How OSF HealthCare Is Making the Case for Nursing Innovation at the Bedside

To foster innovation at the bedside, CNOs must provide nurses with opportunities to be at the forefront of change in their health systems, says this nurse leader.

As technology becomes more incorporated into bedside nursing workflows, nurses themselves will need to be more involved with innovation.

As the primary users of many technologies, nurses are in the unique position to be able to provide feedback on what is and isn't working, and how to grow initiatives that will improve overall care quality and outcomes. It's up to CNOs to foster innovation at the bedside and to provide nurses with opportunities to be at the forefront of change in their health systems.

Nikki Graham, vice president of nursing, clinical practice, innovation, and education at OSF Healthcare, called nurses the "experts in care."

"Nurses know what works, what's not working, and why it's not working," Graham said. "They often see nursing practice situations and have solutions in their head and think, 'it would be better if,' but they don't always have a well-defined pathway to make the change."

Enhancing bedside innovation

To help give nurses an avenue to innovate, OSF Innovation launched the Nursing Innovation Fellowship, with the primary goal of developing peer coaches who can help improve practice at the bedside and bring innovative ideas to fruition, Graham explained.

"[The peer coaches] are uniquely seated to think about and challenge nursing practice. "So, they can question and bubble up some of those ideas that come up from their peers as well."

The program began in 2024 with a cohort of five fellows, and Graham explained that it's no easy task to get accepted. Candidates must be at least four to five years into their nursing careers and they must have good outcomes and be seen as leaders among their peers. Then, they write an essay of at least 1,000 words about why they want to participate, and they must receive a recommendation from their CNO. The last step involves sitting through a panel of nurse leaders for selection.

Ideal candidates are those who are enthusiastic and flexible with availability, Graham said.

"To be chosen, they have to be really excited, but they also have to be flexible because we ask a great deal of them, [and] they work in a shared role," Graham said. "They still work two shifts a week and then the rest of their time gets divided into their innovation duties and education."

Peer mentorship is critical

Graham emphasized that peer mentorship is important in nursing because of trust and feedback. Nurses can share strategies and outcomes with each other while finding individualized solutions.

"You'll trust your peers a lot more than someone who's not doing the work, who's trying to tell you how to improve and be better, right?" Graham said. "[The peer coaches] are supportive, they have a supportive approach and they're doing the work."

So far, the program has yielded positive results as well. According to Graham, the fellows helped and coached on med surg units, and were able to improve patient experience harms and decrease patient harms just through coaching. There are also now several innovations currently in prototype development.

"It takes a village," Graham said. "My leadership rolled out the red carpet and said, 'do it, and have fun,' and that kind of support is what it takes."

The special ingredient that makes this program special, according to Graham, is that the fellowship is driven by bedside nurses.

"There's a lot of innovation programs that focus on leaders, and that is necessary," Graham said. "Everyone's all in, from healthcare analytics to innovation, everybody is coming to the table, and I think the unique piece about our program is that peers are the powerful influencers. That's where the work happens, its grass root change at the point of care."