Building Sustainable Innovation Programs in Academic Pediatric Healthcare
With Dr. Todd Ponsky · hosted by Dr. Anthony Guerra & Dr. Todd Ponsky
Chapter 1 of 9
Innovation evolution
Introduction and Evolution of Innovation at Cincinnati Children's
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Cincinnati Children's Hospital received a philanthropic gift from William Proctor many years ago that has grown to support a healthy research foundation, enabling the institution to excel equally in clinical care and research.
Most traditional technology transfer programs at academic medical centers are not financially sustainable; they function more as academic support for researchers rather than profitable enterprises.
The Frontline Innovation program was created because most innovation was coming from full-time researchers, while busy clinicians lacked the bandwidth and experience to innovate despite having valuable insights.
The Morbidity, Mortality and Innovation conference model produced six provisional patents in a few months by converting surgical complications into innovation opportunities.
External partnerships allow companies to collaborate with Cincinnati Children's for pilots and testing, creating joint ventures or shared upside arrangements that involve clinicians and researchers.
Health Service Ventures examines daily hospital operations (service lines, pharmacy, pathology, sterile processing) for optimization opportunities that could be scaled into for-profit entities through partnerships with other hospitals, capital partners, or industry.
Quality improvement and innovation traditionally sit far apart in organizations, but mirroring them allows complication conferences to identify unmet needs where no existing solution exists.
When an unmet need is identified through M&M conferences, the team first searches to see if a solution already exists (often it does but was unknown), and if not, consults external partners to validate the problem's significance before creating a solution.
Engaging frontline staff in innovation is harder than initially expected; busy clinicians and especially nurses lack time despite being most aware of problems and having creative solutions.
Active embedded pursuit—sitting where frontline staff already work rather than waiting for them to come to innovation offices—is necessary to engage busy clinicians.
Aligned incentives (financial, academic, or other benefits) are necessary to motivate frontline staff to participate in innovation, as innovation is not currently celebrated in academic promotion processes.
Frontline innovation engagement has been easier on the physician side than the nursing side, despite nurses being most aware of frontline problems.
Chief Nursing Officer Barb Tafani provides exceptional support for nursing innovation engagement, stating 'we just have to' when asked how to overcome barriers.
Nurse practitioner Abby Hess leads frontline nursing innovation efforts and has successfully moved several initiatives forward.
Innovation opportunities are prioritized based on whether the problem is widely felt across organizations, as this indicates a potential market; narrow-focus problems may be directed to alternative paths like publication or philanthropic funding.
Clinical innovation at Cincinnati Children's focuses primarily on device and digital solutions rather than drug discovery.
Traditional medical device development requires prototyping, testing, FDA approval, and can take many years and significant money, whereas digital solutions can be rapidly developed using no-code platforms.
No-code/low-code ('vibe coding') platforms allow individuals with zero coding experience to create functional applications by describing problems to a chatbot, with solutions completed within a day.
Cincinnati Children's CEO promotes a 'how might we' culture of cross-collaboration that percolates down through the organization, with IT teams never saying no but instead exploring possibilities.
The organization is exploring development of an internal no-code platform where every individual could create their own solutions for patient triage, response time, and workflow efficiency.
Process-focused innovations are handled by the Anderson Center, a separate group within the hospital with its own innovation function.
Innovation at Cincinnati Children's requires true triangulation between innovation, IT, operations, quality, and clinical teams rather than being housed solely within IT.
Regular meetings with IT focus on collaborative agreement about what needs to be done rather than ownership disputes, though there are defined lanes of responsibility.
Cybersecurity review is integrated into all innovation projects through partnership with the cybersecurity team, providing necessary checks and balances.
While all CEOs claim to believe in innovation, real executive cover is proven by tolerance for failure, with Cincinnati Children's leadership (Oliver Ryan and Steve Davis) actively requesting to see failures as evidence of sufficient risk-taking.
Angel Ho assists with cross-stakeholder conversations, helping bring stakeholders together when innovation initiatives might otherwise step on toes or face resistance.
People instinctively resist innovation out of fear rather than genuine opposition; effective leadership removes that fear by making staff feel safe to take risks.
Organizations that plan endlessly without executing do so because staff are afraid of missing something that could go wrong; executive cover that ensures safety reduces this paralysis.
A small number of healthcare leaders are actively testing and playing with new tools, posting about successes and failures, and this hands-on experimentation is necessary to understand tools well enough to apply them appropriately.
Ponsky seeks novel solutions to daily problems regardless of whether they involve AI, focusing on cutting-edge, easy-to-use technology that anyone can use without technical background.
Despite conducting workshops promising to make attendees 10% more effective with AI tools, adoption remains challenging as people find the technology overwhelming even when shown it's accessible.
The 'clay mindset'—viewing the world as malleable rather than static and actively looking for inefficiencies to fix—is a worldview that drives innovation behavior.
Educating the workforce about innovation tools will not automatically create innovators; those with a clay mindset are likely already innovating, while others may need their unmet needs identified and solutions provided for them.
The clay mindset can be learned through exposure and environment, as evidenced by Ponsky's father inventing things and all siblings developing similar approaches, suggesting it's contagious when people see successes.
Surgeons should think 'how could we have done that better' after finishing cases rather than immediately moving to the next case.
The key to workforce innovation adoption may be helping staff articulate unmet needs and finding solutions for them rather than expecting everyone to independently identify and solve problems.
Finding frontline workers who have both domain expertise and a clay mindset represents the 'golden goose' for innovation—perhaps 1 in 10-15 people—and these are the individuals to pull into innovation efforts.
Thomas Friedman's book 'Thank You for Being Late' contains a metaphor that sitting passively in a kayak on rough water leads to flipping, while paddling (being proactive) prevents it.
Adam Grant's concept of 'confident humility'—being confident you'll find answers while humble enough to seek help from those who've already solved similar problems—is essential for innovation leadership.