As Cleveland Clinic celebrates its centennial anniversary in 2021, leaders tout the invaluable role of nurses in the healthcare system’s success. But their contributions go beyond excellence in clinical care. Cleveland Clinic nurses help shape their profession and the overall healthcare landscape through research and innovation.
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Since its formal inception as a one-person support department in Cleveland Clinic’s Nursing Division in 1988, Nursing Research and Innovation has evolved into a robust office led by ACNO Nancy Albert PhD, CCNS, CHFN, CCRN, NE-BC, FAAN. Albert and a team of five nurse scientists guide and support nurses in conducting, translating and disseminating research that increases knowledge about clinical and administrative practices and facilitates evidence-based practices to improve patient outcomes.
“For Cleveland Clinic to be a leading hospital in the country, with a leading nursing institute, we can’t rely on others to develop the science and foundation that form our practices,” says Albert. “We need to be an integral part of the development process.”
Between 2004 and 2020, more than 900 nursing research projects have been initiated across the Cleveland Clinic Health System. Last year alone, there were more than 100 active nursing research projects. Topics vary widely, from the relationship between exercise volume and COVID-19 disease severity to the impact of the aesthetic environment in the OR.
“All nursing practices should be based on science and evidence whenever possible. We should practice based on highest quality and strength of evidence that forms the basis of how we implement best care of patients and how we achieve best outcomes,” says Albert. “The best way to obtain solid evidence is through research.”
Between 2% and 5% of the 28,000 nursing caregivers at Cleveland Clinic will lead or participate in the conduct of a nursing research project at any given time. The Office of Nursing Research and Innovation supports them in several ways. Each researcher is paired with a nurse scientist mentor. In addition, nurses have access to an intranet website featuring a research database and templates, checklists, forms and information about planning and conducting research, as well as disseminating and translating completed research. Other resources include online educational modules, workshops, internal nursing research and literature review grants, statisticians and an art and photography department.
“We support nurses from the inception of a research question all the way through dissemination in a peer review journal and translation or implementation into practice,” says Albert. Between 2012 and 2020, Cleveland Clinic nurses were authors on nearly 200 published research papers, and in 88 papers, nurses served as first authors.
As its name suggests, the office also fosters innovations. “We believe every single Nursing Institute employee can support innovation, whether they come up with a clever idea or raise awareness of an issue that happens repeatedly and could minimize patient care or decrease the effectiveness of what we do day in and day out,” says Albert. “Part of our job is to let nurses know what resources are available and help them understand that it’s everybody’s job to use their voice, communicate ideas and foster innovation.”
A part-time innovation coordinator in the Office of Nursing Research and Innovation helps nurses move their ideas forward on paper and to Cleveland Clinic Innovations (CCI), the healthcare system’s commercialization arm. If innovations make it to the prototyping stage, the Office of Research and Innovation partners with nurses to perform a rigorous review of the project and its value.
CCI employs a dedicated team, including market analysts, subject matter experts, patent attorneys and former medical industry leaders. “We have wonderful teamwork and connectivity to engage and support anybody on our team who comes up with a cool idea,” says Albert. “We have a team-behind-the-team that can help out.”
While other healthcare systems support nursing research and innovation, Albert says a handful of factors make Cleveland Clinic a leader in the field. First, Albert and the other nurse scientists are all PhD trained and have research backgrounds. “We know how to mentor someone appropriately so that their proposal is rigorous, their methods are high strength and their analysis plan is complete. A research study that is completed with high quality, even if it is simple, will be more likely to be shared nationally and internationally, published in a high-tiered journal and translated into practice,” says Albert.
In addition, Cleveland Clinic’s nurse scientists focus their time on research and evidence-based practice work, not side projects that minimize the impact on setting a foundation of science. “They devote all of their time to their craft, which allows them to get better at what they do and offer high-quality services with less need for revisions,” says Albert. In this way, the nurses who are mentored can spend more time on implementing their research projects, rather than developing and then revising them up front.
Finally, and perhaps most importantly, Cleveland Clinic leaders wholeheartedly support research and innovation. “Our Nursing Institute leaders understand the value that new knowledge and science brings to Cleveland Clinic patients and nursing teams. They share their enthusiasm for nursing research projects and encourage and support our nurses to be successful,” says Albert. “Leaders also understand the value of innovative ideas and bringing innovations to life. And because they understand the value of our programs, we are able to truly support the nurses we serve.”
As Cleveland Clinic embarks on its next century of providing world-class patient care, the Office of Research and Innovation is evaluating candidates for a sixth nurse scientist position. In addition, it plans
to increase the number of high-quality research projects that nurses produce and share to further the foundation of nursing.
The Office of Research and Innovation offers a fellowship program to non-Cleveland Clinic nurses with PhDs who want to become clinical scientists. Albert envisions branching out and consulting with non-Cleveland Clinic hospitals that want to become more engaged in research but lack sufficient internal support.
“Down the road, I foresee us as a regional or national presence, helping other sites,” she says. “In research, multi-center studies are important, so by helping others we create stronger science.” And stronger science that supports nursing practices and patient care outcomes are the ultimate goals
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