title: A Century of Surgical Innovation at a Boston Hospital.
abstract: BACKGROUND
  Innovation has been a central focus of the Department of Surgery at the Brigham and Women's Hospital since its very inception. Here we review examples of innovations originating in this Department and analyze factors that have been critical to successful innovation. Finally, we discuss challenges to sustainability of innovation in this Department.
  
  
  METHODS
  Narrative review of the literature, interviews, and personal observations.
  
  
  RESULTS
  Examples of innovations reviewed here were each dependent on three critical elements: 1) multidisciplinary collaboration among surgical innovators and individuals outside of surgery who offered complementary skills and expertise, 2) a rich institutional environment that sustained a diverse complement of innovators working in close proximity, and 3) Department Chairmen who facilitated the work of innovators and promoted their contributions, rather than seeking personal prestige or financial gain. Contemporary challenges to sustainability of innovation include the prevailing emphasis on clinical efficiency and on cost containment.
  
  
  CONCLUSIONS
  We have identified factors critical to successful innovation in a Department of Surgery. The relevance of these factors is unlikely to be diminished, even in the changing landscape of modern medicine.
authors.affiliation: 1 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: JaBaris D
authors.initials: JD
authors.lastname: Swain
authors.affiliation: 1 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sharma
authors.affiliation: 1 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Rowza T
authors.initials: RT
authors.lastname: Rumma
authors.affiliation: 2 Department of Surgery, West Roxbury Campus, VA Boston Healthcare, Boston Massachusetts.
authors.forename: P Marco
authors.initials: PM
authors.lastname: Fisichella
authors.affiliation: 1 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Department of Surgery, West Roxbury Campus, VA Boston Healthcare, Boston Massachusetts.
authors.forename: Edward
authors.initials: E
authors.lastname: Whang
mesh_terms: D001900:Boston; D013502:General Surgery / Q000639:trends*; D006784:Hospitals, Teaching / Q000639:trends; D006801:Humans; D009936:Organizational Innovation
keywords: Brigham and Women's Hospital; innovation; surgery