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Bill Klaproth (Host): Do you know what an onsite maker-space is and how it can benefit you and your staff? And how did it help Unity Point Health St. Luke's Hospital in Cedar Rapids, get through the pandemic? And what is the outlook for the future of the maker-space? Well, let's find out with Rose Hedges, Nursing Research and Innovation Coordinator and Carmen Kleinsmith, Senior Vice President and Chief Nurse Executive, both are from Unity Point Health St. Luke's Hospital in Cedar Rapids.

This is Today in Nursing Leadership. A podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Rose and Carmen, thank you so much for your time. This is going to be a great podcast. I'm so interested in learning more about this. So let's start with this, so we're all on the same page and we all understand what this is. Rose, can you tell us what is a maker-space and what is the inspiration for this?

Rose Hedges, DNP, RN (Guest): Sure. So a maker-space is a physical place where someone can go and prototype or experiment or make their idea come to life in a tangible thing.

Host: So, when you say, make their idea come to life, this would be, say a nursing, you know, I think we could do this better. This would help us be more efficient or this would help with patient care?

Rose: Absolutely. It could be something as simple as a headband that helps hold oxygen tubing out of the way, to a device that's coded to hear a certain sound and then send me a text message.

Host: And Rose, you brought this to the organization. Is that right? Like, hey, why don't we start this? This would be good for us. Is that correct?

Rose: I did.

Host: Okay. So, what was your inspiration then? What excites you about this? What made you thought this would be great for Unity Point Health St. Luke's Hospital?

Rose: Well, I'm excited to tell this part of the story, I love doing so. I started at St. Luke's Hospital in 2010 as a bedside nurse working in critical care. During that time I was kind of intrigued and interested in going back to school. And I started studying innovation during my doctorate and kind of a tool to use innovation, to keep nurses at the bedside as a recruitment and retention kind of effort.

I found a little company, MIT, that was a spin-out called Maker Health. Partnered with them to start doing mobile innovation labs. Kind of the idea of a Maker-space, but mobile. So, I had a cart with all sorts of different materials that I would go around and host these mini maker labs, if you will, every month or so. And we would bring ideas to life. We would make something right there on the spot in partnership, and we would have these devices or new processes that we would be able to use to use help improve the way we provided care or maybe something we could use directly with the patient. And over the course of about 18 months, I had this great portfolio.

Carmen was always there to support me and cheer me along. And one day I said to her, Carmen, we really have something here. There's a lot of people engaged in what we're doing, a lot of ideas. They're starting to just, you know, as I walk down the hallway, somebody says, oh, hey Rose. I had an idea about, I'm really glad I ran into you.

And I said, wouldn't it be great if we had a physical space that they could come to, to bring their ideas and we can more rapidly get these ideas out on the unit. And that's kind of where the story starts. So, we worked together. I went to Carmen and said, let's do this. And she said, yeah, let's figure out a way to do this.

So we built a business plan and in collaboration with our foundation here, pitched to them, and they saw all the work we were doing and the great things that were coming out of it and wanted to support us. So, in the fall of 2019, we opened the doors to our physical maker-space inside the main hospital, right by the coffee shop, called Generate.

And it was incredible. So that was in the fall of 2019. And we all know what happened in spring of 2020.

Host: Right? Yeah, well, it sounds like it was very well received then, the maker-space. It seems like the nurses were very interested in this. Obviously, if they were stopping you in the hallway saying Rose, I've got an idea. So Carmen, let me ask you this. Why did you think, wow, this is really good, Rose and I have something here. Let's carve out a space. Why was this important to you to inhibit this? A maker-space to promote it, I should say?

Carmen Kleinsmith, MSN, RN (Guest): Well, if you've seen Rose in action, you can't miss the passion that she has with this kind of work. And truly, watching team members work in these little pop-up labs, she was facilitating, taking just regular, everyday kind of materials and prototyping things that would help them be able to do their work easier, it was fascinating. And so as she talked with me more and more about, what about putting a place on site within the hospital walls that people could come to? My first inclination was, oh gosh, where are we going to find the space for that? And, you know, it's probably not in our budget and.

But I couldn't deny the fact that it would be something very unique to us that would ideally further engage our team members in decisions about their work, get their feedback, help them feel that they're more empowered in being able to impact their work and who doesn't want that, in their teams.

So we went to the foundation, as Rose said. Our foundation here at St. Luke's is so, so supportive, of endeavors from our all of our team members through scholarships and other types of support. And it was an easy sell, not only to the president of the foundation, but then we presented our business case to the foundation board and they too very much supported the work.

And so we got right to work and creating the space. There actually was some vacant space that used to be the old library back when you had books in libraries and you had to have physical space for all of those periodicals. That space happened to be vacant and happened to be on the first floor, happened to be on a pathway within the organization that people can get to easily and walk by often. And, we pitched that and again, got good support to converting that space to our maker-space.

