johnson & Johnson in 2019. This in-person hackathon was transitioned to a semi-annual virtual format with the assistance of additional collaborators, Microsoft, and devup during the COVID-19 pandemic (University of Pennsylvania School of Nursing, 2020).

The NH4H virtual hackathon takes place twice a year on the Microsoft Teams (n.d.) platform. Similar to in-person hackathons, the event runs over a weekend, starting with nurses and others pitching problems they want to create a solution for on Friday night, and ending with pitch presentations of the solutions created on Sunday afternoon. During that time, nurses, designers, entrepreneurs, engineers, and others form teams around the topics and work over the weekend to create minimally viable products (MVPs) or low-fidelity prototypes that accurately depict how the solution would solve their problem.

...teams work with mentors to form problem statements, ideate solutions, create a prototype, and test solutions.During the event, teams work with mentors to form problem statements, ideate solutions, create a prototype, and test solutions. Teams also receive design thinking education, attend practice pitch sessions, and can network with other like-minded innovators and mentors. Coaches and mentors who help teams during the hackathon provide domain or regional expertise; challenge team ideas to push the problem statement and solution forward; and direct teams to appropriate resources. The final pitch event is a fast-paced presentation that addresses the background, problem, and solution presented to a panel of expert judges such as venture capitalists, healthcare administrators, and business leaders.

...there were over 200 nurses who worked together with others to create solutions for problems faced within and outside of the United States.The most recent NH4H held in May 2021 was a testament to the nurses' abilities to work with professionals around the globe to collaborate and address the needs of various populations. Over 700 students and professionals from diverse backgrounds from 26 countries, 39 states, and Washington DC, registered for the virtual hackathon (J. Littlejohn, personal communication, May 16, 2021). Notably, there were over 200 nurses who worked together with others to create solutions for problems faced within and outside of the United States. This demonstrates how intentional and well-supported nurse-led innovation can address unmet needs within the organizations where nurses learn, work and lead.

Several notable products and services have emerged from these nurse-led hackathons since 2017, including the IV SafeT Lang Lock intravenous (IV) medical device to secure IV tubing to the IV catheter or other IV tubing and accessories (McLaughlin & Watman, n.d.); the uNight Light hands-free LED night light to improve visibility for night shift nurses (Lumify Care, n.d.); and the Fifth Window App (formerly WellNurse) to improve the well-being of the clinicians (Fifth Window, 2021).

Innovation Incubators

Innovation incubators are designed to take an early-stage idea and develop it further with research and testing.The term incubator, which arose for the first time in the 1970s in the United States, was associated with the incubation of companies (Stein Backes et al., 2015). Innovation incubators are designed to take an early-stage idea and develop it further with research and testing. Incubators assist startup companies with dedicated time and resources focused on business development to create a sustainable business model (Gilhuly-Mandel, 2018). From the idea stage onward, startups entering incubators can be supported for months, with higher equity taken in each startup. Incubators provide resources until startups are in position to receive external investments. (Gilhuly-Mandel, 2018).

One example of a nurse-led innovation that spun from an incubator is the Virtual Reality Sudden Cardiac Arrest (VR SCA) system (Karwat & Leary, 2018). The VR SCA system placed 3rd in the final pitch event at the 2016 Philadelphia Social Innovation Lab, a 15-week social sector enterprise incubator. The team then created a company through the University of Pennsylvania’s Penn Center for Innovation Ventures called ImmERge Labs to commercialize this technology. While the company has since dissolved, the VR SCA technology is currently being licensed to a development company (M. Leary, personal communication, June 17, 2021).

An example of a nurse-led incubator within a healthcare system is The Center for Innovations in Care Delivery at Massachusetts General Hospital in Boston, whose focus is on influencing practice through interdisciplinary innovation. It reflects the belief that nurses and other patient care professionals are in the best position to recognize inefficiencies and gaps and identify opportunities for improvement in care and services. (H. Nadel, personal communication, July 2021).

Applicants must perform a preliminary market search to see if any solutions already exist...To accomplish this, The IDEA (Innovation, Design, Excellence, Awards) Program was created in 2017 to award two individuals or teams $5,000 grants to mature their solution. The application process includes questions that encourage the applicant to think critically about their solution beforehand. Applicants must perform a preliminary market search to see if any solutions already exist; if so, they must consider how their solution(s) will differ or what gaps their product will fill. A proposed budget requires details about how the money will be spent and projected milestones. These application components are common to many incubators; the application process introduces a forcing function to reflect on the venture and acts as an educational tool such that the questions differentiate this process from a research or quality improvement application.

