January 7, 2025 • 28 mins
Ep. 41 : Today we have an inspiring conversation with our guest, Ty Hagler. Ty's extensive career spans across teaching creativity and fostering team innovation with a mission to shift healthcare from a technology-push model to a market-pull approach.Ty emphasizes the crucial role of empathy and nurse-led innovation in solving healthcare challenges, often overlooked in traditional models.
We dive into his journey, the importance of consulting frontline healthcare workers, and how his company, Trig, integrates nursing insights to create impactful healthcare solutions. We also touch on real-world examples, challenges in healthcare innovation, and the exciting future trends driven by nurse-led initiatives. Stay tuned for an engaging discussion that highlights the power of nurses' voices in transforming patient care and healthcare innovation.
Ty's company, Trig offers a Nurse- Led Innovation program, For more details visit : https://med.trig.com/
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00:00 Earned MBA, focused on medical devices, improved outcomes.
06:45 Tech-driven healthcare lacks user-focused innovation feedback.
08:00 Policy issues and inadequate nurse-engineering communication hinder innovation.
12:13 Lack of innovation understanding halted business strategy.
16:08 Intellectual property ownership depends on employment agreement.
19:29 Clear problem scoping and validation in innovation.
23:09 Excited about nurse-led innovation amid tech hype.
25:56 Bassinet innovation aids C-section moms postnatal care.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:35):
Welcome
back to another episode of Nurses with Voices. I'm your host, Dr. Lendra,
(00:58):
and today I have Ty Hagler with us. Ty has
spent his career not just as a creative, but in
teaching others to be creative both as
individuals and in team settings. His mission is to change
the culture of healthcare innovation from technology
push to market pull. And the change starts
(01:19):
with educating physicians and nurses to take a
empathetic approach solving the wealth of problems in
our healthcare system. And I love that
Ty addresses this because so often certain
things are just not talked about and not discussed and we need to
really start looking at other innovative solutions. Ty,
(01:42):
introduce yourself so that we can dive
into the mission of your business and what you're doing for
healthcare. Thank you so much for having me on this podcast. I mean, nurses with
voices, absolutely like this, you know, like I think nurses need more
voices because they've systematically, historically not been
given voice and the work you're doing is so important. So for my background
(02:04):
I've got my undergraduate degree is in industrial design,
which healthcare doesn't often interact with U.S. industrial designers.
But so industrial engineering is systems and, you know, kind
of figuring out supply chains. Industrial design is about like
how do cars look, how do shoes look, how do you make
things look good? So my undergrad is from Georgia Tech and industrial design.
(02:26):
I then was at Home Depot as part of the in house innovation department
for about four years. And so that was an eye opening experience
to figure out how innovation works in big box retail for consumer
products. Went back to school, got my MBA at NC State as part
of founding trig was like, okay, I've got to run a business, figure out how
to do that, let's get an mba and then would I think I probably
(02:48):
used the MBA in a Different way than most people would. I took it as
night classes, but, you know, as part of the MBA education, got exposed
to medical devices and some of the early products I got to work on were
ones that changed outcomes, saved lives of
children. And then that was something that just kind of blossomed and matured
as we really started furthering to invest in that. And then as was
(03:10):
looking at the reasons why medical devices fail, too often
it's because nurses aren't consulted.
And there's like some stories out there of company
medical device companies, major medical device companies
will easily spend up to $500 million in development
costs, then find out that we should have talked to the hospital, we should have
(03:33):
talked to the end users in more detail. But seek
disconfirming evidence. Not just, you know, let's, we checked the box and we're
validating things. But no, shut the project down early rather than wait
to the very end the commercialization stage, because there's so often you
can feel like you're doing activity as though evidence of that. You're
making your way to a successful commercialization and you're working your
(03:55):
way towards a goal that you ultimately will. If you're climbing a mountain
to realize that the mountain has a sheer cliff on the other end, there's no
rainbow on the other pot of gold at the end of the rainbow there, you're
just like, it's just done. So like figuring out the right mountains to climb,
you know, the right ideas. The most meaningful projects to work on
is so much a part of early stage of innovation. Part of the education
(04:16):
is like helping people to learn from the
significant mistakes that have gone before in the field of innovation. I
can so appreciate how you mentioned that no one
consults with nursing when they come up with these
solutions that are going to affect our
workload, they're going to affect our productivity.
(04:38):
There are so many areas of nursing that it's going to affect and no one
consults us, even when it comes down to, you know,
building new wings of hospitals. Right. And just even
go back, going back to electronic documentation initially,
and I'm sure I can, I can pull some facts that abacus. That
is what really paved the way for nurse informatics.
(05:01):
Because when they started implementing EMRs, electronic medical
records, the first thing we was, we were saying was who created
these systems? Because clearly they didn't consult nursing
when they started creating these electronic documents, documentation systems,
because nothing made sense. And once they did start
to consult with nursing, it started to make more sense and then the
(05:23):
workflows became better. I know with anything that's new, you know, there's
going to be challenges, there's going to be struggles. But there was
clearly no consult with nursing when they
implemented, initially implemented electronic documentation. We've come a long
way now, but I just use that as an example. Yeah.
