How The Nicholson Foundation Brought Innovation to the Healthcare Safety Net

Note: This story is part of Our Legacy Series about important work the Foundation has supported that others might want to continue and build on after we close our doors the end of 2021.

Innovating healthcare delivery systems to provide better care for more people in underserved communities has been an important element of The Nicholson Foundation’s grantmaking since 2014.

The concept of applying innovation to the healthcare sector has been a perennial hot topic, and for an obvious reason: to provide more care for more people requires either more money, or a more innovative approach.  Innovation offers the promise of providing better care for more people at lower cost.  And vulnerable populations—typically not the focus of technological innovations in the healthcare industry—stand in particular to benefit from new approaches.  Thus, the Foundation sought to explore how to fund innovations within the healthcare safety net that could lead to sustainable systems change.

Early Efforts

The foundation’s first forays into the innovation space began with two strategies:

  • Funding competitions designed to unearth promising models or interventions in healthcare delivery.  Through this approach, we sponsored two “Idea-thon” innovation competitions with Health 2.0, a digital health media company, and Rutgers University, which provided the participants. 
  • Exploring possible investments in healthcare-related technology solutions such as medical devices.  This approach led to several small projects with start-ups that focused on the needs of underserved populations.

While both approaches showed the potential to yield good ideas, the foundation decided they wouldn’t lead to sustainable systems change as they would require continuous funding to remain viable.

New Partnerships Lead to New Ideas

Our explorations into the healthcare innovation space led us to organizations applying innovative techniques in the healthcare industry, including the Oakland, California-based Center for Care Innovations (CCI) and Stevens Institute of Technology in Hoboken, New Jersey. 

The Foundation first began working with staff at Stevens through the entrepreneurial technology-focused grants previously mentioned.  This relationship led to a larger grant in 2019 to create and implement a technology-based educational and organizational development program at Monmouth Medical Center in Long Branch, New Jersey.  The aim of the project is to improve the quality of care and enhance patient satisfaction scores for Monmouth’s expanding population of Medicaid and other safety net patients.  Although the COVID-19 pandemic delayed the implementation of the project, Stevens hopes the platform will prove successful and that they will be able to expand this service to other safety net hospitals.

The Nicholson Foundation has been partnering with the Center for Care Innovations since 2015, initially working to build human-centered design skills in nine safety net organizations in New Jersey to implement innovation strategies that would lead to lasting improvements.  A key to CCI’s approach is using a collaborative peer-learning approach to apply the principles of human-centered design to a critical problem within the organization.  Human-center design is a problem-solving approach based on understanding the perspective of the individuals who experience a problem and whether the solution that has been designed for them is truly meeting their needs.

Building a hospital-based innovation center

This introduction to human-centered design eventually led us to the capstone of the Foundation’s work on innovation in New Jersey—the creation of a hospital-based innovation center.

Innovation centers are designed to be catalysts for continuous innovation, embedded within the hospital.  Staff members are brought together across disciplines to work with innovation coaches to design solutions to problems they are encountering in their day-to-day work.  The innovation center also helps staff define and track the data that will help in evaluating the outcome and proving if the projects are successful.

The Nicholson Foundation engaged the leadership at St. Joseph’s Health, a safety net hospital in Paterson, New Jersey, in an intensive 6-month planning process that included a site visit to Columbus Regional Health in Columbus, Indiana—the site of a nationally-recognized, hospital-based innovation center.  The group also attended training in human-centered design, and explored different models of innovation at various organizations.

Due to the success of this planning grant, in 2019 the Foundation provided St. Joseph’s an $800,000 grant to create its own innovation center.  We also provided a grant to CCI to assist St. Joseph’s with implementing the innovation center.

Since launching its innovation center, St. Joseph’s has hired a center director, partnered with a human-centered design trainer to build the skills within their organization, and is selecting satellite offices throughout the St. Joseph’s system.  It will soon be onboarding two innovation strategists. It has held human-centered design training sessions and has identified initial projects.  With strong support from senior management, the Innovation Center at St. Joseph’s is poised to serve as a model for other safety net hospitals.  At the conclusion of The Nicholson Foundation’s grant, St. Joseph’s hopes to share lessons learned with other hospitals that will allow them to replicate the model.


Our nearly decade-spanning journey through the world of innovation brought us into partnership with many organizations across several states.  It has yielded considerable and valuable information about applying innovation to the safety net healthcare environment, as well as the critical role of human-centered design in these efforts. More so, the knowledge The Nicholson Foundation has gained about applying innovation to deliver better healthcare solutions for vulnerable populations could be equally valuable to other funders interested in furthering the work we helped start.