The committee that judges the applications includes leaders throughout Massachusetts General Hospital, past recipients of the IDEA awards, community members, other interdisciplinary staff, designers, and people involved in the supply chain. IDEA grants are awarded to individuals and teams who have ideas that will advance, enhance, or improve patient care; score the highest on criteria such as measurable outcomes; and have the likelihood to make a significant, sustainable difference in practice.

Once a prototype is complete, concept testing and design iterations with constant feedback from the end-users are initiated.The center's most important and unique offering is one-on-one mentoring by the director; the awardee spends 6-8 months with access to the mentor. (Wicks, 2019). IDEA recipients are taught Human-Centered Design methodology, the importance of building prototypes, and testing for proof of concept. Once a prototype is complete, concept testing and design iterations with constant feedback from the end-users are initiated. The vision for this one-on-one mentoring is centered on success and scalability for the awardee and the belief that awardees will then teach others and become innovation champion for their units and specialties. As of publication, there are eight projects in differing stages of development or commercialization.

Several notable examples include ‘Grab-a-lab’, a piece of proprietary medical equipment that dispenses clear, plastic bags in real time to allow healthcare providers to securely obtain and transport lab specimens while avoiding cross contamination of viruses and bacteria (Massachusetts General Hospital, 2020); JRAD, a bathroom safety harness to keep patients safe while maintaining their dignity and privacy while toileting (Giuliano, 2017a; 2017b); the blood transfer shield, a closed system device to transfer blood into pediatric microtainer tubes to prevent anxiety of accidental exposure to blood for staff while reducing needle and splash injuries (Smith, 2019). These, and several other innovations, have provisional patents in place.

A critically important gain from the IDEA incubator has been the joy and empowerment the nurses and other front-line staff feel...A critically important gain from the IDEA incubator has been the joy and empowerment the nurses and other front-line staff feel from learning these new skills and using design thinking and creativity to solve problems they encounter every day.

Innovation Accelerators

Innovation accelerators take an established minimum viable product (MVP), develop a company around it, and are often pivotal to the success of young ventures (Gilhuly-Mandel, 2018). Accelerators aim to help individuals and startups achieve a level of business growth in months instead of the years that would be required if they were to pursue it independently (Gilhuly-Mandel, 2018). They assist startups with the development of projects and provide the foundational resources to form strong value propositions to attain external funding (Gilhuly-Mandel, 2018). Accelerators typically work very closely with multiple partners across industries and corporations to partner with the concept and provide mentorship.

The innovation accelerator is designed as an educational opportunity for the applicants...Many accelerators within healthcare (Digital Health Today, n.d.) provide early stage medical device and healthcare technology companies with an entrepreneurial curriculum and personalized business development plans to accelerate go-to-market and investment possibilities. These are more commonly supported by institutions and play a crucial role in healthcare innovation (McVeigh, 2021). However, even as recently as 2017, only one documented nurse-led startup emerged from a healthcare accelerator (Anonymous, 2017). Today, this gap is being filled by emerging nurse-led accelerators inside and outside of academic and healthcare institutions, such as the Penn Nursing Innovation Accelerator (University of Pennsylvania School of Nursing, 2021) and newly launched Nursing Innovation Hub (NIHUB), which includes an accelerator component (Aaron, n.d.).

The University of Pennsylvania School of Nursing (Penn Nursing) launched its innovation accelerator program in 2020 to provide faculty and students with a structure to develop an innovation idea that includes an existing low-fidelity prototype. The Penn Nursing innovation accelerator is a 10-month program that provides up to $10,000 in funding, education, and mentorship. The innovation accelerator is designed as an educational opportunity for the applicants and those who ultimately advance to the innovation accelerator program. To focus on the innovation accelerator's educational goal, a 3-round process was created.

For Round 1, applicants provide a comprehensive application, including a problem statement, approach, and description of the population affected. A detailed timeline with milestones is required, along with the amount of funding requested, up to $10K.