Because it's so important. If you're going to spend $500
(05:44):
million on a solution, you better
consult with the stakeholders. And I don't just mean those executive
leaderships. And, and that's another reason
why I, you know, I'm taking this time to pivot
the podcast somewhat because other perspectives matters as
well. Right. Your stakeholders are not just the nurses
(06:06):
and leadership. Your stakeholders are your bedside nurses. Your
stakeholders are professionals like yourself
who have innovative solutions for nursing and want to
partner with nursing or the healthcare profession so that
you can have innovative solutions that are going to
impact positively the workflow. You
(06:28):
mentioned wanting to change healthcare innovation from a
technology push to a market pull. Can you
share some examples where this shift made a
tangible difference in patient outcomes and just explain a little
bit more about what you mean by that? Yeah, I'm glad you referenced that. I
mean like what you just talked about with electronic health care records was very much
(06:50):
a technology push idea first
approach of, you know, like we've got problems with paper
documentation so therefore we're going to centralize everything
top down mandate everybody start using this system
and then start like doing this iterative without really a true north
star in place. In terms of let's prioritize the end
(07:12):
user. I mean I think of nursing has the misfortune
of being the settlement layer where you have top
down decisions and that have, you know, like, you know, in the
abstract they make sense. But then when it filters all the way down to the
reality of you're making decision A versus decision B at the
bedside. That's where the consequences of
(07:34):
an abstract decision brought down to
reality. Then get the nurses bear the brunt
of that and there's not a feedback mechanism back up to the
policy level decision in order to make those changes. And I think
that's a significant just overall approach to how
healthcare innovation emerges because there's some
(07:55):
fundamental biases that come from a technology push standpoint
that. So basically some of the problems that have emerged
are due to policy. They're due to basically
like, you know, how we're getting feedback. And so is
that you have a say like a class of biomedical engineers that are, you know,
all bright eyed and bushy tailed, eager to go find problems within healthcare and you
(08:18):
go start Talking to nurses and you ask nurses what the biggest problems
they're facing and nurses will take a risk and start
unloading on like, well, these are some big problems I'm facing. And because
there's not training for nurses to be able to help really articulate
the problem, the engineering team will go, this is weird and scary
and doesn't sound like something I can engineer my way out of. There's no like
(08:40):
mathematical formula, there's no like obvious technology
solution. So therefore I'm going to filter a lot of what I'm
hearing down to something that makes for a technology.
And I think that's a, that's 95% of
healthcare innovation that's happening today. And I think the revolution that
you're really starting to see happen is with nurse led innovation is
(09:02):
that nurses can serve as the North
Star, meaning that you can be
the one to like filter out the bad ideas. We're going to have a lot
of ideas that generate and then also as you start getting into
basically like, well, we can go this way and go that way and add this
feature and like, you know, add all this functionality because that happens over the
(09:24):
course of product development, development where you're constantly diverging.
And I think the nurse filter of just that truth
telling and pragmatism of like, I don't care about any
of this that you guys are talking about and dreaming up over here. It has
to serve this job. Don't make it more complex, don't add
to my workload, fix the problem. And I think that
(09:46):
source of reality and ground truth is so often missing because
it's, there's not, you know, like, you don't have a lot of people that
are sitting at bedside. It's nurses that are sitting there and they are
a source of truth and need to be in a leadership
role. The challenge that's been in the barrier there
is that the mindset required to do innovation
(10:09):
is different than the training you get in nursing school. And it's a
relatively simple flip of the switch, but it's also something
that's not part of that framework and understanding. So
and this comes down to, you have to like within medicine
particularly, I mean like medical schools as well, with physicians also
have this training that you want to always be right. If
(10:31):
you're ever wrong, then that's catastrophic. In a healthcare situation,
a critical situation, if you're ever wrong, if you misdiagnose, then
you have lots. It's like downside risk for the patient. There's, you
know, like a lot of risk Associated with being wrong within
healthcare. From an innovation context,
you are wrong 95% of the time, maybe
(10:52):
99% of the time. But when you are
right, then it has significant upside potential. And so it's
really a shift in thinking from being always
right to being only right once. And the
way that you proceed and navigate in an
innovation context is very different than what you navigate from a bedside
(11:14):
standpoint point. However, if you can navigate that flip in
mindset, then that's something where you can then start testing experiments
in a controlled environment. Not at bedside necessarily. But I do
think that also nurses come up with some of the best
kind of like let's call it MacGyver Duct Tape Solutions at
bedside that like you get the empirical feedback on
(11:36):
that. But then if you do come up with something and you validated it at
bedside, then nurses need to be taken seriously and be
able to participate in the upside when you do identify those
opportunities. But that's also something that,
that and so one of my first projects that like I worked on Home Depot
was one where I had identified a new market opportunity. It was
(11:58):
something that my boss had given to me of like, hey, this, you know, young
kids coming in, let's give them a challenge and then came back with
something that was a great idea, transform, you know, one of the
entire product categories within Home Depot. And so it checked all the boxes of
my training. But from a business strategy standpoint,
it got shut down pretty quickly in part because the
(12:18):
organization didn't know how to understand innovation and also
navigate vendor relationships. And who really to believe in terms of your
feedback on a given idea. But when it comes to the complexity of actually bringing
innovation to market, the better question to ask is who
can I find the really good regulatory consultant who
has expertise in the relevant regulations for my
(12:41):
specific, specific idea. Is this something that from a health economics
and market access standpoint that I can find the right reimbursement
pathway for this or is this just a direct to patient, you know,
out of pocket expense? There's you know, or like for patent attorneys, like
when's the right time to engage a patent attorney? Like, and is
a patent actually market validation or is it just a tax on your
(13:03):
idea? There's a lot of different concepts to play
through, but then finding the right team to assemble
around you so that you can be more effective and also not take you
away from the biggest source of strength that you
have, which is connection with patients and bedside and that ground
truth so that you can be the North Star for this team
(13:25):
of experts that assembles around you so that it can stay within
your source of strength. And also like your ability to lead that
team without having to be the most knowledgeable person in the room,
you just are the closest to the truth. It's interesting.
