Improving the health care system through nursing innovation

On May 9, more than 70 people came to a knowledge exchange and dissemination day at the University of Montreal’s Laval campus to find out about nine nursing innovations that can improve frontline care and services. It was co-organized by Professor Arnaud Duhoux of UdeM’s Faculty of Nursing, who is interested in the role of nurses in delivering frontline care and services.

The event attracted strong interest in the nursing community. As the vast health care system is managed differently from one region to another, attendees wanted to learn about other ways of doing things that could bring positive change to health care. Representatives of the nursing organizations—the Ordre des infirmières et infirmiers du Québec and the Fédération interprofessionnelle de la santé du Québec—came to pick up new ideas. The Ministry of Health and Social Services (MSSS) sent officials from several branches, including the nursing care and services directorate.

“It turned into a bigger event than we had expected, due in part to the presence of the MSSS representatives,” said Duhoux. “It shows there’s considerable interest in the subject. Given the current plans to revamp the health care system, we hope the policy-makers will take inspiration from some of the approaches that were presented.”

Innovations designed with users in mind

All of the projects presented were aimed at improving access to frontline health care, the first place people go when seeking care.

Each of the innovations made full use of the capabilities of clinical nurses and specialized nurse practitioners. They demonstrated not only the clinical and organizational leadership of nursing professionals, but also their ability to come up with and implement novel ideas to improve frontline services.

The projects included community and mobile clinics for marginalized populations that have difficulty obtaining health care services, specialized clinics (wound care, breastfeeding) using an intrapreneurial model in university-affiliated family medicine groups, and clinics with innovative organizational models where nurses play a prominent role within interdisciplinary institutions.

“Over the years, I’ve seen how frontline nursing innovations can fill gaps in the health care system and take care of populations which, for various reasons, do not have access to the existing system or are rebuffed by it,” said Duhoux. “But the way Quebec’s current system is designed and funded doesn’t encourage nursing entrepreneurship and is a major barrier to new ways of doing things. The situation is backwards. Some of the outside-the-box approaches that were presented use volunteers or are struggling to obtain public funding, and the health care system is sending them patients. It should be up to the system to look after these patients, and to make its funding structures more flexible to incentivize innovation and let everyone get the care they need.”

To follow up on the event, a document summarizing the ideas and discussions will be produced. Arnaud hopes that the presence of policy-makers such as the officials from the MSSS nursing care and services directorate will help prompt consideration of the possible role of nurses in the redesign of the health care system.