Information sessions are held to prepare applicants for the submission process. During these sessions, applicants receive an overview of the accelerator program and details of each stage, including the criteria for review, how to write a problem statement, and what information and materials to include in each round. Applications are reviewed by the Penn Nursing Innovation Advisory committee members and ranked on the value of the innovation in health and healthcare, the team's strength, their ability to assemble other team members with needed skill sets, and the feasibility of scaling up the idea.

Information sessions are held to prepare applicants for the submission process.Selected round 1 applicants move to the second round. This consists of a 30-minute interview where the teams describe their project in greater detail, including their budget with justification, and demonstrate their low-fidelity prototype. Prior to the interview dates, all finalists are offered an education session with a business librarian to learn about the strategic management template, Business Model Canvas (Business Models Inc., 2021). The 1-hour session includes an overview of a Business Model Canvas, a review of each component (e.g., budget), and resources such as databases and websites where various health and healthcare business data can be found.

Finalists emerging from the second round are invited to round 3, where they present at the pitch event to a panel of innovation and entrepreneurship judges from the University of Pennsylvania, the greater Philadelphia Innovation and Entrepreneurship ecosystem, and nursing innovation and entrepreneurship leaders. Round 3 applicants are given a pitch template to use for guidance and provided a 30-minute practice pitch session with feedback from innovation and entrepreneur experts. Teams also meet with Penn Center for Innovation colleagues to review any intellectual property (IP) concerns and discuss the patentability of their solution.

In addition to providing up to $10k in funding, participants receive mentorship from within Penn Nursing and outside mentorship from innovation and entrepreneurship experts. All participants’ needs are assessed at the start of the accelerator program; they are matched with appropriate mentors based on these needs. Periodic educational sessions are curated to meet the needs of individual teams. Specific resources are provided as supplemental materials (e.g., reading, listening, watching materials) to assist in the educational process.

For nurses to lead in health and healthcare innovation, they need the mentorship, resources, and support...Though conceptualized to provide funding, the Penn Nursing innovation accelerator is an educational opportunity to teach students and faculty the entrepreneurial language and process. For nurses to lead in health and healthcare innovation, they need the mentorship, resources, and support to create a foundation to take their ideas to the next level. The goal of the Penn Nursing Innovation Accelerator is to serve as a starting point where Penn Nursing faculty and students can take the innovations created and apply for other programs, funding, and ultimately commercialization.

To date, the Penn Nursing Innovation Accelerator has three teams actively participating. Despite the difficulties posed by the pandemic, the current teams are at various stages of development. One team, focused on monitoring heart failure in older adults, is working with a company to produce a high-fidelity prototype of heart failure monitoring socks to test with patients (P. Cacchione, personal communication, June 17, 2021). The remaining two teams are working on devices to address post-partum hemorrhage, as well as a device to prevent elopement by children with autism, respectively. Both teams are in the process of becoming limited liability companies (LLCs) while also applying for more funding, developing prototypes, and testing with patients and consumers.

Discussion/ Implications

There are 19 million nurses worldwide and 4 million in the United States (AACN, 2019; NCSBN, 2020). To bring health and healthcare innovations from conception to fruition, we need nurses and the nursing profession to embrace the innovation ecosystem. By working on interdisciplinary teams, nurses can leverage their skills, knowledge, and experience as subject matter experts (Koszalinski et al., 2021).

Participation in hackathons, incubators, and accelerators offers ways for nurses to grow knowledge, experience, and resources within the innovation ecosystem.Participation in hackathons, incubators, and accelerators offers ways for nurses to grow knowledge, experience, and resources within the innovation ecosystem. For example, the NH4H brought nurses together with colleagues in other disciplines such as engineers, designers, and entrepreneurs. This was an effective way to build diverse teams and validate ideas. It constitutes the first step in launching an innovation, and perhaps most importantly, developing an entrepreneurial spirit and mindset.

However, the output of a successful hackathon is often only the initial seed of an entrepreneurial venture. These ideas need further research, refinement, and support to become viable, sustainable solutions to the problem that was "hacked." This is where the innovation ecosystem becomes increasingly important, incorporating incubators and accelerators, and where leaders from inside the profession are needed to encourage participation.