Nurses have been talking about workarounds,
right? That's what they are. They're workarounds. We duct tape things. I won't name
(13:47):
the organization. However, I can think of one nurse who
created a device where you wouldn't have to disconnect the
IV tubing. You can just hang your IV tubing. And because your
tubing would be changed every 70 to 96 hours, depending on your state or
hospital. So instead of having all of this different tubing, you have one tubing, and
the one tubing actually can attach the different piggybacks. And she
(14:09):
actually created this on the organization's time.
And because of that, the organization owned it. So she wasn't
able to patent the organization sold it out,
and everyone loved it. But again, this came from a nurse. So
we're very innovative with solutions because we see all the
time what needs to be done. But
(14:31):
no one teaches us the innovative side of taking
this idea and partnering with a technology
company or partnering with a business that can really
help us market this and roll it out effectively.
And I also remember working at an organization where the
cno, she created this acuity
(14:53):
system. We did the research for her. She created this
acuity system, and all of the nurses, all the discharge nurses, they would
do the acuity for each shift. And, you know,
after six months or a year, she took the idea and
she pitched it to a company. And just like that, she was
a millionaire because it helped with the acuity and help. And we've been talking
(15:16):
about acuity in nursing and healthcare for years, right? That's
one of the things I know a lot of union workers, I should say, and
that's one of the biggest things are acuity and staffing and making sure staffing
is appropriate for acuity models. Well, here you have a
chief nursing officer who pitched the idea to a company
and basically became a millionaire off of the idea.
(15:38):
So there's so many ways of
be being innovative. And we know as nurses, when it comes
to what we need, right. When it comes to our healthcare, what we need on
the front line. We know. And I guess my question to
you would be, how do you integrate
insights from frontline healthcare workers
(15:59):
like nurses into your product design process?
And what role do they play in shaping the
healthcare innovations at Trig? That is such a good Question,
and I think it's a complex answer, and I want to back up a level
because you touched on the organization owning the rights to the
intellectual property that was created. So if you
(16:20):
are working at, say, an academic institution or a
hospital that has an active intellectual property
capture mechanism within their hospital, that is something that oftentimes is
part of your employment agreement. That if you're creating intellectual
property, if you're generating ideas during your
time and that hospital, then they do have the ability to
(16:43):
basically take ownership, have power of attorney over the
intellectual property. And so then that becomes a question of,
and I think to you, the individual innovator, what is
the value proposition that your organization is providing
to you that you can trust them with your idea? But I think that's a
question back to your local context
(17:05):
and the employment agreement you have with your institution and
to just ask some hard questions of if I trust you with an idea,
I haven't come up with one yet. But if I do trust you with this,
what resources do you have in terms of helping me to secure and protect the
patent that is valuable? Because a
large institution protecting a patent is much more
(17:26):
intimidating than say, an individual who has
just barely enough money to file the $15,000 to get a patent.
And then the real value of the patent is in the litigation afterwards to defend
the patent. There is a source of strength there. There is a value proposition
to make sure you also want to understand what the upside
is. Back to you, the inventor, if there are, you know, like
(17:49):
royalties that come out of. Share with the
listeners what you guys are doing to integrate these
insights for nurses at Trig. So Trig at ITS or
we're a industrial design consulting firm. So we do offer
training, we also offer innovation management. So helping a pipeline
of ideas for an organization go through and reach maturity and
(18:11):
commercialization. And then we do work in say, like market
research, kind of physical prototyping and product development. For
anybody who's watching on video, you kind of have an. I have an array
of different devices that we've worked on and helped
commercialize. Behind me here on the display shelf, we also get
into developing brands for those products we designed and also
(18:33):
developing digital experiences in terms of UX layouts,
websites, commercial landing pages, that kind of thing. So that's kind of our
core offering. But within the training, something that we're experimenting
with is taking. Allowing nurses to go through a
process of how do you scope a problem in the first place
and really bracket it down to like, what is something that's achievable
(18:55):
that's within your scope. That's also not too narrowly defined, but not so
broadly defined. Like, you know, like healthcare is too
expensive. Let's solve that problem. Like, well, let's try to bracket that down
a little bit, right? And then like, you know, versus like we're gonna improve
the, I don't know, thread count on the sheets by like, you know,
a percentage increase. Like there's an array of, you
(19:18):
know, like different possible scopes you could have for the problem. And
so just helping with that as a starting place so that you've got
something that's one validated and worth your time. Then
after getting going through that early problem scoping phase, is then going
through our empathy course where we'll take nurses who
have a given problem scope and then walk through a series
(19:41):
of validation steps to really make sure you've got consensus
on what truly the problem is so that it's clear to
articulate. One of the best examples of this comes from Steve
Jobs, where he marketed a thousand songs in your pocket.