Host: Wow, what a great story. I love that. So, you said this was well received by hospital leaders. Basically an easy sell. I'm so happy to hear that. So Rose, you said, here we go, we got this thing off and running and of boy, this is going to be great. And then, oh, bam, the pandemic hit. So, were you afraid this was going to be shut down? You're like, oh no, now what, tell us how, how, what happened when the pandemic hit?

Rose: I can physically put myself back in that exact day. When I had the fear come over me, that they are going to shut me down, and this is going to kill the maker-space. I started getting emails. As most hospital employees can relate that all non-essential staff were to be working remotely, if they're not working at the bedside. We were preparing for kind of the unknown. We didn't know what was coming. We saw it on the coast, east coast, west coast, across the ocean. What was happening in here in the Midwest? It hadn't hit us yet. We didn't know. So I was getting these emails and I can remember it was late at night, but I couldn't sleep. So I sent Carmen an email and I said, what's going to happen to the maker-space? Here's a mask we created and we think that we can make more things to help, but, well, what are your thoughts? What's, what's going to happen with, with our doors? Are they going to stay open or shut?

Host: Right. So, Carmen, you, so how did you keep this open? Why did you keep this open? Why did you want to keep this going through the pandemic? Which was obviously, hit all of us so hard and unexpected, and our world changed overnight, basically. Why don't you keep this going?

Carmen: Well, because again, if you see Rose in action, she has this great passion to make things better. And oftentimes here in the Midwest, we see things happening on the coast before they actually come to us and then they work their way to the Midwest. So, we were kind of seeing what was being experienced, particularly on the east side of the nation and how PPE supplies were not able to keep up and we're going to need masks. We need hoods. We need all kinds of things that looks like are being problems everywhere else. And so the mask thing was something immediately that, that we needed to correct. And immediately, that's one of Rose's innate abilities to know what's needed first and how to prioritize that.

And so, she got right to work, with recruiting folks to work in the lab to help get these masks put together for not only the organization, but for our community. As she said, you know, all direct caregivers were being asked to be available to take care of patients, but we did have some caregivers and others in the organization that could not be at the bedside for whatever reason.

And so those were the folks that we would recruit to help Rose out with the plans that she had for the day. And again, it started with masks. But it quickly went to other types of equipment as well. And, we had incident command open, practically 24/7 there at the beginning. And if someone came to incident command and said, hey, we have a problem. We've got to transport COVID patients through these hallways. How are we going to protect them? We'd pull Rose in and say, Rose, here's the problem. Is this is something that the maker-space can help fix for us and she take it back and turn it around. So, I think I'll pause there and see how she would like to add to that.

Rose: Yeah, it was incredible. Carmen responded to my email and said, of course, we're going to keep you open. You're helping. This is great. We are being, we're responding. So, as Carmen said, it kind of started out with, we created a mask and we put a YouTube video out there and just said, hey, here's a cloth mask. Here's a pattern that we created that you can put a filter in if you need to. If you have the ability, and you'd like to donate some to our organization. Sure. And well, now I can see 4 million views later in 40,000 masks that were donated to our hospital. That was a success.

And it started with that. And as Carmen mentioned, the incident command would send us ideas our way, say, hey, somebody came down and said, what about when a patient we think might have COVID is in the back of an ambulance? How do we safely keep our caregivers safe and the patient safe and get them from the back of the ambulance, through the ambulance bay, in the hallway of the ER, into the room safely. Well, we didn't really think about that, maybe. What do you do? So they brought that idea to us and we, with the materials we had here, created a pop-up tent that we could safely cover the patient and make sure that they were safe, but we could still see them and get them safely into the room they needed to be. And that's just one project, but things like that, were kind of walking in the door everyday.

Host: So it sounds like the maker-space, uniquely positioned St. Luke's to respond to all of the unique needs of dealing with the pandemic. Is that right?

Rose: Yes.

Carmen: Very much so.

Host: I know you said you were afraid. Gosh, am I going to be shut down? But in hindsight it really was really valuable and a useful tool to have at your disposal during the pandemic.

Carmen: Absolutely. People were either walking in to the, to the space, or like I said, bringing up ideas in incident command that they were looking and seeing as, as concerns and the group in the maker-space, would kind of walk through what the, what the problem is, what do we need to fix it? What would it look like and get all the right stakeholders there? I think Rose you had all different kinds of folks there, disciplines, different people, that came down, to get help.

Host: Wow. This is really, really interesting. So, for someone listening, saying to themselves, okay, this is pretty cool. I want to do this. How can somebody start this? Where should they go first? What should they do? What is needed? Rose, let me ask you first, for someone listening to this and when they want to duplicate this or have some form of this what should they do?

