The basics:

• Hackensack Meridian Health‘s Bear’s Den program lets staff pitch solutions to health care challenges
• Initiative funds and pilots innovations aimed at improving patient care
• Winning concepts focus on patient communication, personalized care and mobility
• Ideas come from frontline clinicians across the HMH hospital network

Some of the newest ideas for improving patient care at Hackensack Meridian Health are coming straight from the front lines. As part of the Edison-based network’s annual Bear’s Den Internal Challenge, staff members pitched practical solutions aimed at addressing everyday health care challenges. And, after being evaluated by a panel that included CEO Robert Garrett, senior executives, board members and outside investors, three of those clinical strategies will be further developed and piloted at HMH locations to determine their effectiveness, according to the network.

Similar to the hit ABC pitch competition show “Shark Tank,” the Bear’s Den Innovation Program is a novel incubator that brings together industry experts and system leaders to evaluate and fund health care innovations.

The panel meets four times a year to review the most promising ideas from entrepreneurs, health care ecosystem partners and some of Hackensack Meridian Health’s 38,000-plus team members. Winning concepts could receive funding, mentorship and the opportunity to be piloted to determine if it can be scaled.

After launching the program in 2017, HMH expanded it two years later to include its own workforce and began encouraging clinicians and employees to submit ideas based on their frontline experiences. The program has successfully advanced numerous internal strategies, and external companies focused on streamlining care delivery, reducing hospital readmissions and empowering patients to partner with their physicians, according to HMH.

As New Jersey’s largest and most integrated network, HMH’s footprint spans 18 hospitals and 500-plus patient care locations. That includes eight community hospitals, three academic medical centers, two children’s hospitals, two rehabilitation hospitals, one university teaching hospital, one behavioral health hospital and one long-term acute care hospital.

“Our yearly Bear’s Den challenge draws from the experience of more than 38,000 team members in real-world health care practice,” Garrett said. “Steadily coming together with new ideas for improvements great and small is how we make our biggest strides as an organization.”

How it works

Each year, the Bear’s Den challenge focuses on a specific health care challenge — such as reducing readmissions or improving patient communication. For 2025, the theme for the internal challenge revolved around humanizing patient care.

“We were looking for our frontline team members to come up with ideas to make it more of a personalized journey and a patient experience that people could feel comfortable with that also tied into hopefully improving our overall patient experience scores over time,” said HMH Vice President And Chief Innovation & Commercialization Officer Sandra Elliott.

This year, HMH select the following three concepts from a pool of nearly 70 submissions:

• The Silent Struggle (Inpatient Rehab Manager/Speech Supervisor Josi Shimkus and Senior Therapist Joy Schiro at Jersey Shore University Medical Center): A modern solution that provides iPads equipped with speech-generating applications to patients who are unable to communicate verbally. This gives a voice to the voiceless, empowering them to express their needs and reducing the anxiety and frustration associated with communication barriers.
• Get to Know Me: Humanizing Patient Care (Educator Weddy Balmaceda; Nurse Leaders Joseph Bunuan, Lisa Obermann and Marinette Gabriel; and Patient Care Services Director Rosalie Grantoza at Old Bridge Medical Center): An initiative centered on a bedside “Get to Know Me” board that allows patients to share personal information, such as their hobbies, values and what makes them feel comfortable. This tool fosters deeper, more meaningful connections between care teams and patients, ensuring every patient is seen as a person first.
• Increasing Pediatric Mobility (Clinical Resource Nurse, General Pediatrics Ashley Sbarra and Senior Child Life Specialist Marissa Samaan of Joseph M. Sanzari Children’s Hospital, along with former employee Kelsey Parodi): A creative “Pediatric Safari Adventure” scavenger hunt designed to motivate and encourage hospitalized children to ambulate. By turning a clinical necessity into a fun activity, this project aims to reduce fear, increase compliance, and make the hospital feel less medical and more fun for the network’s youngest patients.

According to Elliott, the Bear’s Den innovation challenges “are really focused in on what we’re trying to accomplish as an organization strategically.”

“So, it could be moving the needle specifically on quality, patient experience or a specific cost reduction, for example,” she said.