The challenge is to make apparent the value that nurses and other clinicians bring to the table.Nurses pride themselves on their technical skills and ability to bring high value and experience to clinical care and all other areas where nurses work and practice. In the context of innovation, these skills are not always valued, and therefore, nurses may not always view themselves as innovators. However, as the individuals who spend the most time with patients and use technology in all aspects of their work, nurses are the most qualified to identify problems in the various care settings along a patient's journey. The challenge is to make apparent the value that nurses and other clinicians bring to the table. Without this, solutions may not be relevant to the problems they purport to solve. That is why it is imperative that nurses show up at these events, participate in hackathons, and move their ideas forward through incubators and accelerators.

...some attention is being given to re-thinking nursing program curricula, with the inclusion of design thinking and innovation.In the context of nurse-led innovation, hackathons, incubators, and accelerators propel nurses to develop and deliver products, technologies, policy, and services to improve health and healthcare in all care settings around the world. Although we have a long way to go to support nurse-led innovation, some attention is being given to re-thinking nursing program curricula, with the inclusion of design thinking and innovation. In response to the lessons learned from the COVID-19 pandemic, the most recent Future of Nursing 2020-2030 report (NASAM, 2021) stated that nursing innovations improved healthcare in real-time for patients and families impacted by COVID-19. The report predicted that nurse-driven adaptations in education and practice will likely drive lasting changes in both, stating that "These and similar innovations may ultimately guide the way to expanding and improving nursing education" (NASAM, 2021, p. 231). Recommendations from this report for nursing education and nurse educators include competencies related to human-centered design and the acquisition of an innovation mindset.

...it is up to nurse leaders to encourage innovation in the workplace and to make these resources available to nurses.There are several barriers to engagement by nurses in this innovation ecosystem that need to be addressed for them to fully embrace their innovative mindset. First and foremost is the lack of knowledge or awareness of existing innovation resources available to nurses both within and outside of their organizations. As the Future of Nursing document (NASAM, 2021) states, it is up to nurse leaders to encourage innovation in the workplace and to make these resources available to nurses.

With this in mind, we offer several calls to action for consideration:

  • Interdisciplinary Collaboration. Nurses should be leaders in all health and healthcare innovation initiatives. Like health and healthcare, innovation does not work in a silo; nurses should collaborate with other disciplines involved in innovation (e.g., engineers, designers, entrepreneurs) as well as with end-users.
  • Cost versus Benefit. Budgetary considerations must recognize the initial cost of these programs and the short-term loss of nurse productivity must be considered in the context of much greater future gains. We propose that, in the long run, the cost/benefit ratio will be strongly favorable.
  • Education. Nursing institutions and organizations need to provide educational experiences, opportunities, and resources to staff to encourage and support life-long commitment by nurses to innovation. The Design Thinking for Health (DT4H) platform, created by the University of Pennsylvania School of Nursing in partnership with the Rita and Alex Hillman Foundation, is an example of a way to provide this type of education. This is a free, online, open-access curriculum created specifically to encourage nurses to lead in innovation and provide knowledge, tools, and resources to do so (Design Thinking for Health, n.d.). Anyone can use the DT4H platform to create solutions to problems they see in practice and incorporate the material in existing workshops and new educational opportunities.
  • Decision-making Opportunities. Nurse leaders must ensure that nurses, with their unique perspective, are intimately involved at all levels of decision-making when health and healthcare problems and health-system operations are addressed.
  • Time and Compensation. For nurses to fully embrace innovation and move ideas forward, health systems must commit to providing them with the time needed in busy clinical schedules to expand contributions beyond their immediate work environment to allow them to pursue their ideas. Hackathons, incubators, and accelerators take an incredible amount of time, energy, and resources. Nurses should be compensated for that work. These programs provide tangible avenues for organizations to employ in supporting nurse-led innovation. 

The Table offers examples of potential organizational resources.

