Holly Krelle

2019/2020 Recent Returners

Holly is a 19/20/21 Harkness fellow, based at NYU Langone Hospital, in their Center for Healthcare Innovation & Delivery Science. Like most of us, her year was somewhat disrupted by COVID19 – she paused her research in March, returned to the UK, and took up a post in the UK Government’s COVID19 Taskforce. She has since (just) returned to New York to complete her research.

Before her fellowship, Holly was a principal analyst at the Prime Minister’s Implementation Unit – the central team responsible for delivering the prime minister’s top domestic priorities. She led on health & social care work force and digital technologies. Prior to joining the unit, Holly worked as a senior analytical manager in NHS England, where her work included leading the evaluations of new digital models of primary care, such as Babylon GP at Hand. She is a social researcher by profession and began her career at the research consultancy ICF International, where she led research and evaluation projects across health, social care, and education for the U.K. government and European Commission. She holds a first class degree in human sciences from the University of Oxford, and an M.Phil. in applied biological anthropology from the University of Cambridge.

Holly’s research focus is on innovation centres in U.S. hospitals, and the extent to which the NHS could, or should, replicate them. These centres use methods including design-thinking, rapid RCTs, and lean/six sigma, with the aim to quickly develop, operationalise and robustly evaluate new innovations (often digital innovations) within a hospital system. They are built from a recognition that healthcare systems have always struggled to do two things: (1) to spread innovative, successful ideas from one part of a healthcare system to another and (2) to support individual hospitals or clinicians to rapidly test, evaluate and scale their own interventions. Effective innovation centres make applied research local, combining the capabilities of robust academic analytical and consultancy support, with an approach that is highly operational and embedded within a hospital.

To date, most of the research on innovation centers has focused on how well they generate ideas, rather than how effectively these ideas are operationalised and evaluated. As a result, there has been little work on how these centres operate and the outcomes they achieve. This study – still in progress – looks at how the centres derive their power and influence, and how they operationalise and evaluate their work. It also includes interviews with innovation leads from two to three major hospital trusts within the UK to understand the potential for these centres within the NHS; what the barriers to implementation are; and what key learnings could be gained from the U.S. context.

Since returning to the U.S., Holly has also begun a second project looking at the transformation of NYU hospital during the first wave of the COVID 19 pandemic. This looks at how NYU’s frontline hospital staff (nurses, physios, cleaners, security guards, IT staff, etc.) innovated during the first wave – and how we might apply those lessons to hospitals operating in more ‘normal’ times.