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November 18, 2019–January 13, 2020 6 Working Nurse l WorkingNurse.com ON THE QUICK Nursing & Healthcare News Implementing Nursing Innovation Introducing Design Thinking for Health A re you looking to introduce more innovations to your clinical practice, or teach nursing students how they can do so? A new online curriculum can help. Designing Innovations That Work Change in healthcare can be a slow, conservative process, full of pitfalls. Just because an initiative is evidence-based doesn't mean it fits the needs of clinicians or patients, leading to resist- ance and a tendency to fall back on the way things have always been done. Some researchers think the answer is a healthy dose of design thinking, a five-stage process based on common tech development concepts like user needs assessment and proto- typing. When applied correctly, this process can result in initia- tives that are better tailored to the needs of the people who'll actual use them. Five-Module Curriculum To familiarize nurses and nurse educators with this process, the University of Pennsylvania School of Nursing and the Rita & Alex Hillman Foundation have launched a new online curriculum, Design Thinking for Health, that explains how design thinking works and how to apply it in healthcare settings. The curriculum is available online for free, offering five mod- ules that learners can complete at their own pace. There are also other resources such as case studies from clinicians who've applied these ideas in the real world. Free to Use and Adapt Although UPenn and the Foundation jointly own the new cur- riculum, they're encouraging nurse innovators and educators to use and adapt the program for their own classes and clinical workplaces. "It is essential that we help all nurses become innovators, which is why this versatile and modular curriculum is designed to be taken up, adapted, used as a reference or infused into practice," says Penn Nursing Associate Dean of Research and Innovation Therese Richmond, RN, Ph.D., FAAN. You can learn more at designthinkingforhealth.org. WN For direct links to the websites cited, find these articles at WorkingNurse.com D espite the urging of hospital associa- tions, the Centers for Medicare & Medicaid Services (CMS) are going forward with their controversial Hospital Compare ratings for 2020, delaying any major changes to the methodology for another year. Ill-Starred? Launched back in 2005 and published on Medicare.gov, Hospital Compare assigns hospitals a single overall star rating, from one to five stars, based on quality reporting measures. Hospitals and hospital associations have long criticized the way CMS uses those metrics to calculate the ratings, which the American Hospital Association (AHA) has called "inaccurate" and "misleading." Despite those complaints, CMS plans to retain the current system for the 2020 rat- ings. Administrator Seema Verma, MPH, promises that the agency will reevaluate its methodology based on stakeholder feed- back, but any changes won't take effect before 2021. "Longstanding Concerns" AHA Sr. Vice President for Public Policy Analysis and Development Ashley Thompson says her organization "is disappointed that CMS intends to continue using a hospital star ratings approach plagued by long- standing concerns about its accuracy and meaningfulness." She thinks CMS should hold off on releasing new ratings until the methodology gets a complete overhaul. America's Essential Hospitals President and CEO Bruce Siegel, M.D., MPH, has called on CMS "to suspend publication of the rat- ings … to avoid confusion among patients and disproportionate effects on hospitals." Comparing Apples to Oranges In March, Siegel wrote a nine-page letter to CMS, detailing a litany of complaints about the rating methodology (such as the lack of risk adjustment for patients' socioeconom- ic status, which penalizes hospitals that treat poorer, sicker patients) and question- ing the value of assigning star ratings at all. "A hospital's single, simplified rating might fail to capture its particular expertise in an area of care most important to a given patient," he warned. "For example, a hospi- tal's complication rate after an orthopedic procedure provides little useful informa- tion to a woman deciding where to give birth." WN Controversial "Hospital Compare" Ratings Continue CMS metrics called "inaccurate" and "misleading"