Table. Nurse-led Innovation and Entrepreneurship Resources

Innovation

Organization

Website

Accelerators

Launch Lane

https://sciencecenter.org/programs/launch-lane

Mass Challenge

https://masschallenge.org/

MCA Americas Nurse Innovator Accelerator

https://mcamericas.org/innovation/startup-support/entrepreneurship-training/nurse-innovator-accelerator

Penn Nursing Innovation Accelerator

https://www.nursing.upenn.edu/innovation/innovation-accelerator/

Techstars

https://www.techstars.com/accelerator-hub

Design Thinking

Design Thinking for Health

http://designthinkingforhealth.org

Health Design Thinking

https://mitpress.mit.edu/books/health-design-thinking

Entrepreneurship

Dreamit

https://www.dreamit.com/

Drexel University/SONSIEL Nurse Innovation & Entrepreneurship Certificate Program

https://drexel.edu/close/programs/sonsiel/

Hackathons

Hack MIT

https://hackmit.org/

Jefferson Health Hack

http://innovation.jefferson.edu/healthhack/

MIT Hacking Medicine

https://hackingmedicine.mit.edu/

Nurse Hack 4 Health

https://nursehackforhealth.org

Hacking Health Camp

http://hackinghealth.camp/about-hacking-health-camp/

Junction Hackathon (Europe)

https://www.hackjunction.com/

Yale Center for Biomedical Innovation & Technology Healthcare Hackathon

www.yalehackhealth.org

Incubators

Innovation Digital Education Academy (IDEA)

https://innovation.massgeneralbrigham.org/about/special-programs/innovation-digital-education-academy

JLabs

https://jlabs.jnjinnovation.com/

Innovation

Johnson & Johnson Nurse Innovation

https://nursing.jnj.com/innovate-with-us

Nursing Innovation Hub

https://innovatenursehub.com/

Nurse Pitch

https://www.himss.org/global-conference/program-nurse-pitch

Penn Nursing Innovation

https://www.nursing.upenn.edu/innovation/

Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders (SONSIEL)

http://sonsiel.org


Conclusions

Nurse-led hackathons, incubators, and accelerators emerged out of necessity...Nurse-led hackathons, incubators, and accelerators emerged out of necessity because nurses needed an outlet to create solutions that improve quality, access, cost, and effectiveness of healthcare. This article has provided an overview of nurse-led hackathons, incubators, and accelerators and demonstrates their ability to unleash nurses’ potential specific to innovation. Based on the barriers and calls to action described above, hackathons, incubators, and accelerators can be included in an academic and clinical educational setting as part of the professional development curriculum. These opportunities, if presented by organizations, can encourage nurses to step outside of their comfort zone.

As the benefits of nurse innovation become more tangible, and recognized from the perspective of the healthcare ecosystem, increased resources can and should be allocated to more sophisticated innovation infrastructure. When given the time, resources, education, mentorship, and partnerships needed to take an idea and turn it into a viable solution, nurses have an opportunity to strengthen the healthcare system and thereby improve outcomes for all.

Authors

Olga Kagan, PhD, RN
Email: Okagan06@lions.molloy.edu

Olga Kagan is an adjunct faculty at CUNY SPS and Molloy College. She holds a Baccalaureate degree in nursing from Hunter-Bellevue School of Nursing, a master’s degree in Nursing Informatics and Administration, and a PhD from Molloy College. She is a founder of OKHCC, a healthcare consulting firm serving individuals, groups, and communities within public and private sectors. Dr. Kagan founded Food Allergy Nursing Interest Professional Group (FANI) on LinkedIn; and received honors and awards for her contributions to nursing research and health policy. Dr. Kagan is a member of the ANA, NYAM, HIMSS-NY, AAAAI, ENRS, and SONSIEL. Currently, she serves as an elected member on the board of ANA-NY, on the CUNY SPS Governing Council; and on the advisory board of the Center for Nursing Research and Evaluation at Molloy College.

Joshua Littlejohn, MPH, MSN, RN
Email: joshua@envoyathome.com

Joshua Littlejohn has over ten years of experience across the healthcare ecosystem to create products and experiences that bring value to patients, providers, and communities. He has a particular passion for products that keep us healthy and foster better connections between people. Joshua began his career in healthcare as a bedside nurse at Tulane Hospital in New Orleans and holds two master's degrees from the University of Pennsylvania in Nursing -Healthcare Leadership and Public Health. Since 2015 he has focused on enhancing the delivery of home and community care using technology. His diverse background in bedside nursing, public health, clinical informatics, and technology has provided a solid platform for creating a range of products. These include communication toolkits used by community health workers in rural Africa, cloud-based data visualization products for multi-hospital health systems, and consumer-facing digital healthcare platforms delivering virtual caregiving to families and clinicians under DaaS and SaaS models.

