Disruptive Innovation in Graduate Nursing Education: Leading Change.

D isruptive innovation. It sounds messy, and rebellious. You may have run across this term in the leadership or business literature. Although disruptive innovation seems to be the new buzzword, the concept itself has been around a long time. For example, ‘‘creative destruction’’ defined businesses that took advantage of new technology and was coined by Schumpeter in the 1930s; in 1989, ‘‘permanent white water’’ denoted the turmoil and chaos in a changingworld, and the use of terms such as reengineering, reinvention, and healthcare reform in recent decades brings visions of change and chaos. However, the goal of disruptive innovation is not to bring chaos but to provide value to underservedmarkets. The innovation’s purpose is to transform an existingmarket or sector by introducing simplicity, convenience, accessibility, and affordability where complication and high cost are the status quo. Initially, a disruptive innovation is formed in a niche market that may appear unattractive or inconsequential to industry incumbents, but eventually the new product or idea completely redefines the industry.6({2) Personal computers, cellular phones, and the Internet are examples of disruptive innovation. In fact, the Internet has been identified as the number 1 disruptive force in recent history. The theory of disruptive innovation was created by Dr Clayton Christensen from Harvard University and posits that transformation in any industry occurs when small entities disrupt larger ones by focusing on efficient and economical processes and procedures as simpler solutions for complex problems; the disruptors also focus on a new or underserved market of consumers. It is important to note that the impetus behind the disruption is not to improve a product, but to meet consumers’ unmet needs. Because these innovations upset the status quo, they are resisted and frequently ignored by those stakeholders, as inconsequential. However, disruptions can also cause the larger entities to innovate to defend theirmarket sector. The goals of both types of innovations (disruptive and defensive), if successful, lead to positive outcomes for the consumer. Disruptive innovation is not confined to the business world, though; so let us talk about disruptive innovations in healthcare and education. The passage of the Patient Protection and Affordable Care Act in 2010 was, and remains, the impetus for much disruption in healthcare deliveryVand ultimately for nursingeducation. Theestablishmentof clinical nurse specialists (CNSs), nurse practitioners, and other advanced practice nurses to address unmet consumer needs has also been labeled as a disruptive innovation in healthcare delivery. Indeed, CNSs have been at the forefront of disruptive change by challenging the status quo and designing innovative processes and procedures to improve the delivery of healthcare and promote positive patient outcomes. The growth of independent primary care andurgent care clinics in retail establishments (increasingly staffed by nurse practitioners and/or physician assistants) and telehealth applications in rural and remote areas of the country are other examples of disruptive innovation in healthcare. In response to the growing recognition of this phenomenon, the Journal of Nursing Administration is implementing a new column to identify the process and impact of disruptive innovations occurring in healthcare institutions. Author Affiliation: President and CEO, CJT Consulting & Education, South Fork, Colorado. The author reports no conflicts of interest. Correspondence: Cathy J. Thompson, PhD, RN, CCNS, CNE, CJT Consulting & Education, PO Box 1263, South Fork, CO 81154 (cathyj. thompson@hotmail.com). DOI: 10.1097/NUR.0000000000000199