That is there's no solution in there. It's the outcome,
it's the unmet need. That by describing that
(20:04):
then you can say, well, how do you actually get a thou? And today of
course, we have, you know, millions of songs. But like, at the time, the ipod
was revolutionary because it allowed for that. So I think being
able to get to that level of clarity is something we offer in the training.
And so some of what we offer is that early stage
prototyping illustration concept validation that
(20:25):
works in concert with the medical innovator so that
we can help to save the overall cost of a development project
and make best use of those, you know, kind of whatever
grant dollars we're working with. In some cases where we feel like there's
a, you know, a matching problem
scope and unmet need, then we will partner with nurses
(20:47):
and go through and apply for grants together and put the right structure in
place that's equitable for all parties. And that's something that we're working
on, putting that structure in a streamlined process in place, which if that's
interesting or exciting for anybody, you know, then like definitely encourage you to take
the course. We have some free offerings there, as well as some paid offerings, but
then also looking to have a series of conversations to filter down to
(21:09):
some of the really exciting opportunities, but also position nurses
as the leader to navigate those opportunities because we
really just see that as, you know, good practice for
innovation as well as recognizing the
strengths and leadership and potential of nurses in
your. Experience what would you say are the most common challenges
(21:31):
healthcare companies face when trying to
balance innovation and practicality? So
I do think that there's a couple of helpful frameworks
that you know, can be useful to establish that North
Star. At the same time, I think, you know, one of my favorite
taglines is that, you know, real innovators ship is that,
(21:54):
you know, you have to, at the end of the day, ship a product. It's
never going to be perfect. There is a point in time when you have to
stop diverging and push to the next product
and just have it be willing to accept good enough. You've reduced,
you know, the risk of harm due to use error and
safety risks. You've made sure it's something that can be scaled up. At the same
(22:15):
time recognizing it's never going to be perfect. And there's always opportunity for
the next product to come out, the next extension, the next
idea. And so being able to bracket what is
the minimum viable product within a healthcare
context so that you have to pass the proper safety checks, but
then allowing yourself the ability to then move on and move on to the, you
(22:36):
know, the next idea is something that it's very challenging to get that
discipline right because you know, you're dealing with the critical use cases
and situations and being able to draw that line in
the sand of like what's good enough. It's very
challenging. So looking ahead, what
emerging trends in healthcare design
(22:59):
excite you? How do you see these
innovations reshaping the future of patient
care and the provider experience? I
am very excited about nurse led innovation. I think the,
the, we are facing a technology bubble right
now where, you know, like, I think, you know, we've kind
(23:21):
of, we're over hyped on artificial intelligence right now.
I think we're right now experiencing all the limitations of it,
just like we did with, you know, like how blockchain is going to revolutionize
healthcare. I'm like, yeah, sure there's some applications,
but it's not quite stable enough yet. I mean like, we'll probably go through this
hype cycle again in five when we have a breakthrough on like the core
(23:43):
functionality. But I think we're on the other side of that bubble
and potentially seeing some of the downside of that. I think so much
of what we're seeing right now in healthcare is due
to bureaucratic debt, not technical debt, but bureaucratic
debt, social debt that I think
because nurses have been the settlement layer for
(24:05):
a lot of the delayed feedback that's happening from a lot of
these policies that are happening. You know, health care is the fastest
inflating cost in the United States economy, and
yet we also have some of the worst health outcomes of any developed
country. So there's a reconciliation that needs to happen. And
so much of those challenges right now are like, innovation can
(24:27):
have limited impact on the ability to affect some of these decisions.
And so much of these are delayed decisions that need to happen at a
policy level. And specifically, I'm thinking about safe staffing for
nurses. You talked about acuity earlier. This is something that has.
Only eight states have any kind of policy around, you know, safe
staffing levels. And I think a lot of the hospital
(24:49):
administration is saying, well, it's complex. You got to deal with patient acuity and
who else is on the floor and all of the different challenges that are out
there. But yet there's not a protection in place for nurses of
a baseline staff level
that you can compare against. If we put, I don't know, like a new AI
bot in place and does that actually make the nurse's
(25:10):
workload better? Well, there's no, like, you know, kind of
control versus variable testing going on. It's just like, just put more
on nurses and, you know, see what happens. And
so I think those controls aren't in place. And I do think we
need changes to happen at a policy level to fix some of
that, that I think there's limits on what innovation can do. So I do
(25:32):
think that the work that you're doing is so important to, I
think, be one of the driving forces for making change happen within
healthcare in the United States. Thank you so much. Thank you
so much for coming on today. Are there, as we wrap up, is there
anything I didn't mention that you want to share with the
listeners? Please go ahead. Any final thoughts that you want to leave
(25:55):
them with? Just one that I'd be remiss if I didn't talk
about is our work on couplet care. So this is a postnatal
infant bassinet we've been working on. And so we've been
going to a lot of the nursing conventions and getting a chance to show this,
but it's directly benefiting moms who have had a
C section and making it so that immediately postpartum. The
(26:18):
current bassinets are designed for, basically a
provider to stand over the infant in a nursery. But for a
mom who's had a C section, for her to be able to lift her sleeping
baby up over and into the bassinet, I mean, she
has to invert her elbows in order to safely put and like put strain on
her stomach in order to be able to put sleeping baby back in the bassinet.
