Nolwenn successfully proved that empowering health professionals is a lever for change that every stakeholder will gain from. Seeing how powerless most her colleagues felt, she realized that the present system contributed to widespread distress and burnout. Building on her initial experience of engaging a team of nurses within the hospital to develop concrete new care solutions, such as a digital application to reduce children’s anxiety before surgery, she identified the key elements any health professional would need to launch his/her own initiative: a core team of motivated staff with an “I can” mindset, a locally registered organization and a sustainable revenue stream to be able to act independently, a recognized identity bringing credibility and facilitating support, and administrative support to ease the whole process. To establish a sustainable revenue stream, Nolwenn taped into an overlooked opportunity in recycling a certain type of non-contaminated hospital waste, such as copper scalpel cables that are usually disposed of at high costs like all potentially contaminated biomedical waste. In addition to sustain local activities, this recycling process is also an opportunity to bring hospital teams together around an environment-friendly action. As for the shared and recognized identity, Nolwenn developed the national brand “Les P’tits Doudous” under which local teams can independently organize. What is more, Nolwenn’s positive and empowering posture is a real shift, giving nurses confidence to launch impactful projects to address local patients’ needs.
To transfer these key elements to other teams of professionals in other health centers, Nolwenn designed a framework of values and tools including general advice, the recycling protocol, a chart to ensure a quality control, the brand (name, logo), document templates and administrative support to register a separate local organization, as well as 2 tablets displaying the digital application she created so that they can quickly implement a first impactful action.
Equipped with this carefully crafted free toolkit, already 40 local chapters emerged across France (Lyon, Montpellier, French Polynesia, Lille, Nancy, Paris, New-Caledonia...), independent but united under the national brand “Les P’tits Doudous”, to replicate the initiative Nolwenn initially led in the public University Hospital in Rennes. This represents about 300 volunteering health professionals who are actively designing and implementing a range of projects, from small local initiatives such as a toy car to take younger children to the operation theatre in a playful atmosphere, to bigger projects such as implementing the use of digital applications to decrease the patient’s anxiety. Nolwenn’s first digital application is a "serious" game that engages children in the fun of playing in order to lower their anxiety level and accompany their hospital pathway before surgery. It was implemented by each and every local team: it is now lowering the pre-surgery anxiety of 50,000 children a year, reducing the length of hospital stay and decreasing post-surgery pain, sleep disorders and drugs intake. Furthermore, it impacted the hospital practice in Rennes and in a growing number of other hospitals: seeing the impact of this new practice, doctors now systematically prescribe the use of the application in replacement of all other premedication. Anticipating impact measurement, Nolwenn directly included data collecting mechanisms in her app so that both health professionals and children from any hospital could provide inputs regularly in order to continuously improve the solution. Beyond the impact on patients, Nolwenn’s initiative also addresses the issue of burnouts and ill-being of health professionals, with first qualitative testimonies showing an increased motivation and potential impact on the rate of sick leaves. Nolwenn is planning to further measure and analyze this impact by working with a psychology university. Finally, the recycling model widely adopted by local chapters positively impacts the environment by recycling tons of materials that were previously incinerated; and offers the additional benefit of avoiding costs for the hospital.
To further structure and enhance this growing decentralized network and its impact, Nolwenn now steps into a national coordination role. To do so, she structured a “mother” national non-profit organization whose role is not only to support existing and future local chapters, ensure values consistency, but also to identify major shared needs across the network of teams, set up priorities and mobilise accordingly resources to develop and launch new projects answering these needs at national scale. The national coordination team also coordinate impact measurement. This mother structure is governed by health professionals representing all local chapters to ensure collective decision-making. Five national-scale projects are currently underway, including a pre-surgery visualization of the operating theatre through an augmented reality application for teenagers, or a software to expand and endorse the knowledge and expertise that patients acquire about their pathology during their hospital experience.
To fund the development of these projects, Nolwenn plans to leverage the power of her brand and digital apps. To do so, she created a sister commercial entity that allows her to manage the sale of “Les P’tits Doudous” by-products (teddy bears, bags, stickers, ...), ordered by local teams and patients, and the sale of her digital products to other interested organizations. For example, firefighters already expressed their professional interest for a real-time tracking application for family and professionals to follow the surgery process of patients. All benefits will be re-invested in the development of further projects, and the capital of this commercial entity is fully owned by the non-profit entity, thus ensuring control by health professionals on the long term. Looking to the future, Nolwenn also identified opportunities in partnering with national health insurance groups who see value in financing initiatives that decrease patient medications and/or increase caregivers’ wellbeing.
The ultimate pieces of Nolwenn’s national role are representation, advocacy and managing international development. Already featured in several media and publicly congratulated by the French President, Nolwenn has now started conversation with key public decision-makers and is leveraging her public and institutional visibility to advocate for a renewed health system in which nurses and all health professionals would have recognition and allocated time for contributing to care innovation. By sharing her experience in national and international health congress, Nolwenn also identified strong international development opportunities. She is currently discussing with health professionals from Canada, US, Europe, willing to replicate her solution. She also travelled to Jordan and used her digital application to overcome a language barrier.