As a physiotherapist turned process improvement manager, my journey in healthcare innovation began when I joined St. Vincent’s Healthcare in 2005. Looking back, I now realize that innovation and improvement were inherently woven into my professional practice from the start. As physiotherapists, we rotate through different clinical areas, and each rotation requires us to undertake improvement projects. This creates a natural culture of innovation and continuous learning.
Our professional framework explicitly includes leadership, innovation, and “creating the service of the future” as criteria we must self-assess and be assessed on annually. While I took this culture for granted initially, it wasn’t until I stepped out of my clinical role that I realized how unique this mindset was – not everyone has the opportunity to approach their work with this improvement mentality.
I progressed from a staff grade position through various rotations to become a senior physiotherapist around 2009-2010, taking on both clinical and educational responsibilities. However, when I transitioned into quality and patient safety, I gained a new perspective on the challenges of implementing change at scale in healthcare.
One of the biggest challenges I’ve observed is the disconnect between individual and organizational innovation. While junior staff across all disciplines – doctors, nurses, physiotherapists – are encouraged to pursue quality improvements, scaling these innovations up to an organizational level often faces significant barriers. Part of this stems from the external pressures our senior leaders face. They’re constantly responding to demands from external bodies and various national programs, which typically focus on pointing out problems rather than building on successes.
In my current role as process improvement manager, I’m working to bridge this gap. For example, I’ve been working with the orthopaedic team for the past year and a half, helping to profile their improvement work to senior leadership and advocate for organizational support to scale their successful initiatives.
Working in healthcare transformation has given me a deep appreciation for the complexities of implementing change in a system that’s constantly in crisis. While we can be critical of senior management, I’ve gained empathy for the challenges they face. They’re constantly balancing transformation priorities against immediate crises – whether it’s bed closures, flu outbreaks, or other urgent matters.
I’ve also observed that we have often fallen into the trap of designing innovations that are person-dependent. We can implement quick fixes that work well until the person who created them leaves, and then everything falls apart. I have to be mindful that many staff members have seen this cycle repeat over twenty years – they’ve seen people come in with change initiatives that ultimately collapsed when that person moved on. It is not surprising to encounter scepticism towards new innovations if the system doesn’t support innovation sustainability.
I’ve learned that embedding improvement support directly within the clinical team is effective in supporting and maintaining innovation momentum. Being present on the wards, chatting with staff, and working alongside everyone from interns to consultants helps create organic opportunities for innovation and improvement. While some institutions have dedicated transformation teams, we’re still developing this culture at scale in our organization. It’s happening in pockets, and my role is about trying to connect these pockets within the orthopaedic service and build momentum for larger-scale improvements.
“My journey into design thinking has reshaped my approach to quality improvement, teaching me to embrace the perpetual space of iteration and uncertainty that comes with innovation– it doesn’t mean we’re not making progress.
It has also helped me to become more flexible in my approach to quality improvement, recognizing that the first solution is often a stepping stone to a more impactful end product.”
One of our biggest challenges is the degree to which our workflows and initiatives are interconnected with other organizations. For instance, we still communicate with other healthcare sites through paper, phone, and email. When you look at our current processes in more detail, many current are actually historical workarounds that have become standard practice, with people not even knowing why they were originally introduced. Attempting to innovate in this space recently, I along with clinical colleagues advocated to implement a digital dashboard system for patient referrals, but faced barriers around funding and IT infrastructure restrictions between healthcare sites.
This is one example of the enormous potential for innovation in healthcare, with many willing and passionate participants. However, the system support and culture needed to nurture these innovations isn’t quite there yet. It’s like that map of Ireland’s GAA pitches – there’s a bright constellation of people across healthcare willing to make changes, but layers of bureaucracy and competing priorities often dim that light, making it challenging to get innovations off the ground.