(26:39):
And so this bassinet we've been working on cantilevers over
the bed makes it easy for mom to quickly simply
place her baby back in the bassinet. And it's something that's led to a
73%, 73% reduction in non medical calls to the
nursing station as part of a clinical study that happened at UNC
Health. And we're currently like in final regulatory
(27:02):
review right now to then be able to start commercializing this which we're
expecting to be able to ship product in Q1 next year. So
really proud of our work there and it's something to check out. Yeah. Couple
care.com where can people find you? Yeah, definitely
LinkedIn. Reach out to me, Ty Hagler and also trig.com
is our website and you can learn more information about what we're too. Well,
(27:26):
there you have it, everyone. Until next time, make sure that
you stay inspired, stay educated and
stay empowered. And thank you so much, Ty for coming on today.
Thank you, Linda, for having me on. This is a great conversation.
Welcome
back to another episode of Nurses with Voices. I'm your host, Dr. Lendra,
(00:58):
and today I have Ty Hagler with us. Ty has
spent his career not just as a creative, but in
teaching others to be creative both as
individuals and in team settings. His mission is to change
the culture of healthcare innovation from technology
push to market pull. And the change starts
(01:19):
with educating physicians and nurses to take a
empathetic approach solving the wealth of problems in
our healthcare system. And I love that
Ty addresses this because so often certain
things are just not talked about and not discussed and we need to
really start looking at other innovative solutions. Ty,
(01:42):
introduce yourself so that we can dive
into the mission of your business and what you're doing for
healthcare. Thank you so much for having me on this podcast. I mean, nurses with
voices, absolutely like this, you know, like I think nurses need more
voices because they've systematically, historically not been
given voice and the work you're doing is so important. So for my background
(02:04):
I've got my undergraduate degree is in industrial design,
which healthcare doesn't often interact with U.S. industrial designers.
But so industrial engineering is systems and, you know, kind
of figuring out supply chains. Industrial design is about like
how do cars look, how do shoes look, how do you make
things look good? So my undergrad is from Georgia Tech and industrial design.
(02:26):
I then was at Home Depot as part of the in house innovation department
for about four years. And so that was an eye opening experience
to figure out how innovation works in big box retail for consumer
products. Went back to school, got my MBA at NC State as part
of founding trig was like, okay, I've got to run a business, figure out how
to do that, let's get an mba and then would I think I probably
(02:48):
used the MBA in a Different way than most people would. I took it as
night classes, but, you know, as part of the MBA education, got exposed
to medical devices and some of the early products I got to work on were
ones that changed outcomes, saved lives of
children. And then that was something that just kind of blossomed and matured
as we really started furthering to invest in that. And then as was
(03:10):
looking at the reasons why medical devices fail, too often
it's because nurses aren't consulted.
And there's like some stories out there of company
medical device companies, major medical device companies
will easily spend up to $500 million in development
costs, then find out that we should have talked to the hospital, we should have
(03:33):
talked to the end users in more detail. But seek
disconfirming evidence. Not just, you know, let's, we checked the box and we're
validating things. But no, shut the project down early rather than wait
to the very end the commercialization stage, because there's so often you
can feel like you're doing activity as though evidence of that. You're
making your way to a successful commercialization and you're working your
(03:55):
way towards a goal that you ultimately will. If you're climbing a mountain
to realize that the mountain has a sheer cliff on the other end, there's no
rainbow on the other pot of gold at the end of the rainbow there, you're
just like, it's just done. So like figuring out the right mountains to climb,
you know, the right ideas. The most meaningful projects to work on
is so much a part of early stage of innovation. Part of the education
(04:16):
is like helping people to learn from the
significant mistakes that have gone before in the field of innovation. I
can so appreciate how you mentioned that no one
consults with nursing when they come up with these
solutions that are going to affect our
workload, they're going to affect our productivity.
(04:38):
There are so many areas of nursing that it's going to affect and no one
consults us, even when it comes down to, you know,
building new wings of hospitals. Right. And just even
go back, going back to electronic documentation initially,
and I'm sure I can, I can pull some facts that abacus. That
is what really paved the way for nurse informatics.
(05:01):
Because when they started implementing EMRs, electronic medical
records, the first thing we was, we were saying was who created
these systems? Because clearly they didn't consult nursing
when they started creating these electronic documents, documentation systems,
because nothing made sense. And once they did start
to consult with nursing, it started to make more sense and then the
(05:23):
workflows became better. I know with anything that's new, you know, there's
going to be challenges, there's going to be struggles. But there was
clearly no consult with nursing when they
implemented, initially implemented electronic documentation. We've come a long
way now, but I just use that as an example. Yeah.
