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Taking a Page From Thomas Edison

December 1, 2006
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The legacy of the Wizard of Menlo Park shows the benefits of LTC managers thinking outside the box by Yael Sara Zofi and Saro Varjabedian
BY YAEL SARA ZOFI AND SARO VARJABEDIAN* Taking a page from Thomas Edison
Facilities trying to survive by innovating have a ready source of inspiration at hand Thomas Edison's numerous patents and inventions are among the most recognizable of the 20th century. He is credited with a mind-boggling 1,093 patents and inventions, more than any other individual in history. His rich legacy can serve as an inspiration to-and guide for-today's long-term care (LTC) professionals, who face daunting pressures and complexities. Here are some key elements of innovation that lie at the heart of Edison's ideas, and initiatives created by five LTC providers that exemplify their meaning.

Key Element 1: Creating a System of Innovation
"My main purpose in life is to make enough money to create ever more inventions...."

In 1871, Thomas Edison took the earnings from his first invention and leaped into the "innovation business" by setting up a lab whose sole function was to act as a "hothouse for innovation." Within a year it had grown into the largest scientific testing laboratory in the world, and by 1887, it was recognized as the world's first full-fledged Research and Development (R&D) center. This organizational system enabled Edison to simultaneously create many innovations. His own role at the lab developed into that of the innovative leader, as he oversaw the development of each team project.

Jefferson's Ferry, which includes The Bove Center, a 60-bed skilled nursing center with 20 beds allocated for dementia and Alzheimer's residents in Suffolk County, New York, exemplifies this innovation system approach. It instituted daily morning meetings for the management team, in which department heads discuss daily events and coordinate activities. They brainstorm on how to continually improve their quality of care. "Thanks to our commitment to open communication," says Administrator Donald Jacobowitz, "we've come up with a number of initiatives. For our dementia and Alzheimer's residents who are confined to their units, we've started a 'lunch-in' program. Every week, they go to the main cafeteria and are served as if they are eating at a restaurant. We also started a Caregiver Support Group, where caregivers and family members run monthly meetings and share ideas."

The Bove Center's innovation system is functioning in a way that would make Edison proud.

Key Element 2: Understanding "Innovation"
"I never perfected an invention that I did not think about in terms of the service it might give others...I find out what the world needs, then I proceed to invent...."

Invention and innovation share the same root, but they differ slightly from each other; the distinction is slight, but important. For example, Edison's very first invention was a voting system that enabled Congress to instantly poll votes. However, because Congress did not purchase this system, it did not qualify as a true innovation. An invention only becomes an innovation if it is implemented, finding a practical use.

This experience taught Edison the importance of first determining whether the market wanted or needed something before he set to work on a specific invention. He made a conscious attempt to peg his efforts to the needs of his environment and evaluated the chances of implementation before committing resources to a specific project.

Elant at Goshen, Inc., a 120-bed nursing home in Goshen, New York, recently replaced paper-based flowcharts with a computer care-tracking system for use by CNAs. The objective was to create a paperless system to monitor and coordinate resident care and minimize human error. "Generally, e-document systems have been for doctors or RNs," says Patti Vuolo, RN, vice-president for Clinical Affairs, "but our system allows CNAs to document the care they provide to the resident via a touch screen displayed on kiosks located in hallways. This system provides for documentation immediately after care is provided, which enhances accuracy." The nurse can check that all care is documented for each shift by accessing user-friendly graphs. This eliminates "missing documentation." The system is integrated with the MDS assessment tool required by the Centers for Medicare & Medicaid Ser-vices as part of reimbursement.

For Elant at Goshen, this was an invention for staff operations that definitely qualified as an innovation.

Key Element 3: Establishing Creative Equitability
"Genius is one percent inspiration and ninety-nine percent perspiration."

Often we think of R&D departments as elite groups of "creatives." Edison, however, downplayed the importance of the so-called creative impulse. According to his model of innovation, creativity is a by-product of hard work.

This idea of creativity as a commonplace attribute inherent in everyone, only waiting to be brought out, demystifies the innovation process, making it accessible to all. Establishing a culture of "creative equality" opens up innovation to the entire organization, allowing for a greater pool of idea-generators and innovation-producers.