Hiyam Nadel, MBA, RN, CCG
Email: hnadel@mgh.harvard.edu

Hiyam M. Nadel is the director of the Center for Innovations in Care Delivery at Massachusetts General Hospital. In this role, she is both a mentor and incubator of ideas for front-line caregivers, conceiving an idea to prototyping and beyond. She is currently an inaugural Johnson & Johnson Innovation Fellow. She earned a BSN from Northeastern University, Clinical Genetics Certificate from Brandeis University, and an MBA from Babson College, focusing on innovation and entrepreneurship. She is a Founding member of the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders. The most recent award she has received is the 2020 Extraordinary Women Advancing Healthcare Award from the Commonwealth Institute. This award recognizes ten remarkable women in Massachusetts who are emerging and inspiring leaders pioneering advances across healthcare and who demonstrate collaboration, mentor others, and encourage diversity.

Marion Leary, MSN, MPH, RN
Email: mleary@nursing.upenn.edu

Marion Leary is the Director of Innovation at the University of Pennsylvania School of Nursing. As the Director of Innovation at Penn Nursing, she works to amplify and educate nurses as health and healthcare innovation leaders. Ms. Leary is a member of the American Nurses Association Innovation Advisory Board and a Founding member of the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders (SONSIEL). She is a host of the University of Pennsylvania School of Nursing podcast, Amplify Nursing, and a contributor to the American Nurses Association's official journal, the American Nurse, as part of the My Nurse Influencer's column. In August 2019, she was named an Influencer of Healthcare winner in the category of Excellence in Innovation by the Philadelphia Inquirer.


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Figure 1. Key Means of Accelerating Nurse-Led Innovation: Hackathons, Incubators, and Accelerators

[View full size]

(Bone et al., 2017; HackerEarth, 2021; Richards, 2021)

Figure 2. The Open Innovation Model

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(Chesbrough, 2003; Used with permission)

Table. Nurse-led Innovation and Entrepreneurship Resources

Innovation

Organization

Website

Accelerators

Launch Lane

https://sciencecenter.org/programs/launch-lane

Mass Challenge

https://masschallenge.org/

MCA Americas Nurse Innovator Accelerator

https://mcamericas.org/innovation/startup-support/entrepreneurship-training/nurse-innovator-accelerator

Penn Nursing Innovation Accelerator

https://www.nursing.upenn.edu/innovation/innovation-accelerator/

Techstars

https://www.techstars.com/accelerator-hub

Design Thinking

Design Thinking for Health

http://designthinkingforhealth.org

Health Design Thinking

https://mitpress.mit.edu/books/health-design-thinking

Entrepreneurship

Dreamit

https://www.dreamit.com/

Drexel University/SONSIEL Nurse Innovation & Entrepreneurship Certificate Program

https://drexel.edu/close/programs/sonsiel/

Hackathons

Hack MIT

https://hackmit.org/

Jefferson Health Hack

http://innovation.jefferson.edu/healthhack/

MIT Hacking Medicine

https://hackingmedicine.mit.edu/

Nurse Hack 4 Health

https://nursehackforhealth.org

Hacking Health Camp

http://hackinghealth.camp/about-hacking-health-camp/

Junction Hackathon (Europe)

https://www.hackjunction.com/

Yale Center for Biomedical Innovation & Technology Healthcare Hackathon

www.yalehackhealth.org

Incubators

Innovation Digital Education Academy (IDEA)

https://innovation.massgeneralbrigham.org/about/special-programs/innovation-digital-education-academy

JLabs

https://jlabs.jnjinnovation.com/

Innovation

Johnson & Johnson Nurse Innovation

https://nursing.jnj.com/innovate-with-us

Nursing Innovation Hub

https://innovatenursehub.com/

Nurse Pitch

https://www.himss.org/global-conference/program-nurse-pitch

Penn Nursing Innovation

https://www.nursing.upenn.edu/innovation/

Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders (SONSIEL)

http://sonsiel.org

 

Citation: Kagan, O., Littlejohn, J., Nadel, H., Leary, M., (September 30, 2021) "Evolution of Nurse-Led Hackathons, Incubators, and Accelerators from an Innovation Ecosystem Perspective" OJIN: The Online Journal of Issues in Nursing Vol. 26, No. 3, Manuscript 3.