Rose: Well, it starts with the culture and the culture doesn't happen overnight, but it starts with enabling people, whether it's a clinician or not, the ability to talk about things like work arounds, which is typically taboo in healthcare or experiment on their ideas, whether that's a break room or you designate a space where someone can bring their idea and say, I think that if we did this, we could really impact patient care by, give them the space, allow them to feel free to talk about those ideas. And it kind of starts with building that culture.

Host: Yeah, that makes sense. Carmen, how about you? What's your thoughts on that?

Carmen: I would agree entirely with that. It takes the culture that the team to be able to speak up ask questions and maybe push the envelope on the status quo and feel safe in being able to do that and have the conversations with the ultimate goal that we want to get to a better place in how we either care for our patients or take care of our teams.

Host: Yeah, that makes a lot of sense. So what is the key takeaway from having a maker-space then? Was there an unanticipated or a surprise benefit outcome of this as well?

Rose: Well, I'm going to go back to culture. I think that our culture, which we already had kind of started growing prior to the pandemic, just blossomed. We have, not even just in our hospital, we have now involved community members, other hospitals in our health system, we also published protocols on, hey, we made this device or this process, and it helped us during this time.

And it might help you too. So, we have that on our external website. We're all about open source sharing on how to kind of create these things and take these ideas and help our patients, but your patients as well.

Host: Carmen. How about you? Any surprise benefit outcome that you saw during this?

Carmen: I probably didn't anticipate that we would have the engagement and the output that we had during the pandemic. I probably would never had anticipated that, that would have occurred like it did. It doesn't surprise me now in hindsight that it did. That was maybe something I had anticipated. Now that that's behind us, it truly just laid the foundation for things to happen going forward so.

Host: So let me ask you that about going forward, where do you see this program going? Rose, let me start with you. So the, the initial pandemic is over. We're still in it, but we have vaccines now. Hopefully the end is somewhere in sight or at least where we can really just manage this thing where it becomes more like a flu in the coming year or so. Where does the maker-space go now? What do you foresee happening with the maker-space in the future?

Rose: Well, I think that the pandemic is a timestamp in our story, but it spring-boarded us to be able to show the rest of the world, the value of a space where people with ideas can work on those ideas. And I would love to say that this becomes the norm across the world. That there's a physical place in a hospital or a care setting where people can do that. They can experiment and prototype and work on these ideas to safely make them things we can use.

Host: That's wonderful. I love that. And Carmen, how about you? What do you foresee happening with the maker-space or what would you like to see happen with it?

Carmen: You know, and if I go back to one of Rose's initial objectives when she proposed this space is as a way to partner with folks for recruitment retention purposes, to engage our community, to kind of look broader than just Unity Point Health St Luke's, but, put more regionally and certainly as a system, I see that as a huge opportunity for us. Rose already does a wonderful job of partnering with our schools at all levels, grade school, junior high, high school, colleges, schools of nursing, working with community partners in innovation. I think it just, as Rose said, it becomes a part of what we do. And although we like to think that it sets us apart a bit because we've jumped into this innovation world head first.

In the future, I think it will be what the standard is. And I think the connections that are made now as Rose continues to grow the program, I think will be invaluable in the future for healthcare and, and for our industry.

Rose: I was just gonna say, I think it's really value added that the listeners understand that having a maker-space or an innovation lab inside of a hospital is not novel. We're not the first. And I, I know we're not going to be the last, but what makes us different is that we're inside of the four walls of the main hospital.

And we also, we're a 2 man team. I'm a nurse that still works at the bedside and we don't make the project for you. We give you the skills so that you can make it. And so you're actually in charge of making the thing that you want to see come to life. So, I think that's what sets us apart and that's how we're unique, but I would love to see more places like this open.

Host: Yeah, very empowering to the individual. So, as we wrap up, thank you both for your time. Rose, any final thoughts, additional thoughts you want to add about the maker-space as you overlook this past couple of years?

Rose: I just want to encourage anyone that's interested in doing what I did, to reach out. I'd love to help you, or even just start asking those questions to your leadership team of, hey, I heard this story. I'd love to do it here.

Host: Absolutely. And Carmen, how about you? Any final thoughts?

Carmen: I would concur with Rose it's, if there is interest, Rose is very willing to share, myself as well, but it's truly, truly been worth the investment for us.

Host: Absolutely. Well, Rose and Carmen, this has been fascinating and informative and inspirational quite frankly. So thank you both for your time. We really appreciate this.

Carmen: Thank you very much.

Rose: You're still welcome.

Host: And once again, that's Rose Hedges and Carmen Kleinsmith. And for more information, please visit aonl.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.