A novel framework for structuring sustainable innovation in surgery

<h2>Abstract</h2><h3>Introduction</h3> Surgical innovation has offered some of the most remarkable advances in technology in human history, often starting in the clinical setting. Despite unique approaches to problem solving among clinical surgeons, there are few structures for innovation which offer a sustainable pipeline of new technology. We hypothesized that a simple framework addressing 4 steps would support sustainable innovation. <h3>Methods</h3> To identify unmet needs, we assembled a team of clinical specialists who attended problem-focused quarterly white-board sessions. Solutions generated were directed towards a single unmet need, using evidence-based-design sketches and prior art assessment in real-time. To assess solutions, solution-specific sub-groups were built with direct institutional availability to engineering, intellectual property, and business expertise. Entrepreneurs and team leaders then built business models for each opportunity. <h3>Results</h3> Unmet need identification was achieved within the first meeting, and the structured framework rapidly yielded innovative solutions in 7 different categories, including surgical training, vascular access, improved ergonomics and patient positioning, visualization enhancement, and workflow optimization. Each project was prioritized for development based on achievable timelines. Within 1-year, this resulted in 3 patent applications, 1 issued patent, 2 funded in-house development projects, and 1 funded clinician-led startup enrolled in a nationally recognized accelerator program, with a combined total addressable market of $9.8 Billion. <h3>Conclusion</h3> We present a successful, innovative structure for a multidisciplinary group within a large academic surgical department focused on education of the innovation process. This clinician centered, stepwise approach provided a pathway for commercialization which is absent in most surgical environments and facilitates rapid generation of highly valuable ideas.