Because it's so important. If you're going to spend $500
(05:44):
million on a solution, you better
consult with the stakeholders. And I don't just mean those executive
leaderships. And, and that's another reason
why I, you know, I'm taking this time to pivot
the podcast somewhat because other perspectives matters as
well. Right. Your stakeholders are not just the nurses
(06:06):
and leadership. Your stakeholders are your bedside nurses. Your
stakeholders are professionals like yourself
who have innovative solutions for nursing and want to
partner with nursing or the healthcare profession so that
you can have innovative solutions that are going to
impact positively the workflow. You
(06:28):
mentioned wanting to change healthcare innovation from a
technology push to a market pull. Can you
share some examples where this shift made a
tangible difference in patient outcomes and just explain a little
bit more about what you mean by that? Yeah, I'm glad you referenced that. I
mean like what you just talked about with electronic health care records was very much
(06:50):
a technology push idea first
approach of, you know, like we've got problems with paper
documentation so therefore we're going to centralize everything
top down mandate everybody start using this system
and then start like doing this iterative without really a true north
star in place. In terms of let's prioritize the end
(07:12):
user. I mean I think of nursing has the misfortune
of being the settlement layer where you have top
down decisions and that have, you know, like, you know, in the
abstract they make sense. But then when it filters all the way down to the
reality of you're making decision A versus decision B at the
bedside. That's where the consequences of
(07:34):
an abstract decision brought down to
reality. Then get the nurses bear the brunt
of that and there's not a feedback mechanism back up to the
policy level decision in order to make those changes. And I think
that's a significant just overall approach to how
healthcare innovation emerges because there's some
(07:55):
fundamental biases that come from a technology push standpoint
that. So basically some of the problems that have emerged
are due to policy. They're due to basically
like, you know, how we're getting feedback. And so is
that you have a say like a class of biomedical engineers that are, you know,
all bright eyed and bushy tailed, eager to go find problems within healthcare and you
(08:18):
go start Talking to nurses and you ask nurses what the biggest problems
they're facing and nurses will take a risk and start
unloading on like, well, these are some big problems I'm facing. And because
there's not training for nurses to be able to help really articulate
the problem, the engineering team will go, this is weird and scary
and doesn't sound like something I can engineer my way out of. There's no like
(08:40):
mathematical formula, there's no like obvious technology
solution. So therefore I'm going to filter a lot of what I'm
hearing down to something that makes for a technology.
And I think that's a, that's 95% of
healthcare innovation that's happening today. And I think the revolution that
you're really starting to see happen is with nurse led innovation is
(09:02):
that nurses can serve as the North
Star, meaning that you can be
the one to like filter out the bad ideas. We're going to have a lot
of ideas that generate and then also as you start getting into
basically like, well, we can go this way and go that way and add this
feature and like, you know, add all this functionality because that happens over the
(09:24):
course of product development, development where you're constantly diverging.
And I think the nurse filter of just that truth
telling and pragmatism of like, I don't care about any
of this that you guys are talking about and dreaming up over here. It has
to serve this job. Don't make it more complex, don't add
to my workload, fix the problem. And I think that
(09:46):
source of reality and ground truth is so often missing because
it's, there's not, you know, like, you don't have a lot of people that
are sitting at bedside. It's nurses that are sitting there and they are
a source of truth and need to be in a leadership
role. The challenge that's been in the barrier there
is that the mindset required to do innovation
(10:09):
is different than the training you get in nursing school. And it's a
relatively simple flip of the switch, but it's also something
that's not part of that framework and understanding. So
and this comes down to, you have to like within medicine
particularly, I mean like medical schools as well, with physicians also
have this training that you want to always be right. If
(10:31):
you're ever wrong, then that's catastrophic. In a healthcare situation,
a critical situation, if you're ever wrong, if you misdiagnose, then
you have lots. It's like downside risk for the patient. There's, you
know, like a lot of risk Associated with being wrong within
healthcare. From an innovation context,
you are wrong 95% of the time, maybe
(10:52):
99% of the time. But when you are
right, then it has significant upside potential. And so it's
really a shift in thinking from being always
right to being only right once. And the
way that you proceed and navigate in an
innovation context is very different than what you navigate from a bedside
(11:14):
standpoint point. However, if you can navigate that flip in
mindset, then that's something where you can then start testing experiments
in a controlled environment. Not at bedside necessarily. But I do
think that also nurses come up with some of the best
kind of like let's call it MacGyver Duct Tape Solutions at
bedside that like you get the empirical feedback on
(11:36):
that. But then if you do come up with something and you validated it at
bedside, then nurses need to be taken seriously and be
able to participate in the upside when you do identify those
opportunities. But that's also something that,
that and so one of my first projects that like I worked on Home Depot
was one where I had identified a new market opportunity. It was
(11:58):
something that my boss had given to me of like, hey, this, you know, young
kids coming in, let's give them a challenge and then came back with
something that was a great idea, transform, you know, one of the
entire product categories within Home Depot. And so it checked all the boxes of
my training. But from a business strategy standpoint,
it got shut down pretty quickly in part because the
(12:18):
organization didn't know how to understand innovation and also
navigate vendor relationships. And who really to believe in terms of your
feedback on a given idea. But when it comes to the complexity of actually bringing
innovation to market, the better question to ask is who
can I find the really good regulatory consultant who
has expertise in the relevant regulations for my
(12:41):
specific, specific idea. Is this something that from a health economics
and market access standpoint that I can find the right reimbursement
pathway for this or is this just a direct to patient, you know,
out of pocket expense? There's you know, or like for patent attorneys, like
when's the right time to engage a patent attorney? Like, and is
a patent actually market validation or is it just a tax on your
(13:03):
idea? There's a lot of different concepts to play
through, but then finding the right team to assemble
around you so that you can be more effective and also not take you
away from the biggest source of strength that you
have, which is connection with patients and bedside and that ground
truth so that you can be the North Star for this team
(13:25):
of experts that assembles around you so that it can stay within
your source of strength. And also like your ability to lead that
team without having to be the most knowledgeable person in the room,
you just are the closest to the truth. It's interesting.