Ideas put in motion

For instance, a proposal from physical and occupational therapists at Jersey Shore University Medical Center encouraged intensive care unit (ICU) patients to maintain movement with physical therapy, which helped shorten stays by about a day.

Another winning idea came from Raritan Bay Medical Center, where a team of nurses designed a cable clip holder to secure the many power cords that can create tripping hazards near patient beds.

Elliott said, “We are trying to drive idea generation … these ideas are evaluated on their potential. And sometimes they’re scalable to all the hospitals and sometimes they’re not because of the high specialty, for example, or maybe the workflow is very different at one of the other organizations. So, what may work at one of our academic medical centers may not work at one of the community medical centers.”

“One of the critical factors that has been helpful for us is really making sure that we engage subject matter experts – the nurses, the nurse managers, the clinicians – in different locations to really help evaluate these ideas for their potential,” she said.

“And as we go forward, we tweak the program to be able to maximize that even further to marry process and subject matter expertise in a way that’s unique,” she said.

“I think we’ve really done a great job in really pushing the envelope further every year and trying to really get down into the weeds of opportunities.”

Diagnosing the problem

Elliott believes innovation starts with empathy.

“If you cannot be empathetic and understand how people interact in a particular scenario, it’s hard to begin to innovate around that. And so, in health care, you have a lot of empathy. We want to care for people and solve their challenges,” she said.

“The other component is that in health care, it’s a solution-based industry … it’s diagnosing what a problem is and then beginning to treat that patient or treat that condition. If that works, then you fine tune it. And if it doesn’t, you see what other solution there may be,” Elliot said.

“Health care is a really a great opportunity to open up these open innovation challenges because a lot of problems happen at the bedside and people have been solving those problems for years in different ways. So, we’re trying to unleash those solutions in a way that really impact more patients,” she explained.

Health care is a really a great opportunity to open up these open innovation challenges because a lot of problems happen at the bedside and people have been solving those problems for years in different ways. So, we’re trying to unleash those solutions in a way that really impact more patients.
– Sandra Elliott, HMH vice president and chief innovation & commercialization officer

HMH also runs more focused internal innovation challenges for different areas, such as pharmacists, according to Elliott.

“That’s where we can tap into our clinical pharmacists to identify opportunities to improve pharmacy care and pharmacy outcomes,” she said. “We’re at a point where we’re starting to prioritize those ideas to really figure out where do we resource the next step. And we’ve gotten ideas from improving access for patients to certain kinds of medications and treatments to how do we operationalize AI to more readily be able to fill prescriptions faster, particularly in our outpatient setting.”

“There’s a lot of interesting opportunity and it’s just a matter of giving people the opportunity to share and think about how we address these challenges,” she said.

Unlocking potential

One of the most valuable aspects of the program is that it brings colleagues together, Elliott feels.

“And that’s what you need, and that’s what you want. It keeps people engaged in their role and also demonstrates how much we value what they’re doing,” she said.

“When you engage people and ask them for input, you realize it’s super exciting because it’s not that they haven’t been asked before, but it’s that when you actively ask and you reward that with time, attention and the ability to see the impact that your idea may have, people get super excited.”

“And a lot of times it’s just that they have a lot of the ideas and they don’t know exactly where to go … so they see it as an opportunity to take those ideas and really vet them out and see,” she said.

Elliott went on to say, “What we’re trying to do with this program at the end of the day, is really just unlock the possible and create the opportunities for individuals to excel and succeed as they desire.”

According to Elliott, they typically receive between 70 and 75 entries per year for the internal challenge.

As for the name?

Along with the opportunity to pilot their ideas, winners receive access to an internal awards platform where they can choose from a range of prizes, like unique experiences or special products they might not normally purchase for themselves.

As for the name Bear’s Den, Elliott said that’s a fun alternative for their Shark Tank-style pitch contest – based on the idea that judges could either give presenters a “bear hug” if they loved the idea or challenge it toughly if they didn’t.

“It’s enabled us to really market something internally,” she said. “We do have somebody that wears a bear suit and people love it. They get their selfies with the bear, which is kind of cool,” Elliott said.

The bear’s name (Hammie) was chosen through an early Bear’s Den naming challenge that drew about 400 submissions and won an employee vote; it stands for Hackensack and Meridian Making Innovation Engaging, according to HMH.

