Introduction: Healthcare institutions welcome innovation projects aiming to improve processes by fulfilling previously identified needs. Despite the adoption of a specific methodology and the identification of potential risk, conducting an innovation project in healthcare often has unexpected consequences. We present and contrast the expected and unexpected difficulties encountered during the design and implementation of an innovative app to facilitate nursing workflow at a patient's bedside.

Methods: Expected risks were collected during feasibility assessment and risk identification analysis, and compared with those obtained during the debriefing before the pilot evaluation of the project. The findings were compared using a thematic analysis.

Results: Although many problems were forecast, unexpected problems were encountered due to change of leadership, difficulty in implementing functionality for heterogeneous practice, security issues due to the introduction of new devices, or insufficiently controlled communication.

Discussion: Based on our experience, we recommend defining a very clear communication strategy as a preventive measure for unexpected events that can be encountered during the development of innovative solutions.