Nurses have been talking about workarounds,
right? That's what they are. They're workarounds. We duct tape things. I won't name
(13:47):
the organization. However, I can think of one nurse who
created a device where you wouldn't have to disconnect the
IV tubing. You can just hang your IV tubing. And because your
tubing would be changed every 70 to 96 hours, depending on your state or
hospital. So instead of having all of this different tubing, you have one tubing, and
the one tubing actually can attach the different piggybacks. And she
(14:09):
actually created this on the organization's time.
And because of that, the organization owned it. So she wasn't
able to patent the organization sold it out,
and everyone loved it. But again, this came from a nurse. So
we're very innovative with solutions because we see all the
time what needs to be done. But
(14:31):
no one teaches us the innovative side of taking
this idea and partnering with a technology
company or partnering with a business that can really
help us market this and roll it out effectively.
And I also remember working at an organization where the
cno, she created this acuity
(14:53):
system. We did the research for her. She created this
acuity system, and all of the nurses, all the discharge nurses, they would
do the acuity for each shift. And, you know,
after six months or a year, she took the idea and
she pitched it to a company. And just like that, she was
a millionaire because it helped with the acuity and help. And we've been talking
(15:16):
about acuity in nursing and healthcare for years, right? That's
one of the things I know a lot of union workers, I should say, and
that's one of the biggest things are acuity and staffing and making sure staffing
is appropriate for acuity models. Well, here you have a
chief nursing officer who pitched the idea to a company
and basically became a millionaire off of the idea.
(15:38):
So there's so many ways of
be being innovative. And we know as nurses, when it comes
to what we need, right. When it comes to our healthcare, what we need on
the front line. We know. And I guess my question to
you would be, how do you integrate
insights from frontline healthcare workers
(15:59):
like nurses into your product design process?
And what role do they play in shaping the
healthcare innovations at Trig? That is such a good Question,
and I think it's a complex answer, and I want to back up a level
because you touched on the organization owning the rights to the
intellectual property that was created. So if you
(16:20):
are working at, say, an academic institution or a
hospital that has an active intellectual property
capture mechanism within their hospital, that is something that oftentimes is
part of your employment agreement. That if you're creating intellectual
property, if you're generating ideas during your
time and that hospital, then they do have the ability to
(16:43):
basically take ownership, have power of attorney over the
intellectual property. And so then that becomes a question of,
and I think to you, the individual innovator, what is
the value proposition that your organization is providing
to you that you can trust them with your idea? But I think that's a
question back to your local context
(17:05):
and the employment agreement you have with your institution and
to just ask some hard questions of if I trust you with an idea,
I haven't come up with one yet. But if I do trust you with this,
what resources do you have in terms of helping me to secure and protect the
patent that is valuable? Because a
large institution protecting a patent is much more
(17:26):
intimidating than say, an individual who has
just barely enough money to file the $15,000 to get a patent.
And then the real value of the patent is in the litigation afterwards to defend
the patent. There is a source of strength there. There is a value proposition
to make sure you also want to understand what the upside
is. Back to you, the inventor, if there are, you know, like
(17:49):
royalties that come out of. Share with the
listeners what you guys are doing to integrate these
insights for nurses at Trig. So Trig at ITS or
we're a industrial design consulting firm. So we do offer
training, we also offer innovation management. So helping a pipeline
of ideas for an organization go through and reach maturity and
(18:11):
commercialization. And then we do work in say, like market
research, kind of physical prototyping and product development. For
anybody who's watching on video, you kind of have an. I have an array
of different devices that we've worked on and helped
commercialize. Behind me here on the display shelf, we also get
into developing brands for those products we designed and also
(18:33):
developing digital experiences in terms of UX layouts,
websites, commercial landing pages, that kind of thing. So that's kind of our
core offering. But within the training, something that we're experimenting
with is taking. Allowing nurses to go through a
process of how do you scope a problem in the first place
and really bracket it down to like, what is something that's achievable
(18:55):
that's within your scope. That's also not too narrowly defined, but not so
broadly defined. Like, you know, like healthcare is too
expensive. Let's solve that problem. Like, well, let's try to bracket that down
a little bit, right? And then like, you know, versus like we're gonna improve
the, I don't know, thread count on the sheets by like, you know,
a percentage increase. Like there's an array of, you
(19:18):
know, like different possible scopes you could have for the problem. And
so just helping with that as a starting place so that you've got
something that's one validated and worth your time. Then
after getting going through that early problem scoping phase, is then going
through our empathy course where we'll take nurses who
have a given problem scope and then walk through a series
(19:41):
of validation steps to really make sure you've got consensus
on what truly the problem is so that it's clear to
articulate. One of the best examples of this comes from Steve
Jobs, where he marketed a thousand songs in your pocket.
That is there's no solution in there. It's the outcome,
it's the unmet need. That by describing that
(20:04):
then you can say, well, how do you actually get a thou? And today of
course, we have, you know, millions of songs. But like, at the time, the ipod
was revolutionary because it allowed for that. So I think being
able to get to that level of clarity is something we offer in the training.