It’s a jungle out there

At Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center in Hackensack, the winning idea of a pediatric safari adventure is part of a bigger project called HEARTS (Helping Engage and Reassure Through Support).

According to HEARTS co-creators Sbarra and Samaan, the initiative is designed to make the hospital experience less intimidating and more fun while helping children stay engaged with treatments.

Components include:

• Treasure chest prizes and sticker reward charts as an incentive and reward system to increase cooperation during medical tasks
• Awards/certificates of bravery after medically invasive procedures
• Discharge certificates for being brave during hospital stays
• Bubbles and pinwheels for nursing staff to use as a kid-friendly alternative to incentive spirometers

Sbarra said, “When we saw the challenge was called Making Care More Personal, we thought this is a perfect fit because we’re always striving to make care in pediatrics more personal every day.”

About a year and a half ago, Sbarra and Samaan teamed up to think about ways “to enhance connection and collaboration” between pediatric nursing and child life.

“We kicked off with a little fundraiser project trying to really get more pediatric resources on our unit to use. Then we just started meeting every month and it just grew,” Sbarra said. “And we got so much feedback that we started, we developed this project. So, it really was a quality improvement initiative for the care of our patients and their experience.”

Samaan said, “We’ve really tried to integrate all of these pediatric-friendly resources with child life and pediatric nursing together.”

Hunting for a connection

The scavenger hunt began in February 2025 with a Valentine’s Day heart hunt for kids. The following month, it evolved into a “lucky hunt” with shamrocks and leprechauns for St. Patrick’s Day.

After seeing how well-received it was by families, patients and staff, they decided to create a safari-style scavenger hunt that could stay year-round. The activity features laminated animal pictures and rhyming riddles scattered around the unit. Younger patients search for animals on the walls, while older kids follow clues starting in the playroom, keeping them engaged, thinking and distracted during their hospital stay.

Besides engaging patients emotionally, the experience improves mobility, aids healing, supports post-op recovery and reduces complications, according to Samaan.

“It’s good for the healing process, and we see a wide array of patients, so it’s good for all different diagnoses, but really getting them up and moving was our goal. And also, we have post-op patients … and they’re in a lot of pain. It’s really hard to motivate a child when they’ve just had a traumatic surgery to get up and move … It’s also hard for the parents to see their otherwise healthy child in this condition. So, using fun and distracting techniques is our goal. We’re trying to get them not thinking about the pain but walking and trying to focus on the riddles and focus on more fun aspects of care,” she said.

Sbarra said before the scavenger hunt being added to the floor, mobilization for pediatric patients “was really driven by the nurse and the staff.”  Developing a static activity was a way “to really intertwine us and make it all collaborative,” she said.

Not just for the kids

It has now become a flexible tool that everyone, from child life specialists to parents to physical therapy staff, can use. Based on their observations, Sbarra said they think it’s an activity that could be helpful for other parts of hospitals, too, like adult and rehab units.

“If you took it up a level and made it more complex for adults, you could totally utilize this,” she said. “There’s so many variations and ways you could change this and take this.”

Sbarra said, “Part of our ask in the challenge is to really invest in technology and touchscreens so that every few hours, the clues could change, the animals could change and it could be even different themes that could change monthly. The goal would be changing to make it accessible to kids that have been here a long time and keeping it challenging and keeping it fun and exciting.”

According to Sbarra and Samaan, the scavenger hunt concept will be piloted at Jersey Shore University Medical Center. They also plan to collaborate with physical therapy and pediatric surgery to create a structured plan, as well as track outcomes like length of stay and physical benefits.

“It really makes everyone smile when they see people using it, trying to figure it out and get walking,” Sbarra said. “I spoke to a dad today and I was like, ‘Oh, I’m so happy you’re doing the scavenger hunt.’ And he said how much they loved it and how it’s all his son is talking about and telling his friends. And that was the whole goal — to not tell your friends about your broken arm or your emergency surgery. But to tell your friends, ‘I was in the hospital and we did a scavenger hunt and I found all these animals.’”

Editor’s note: This story was updated at 11:23 a.m. March 27, 2026, to include another member of the Increasing Pediatric Mobility team.