And so some of what we offer is that early stage
prototyping illustration concept validation that
(20:25):
works in concert with the medical innovator so that
we can help to save the overall cost of a development project
and make best use of those, you know, kind of whatever
grant dollars we're working with. In some cases where we feel like there's
a, you know, a matching problem
scope and unmet need, then we will partner with nurses
(20:47):
and go through and apply for grants together and put the right structure in
place that's equitable for all parties. And that's something that we're working
on, putting that structure in a streamlined process in place, which if that's
interesting or exciting for anybody, you know, then like definitely encourage you to take
the course. We have some free offerings there, as well as some paid offerings, but
then also looking to have a series of conversations to filter down to
(21:09):
some of the really exciting opportunities, but also position nurses
as the leader to navigate those opportunities because we
really just see that as, you know, good practice for
innovation as well as recognizing the
strengths and leadership and potential of nurses in
your. Experience what would you say are the most common challenges
(21:31):
healthcare companies face when trying to
balance innovation and practicality? So
I do think that there's a couple of helpful frameworks
that you know, can be useful to establish that North
Star. At the same time, I think, you know, one of my favorite
taglines is that, you know, real innovators ship is that,
(21:54):
you know, you have to, at the end of the day, ship a product. It's
never going to be perfect. There is a point in time when you have to
stop diverging and push to the next product
and just have it be willing to accept good enough. You've reduced,
you know, the risk of harm due to use error and
safety risks. You've made sure it's something that can be scaled up. At the same
(22:15):
time recognizing it's never going to be perfect. And there's always opportunity for
the next product to come out, the next extension, the next
idea. And so being able to bracket what is
the minimum viable product within a healthcare
context so that you have to pass the proper safety checks, but
then allowing yourself the ability to then move on and move on to the, you
(22:36):
know, the next idea is something that it's very challenging to get that
discipline right because you know, you're dealing with the critical use cases
and situations and being able to draw that line in
the sand of like what's good enough. It's very
challenging. So looking ahead, what
emerging trends in healthcare design
(22:59):
excite you? How do you see these
innovations reshaping the future of patient
care and the provider experience? I
am very excited about nurse led innovation. I think the,
the, we are facing a technology bubble right
now where, you know, like, I think, you know, we've kind
(23:21):
of, we're over hyped on artificial intelligence right now.
I think we're right now experiencing all the limitations of it,
just like we did with, you know, like how blockchain is going to revolutionize
healthcare. I'm like, yeah, sure there's some applications,
but it's not quite stable enough yet. I mean like, we'll probably go through this
hype cycle again in five when we have a breakthrough on like the core
(23:43):
functionality. But I think we're on the other side of that bubble
and potentially seeing some of the downside of that. I think so much
of what we're seeing right now in healthcare is due
to bureaucratic debt, not technical debt, but bureaucratic
debt, social debt that I think
because nurses have been the settlement layer for
(24:05):
a lot of the delayed feedback that's happening from a lot of
these policies that are happening. You know, health care is the fastest
inflating cost in the United States economy, and
yet we also have some of the worst health outcomes of any developed
country. So there's a reconciliation that needs to happen. And
so much of those challenges right now are like, innovation can
(24:27):
have limited impact on the ability to affect some of these decisions.
And so much of these are delayed decisions that need to happen at a
policy level. And specifically, I'm thinking about safe staffing for
nurses. You talked about acuity earlier. This is something that has.
Only eight states have any kind of policy around, you know, safe
staffing levels. And I think a lot of the hospital
(24:49):
administration is saying, well, it's complex. You got to deal with patient acuity and
who else is on the floor and all of the different challenges that are out
there. But yet there's not a protection in place for nurses of
a baseline staff level
that you can compare against. If we put, I don't know, like a new AI
bot in place and does that actually make the nurse's
(25:10):
workload better? Well, there's no, like, you know, kind of
control versus variable testing going on. It's just like, just put more
on nurses and, you know, see what happens. And
so I think those controls aren't in place. And I do think we
need changes to happen at a policy level to fix some of
that, that I think there's limits on what innovation can do. So I do
(25:32):
think that the work that you're doing is so important to, I
think, be one of the driving forces for making change happen within
healthcare in the United States. Thank you so much. Thank you
so much for coming on today. Are there, as we wrap up, is there
anything I didn't mention that you want to share with the
listeners? Please go ahead. Any final thoughts that you want to leave
(25:55):
them with? Just one that I'd be remiss if I didn't talk
about is our work on couplet care. So this is a postnatal
infant bassinet we've been working on. And so we've been
going to a lot of the nursing conventions and getting a chance to show this,
but it's directly benefiting moms who have had a
C section and making it so that immediately postpartum. The
(26:18):
current bassinets are designed for, basically a
provider to stand over the infant in a nursery. But for a
mom who's had a C section, for her to be able to lift her sleeping
baby up over and into the bassinet, I mean, she
has to invert her elbows in order to safely put and like put strain on
her stomach in order to be able to put sleeping baby back in the bassinet.
(26:39):
And so this bassinet we've been working on cantilevers over
the bed makes it easy for mom to quickly simply
place her baby back in the bassinet. And it's something that's led to a
73%, 73% reduction in non medical calls to the
nursing station as part of a clinical study that happened at UNC
Health. And we're currently like in final regulatory
(27:02):
review right now to then be able to start commercializing this which we're
expecting to be able to ship product in Q1 next year. So
really proud of our work there and it's something to check out. Yeah. Couple
care.com where can people find you? Yeah, definitely
LinkedIn. Reach out to me, Ty Hagler and also trig.com
is our website and you can learn more information about what we're too. Well,
(27:26):
there you have it, everyone. Until next time, make sure that
you stay inspired, stay educated and
stay empowered. And thank you so much, Ty for coming on today.
Thank you, Linda, for having me on. This is a great conversation.
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