As a visitor to British Columbia, I was impressed by the Quality Forum. As far as improvement conferences go, it was phenomenal – a great mix of topics with engaging workshops. One of my favorite parts of the conference was the workshop on gamification. I wasn’t sure what to expect when I sat down in the packed session, but it turned out to be incredibly interesting and informative.
Gamification is both more and less than I thought it was. I can tell you one thing Gamification is not—it isn’t about creating games that reflect health care; rather, it uses the design that makes games so engaging and addictive and applies that to our work in improvement. One of the biggest challenges I’ve faced in creating successful and meaningful improvement is simply getting people motivated. Gamification takes a media where people are intensely motivated and applies that learning to our work.
Some of the features of games that we know to be useful to us are dynamics (the narrative or big picture that drives players), mechanics (the “rules”), and components (the tangible bits of the game such as prizes, a leaderboard, or other means of interaction).
This led into a really interesting discussion about incentives and motivation. The example of the 150 Lives in 150 Days campaign was fantastic – with the end goal of increasing use of sepsis protocols, they created a narrative about sepsis (the dynamic), fostered a friendly but competitive environment (mechanics), and pushed the teams forward by keeping them motivated over 150 days with a variety of components, such as a timer that counted down towards the end of the challenge and displayed the number of lives saved.
But perhaps the most interesting part was that although they had a small prize for winning teams – pizza parties – this didn’t detract from the dynamic: the narrative of saving lives from sepsis.
Another big topic of conversation was motivation itself: its different types (amotivation, extrinsic, and extrinsic), and how to tap into these to improve impetus for initiatives.
Finally, we spoke about “user types” and designing a system that works around your “end users,” rather than assuming that one size fits all. We should be cognizant of our audience and cater the improvement towards them – know who you can motivate with honest feedback or rewards, for example, versus those who may be trickier to persuade.
Overall the workshop gave me a great introduction into gamification and provided me with real tools to apply to future projects. To sum it up, gamification in health care is about a lot more than creating games – it’s about changing culture!
Lakshman Swamy received his MD/MBA from Wright State University in Dayton, OH and is now an internal medicine resident at Boston Medical Center in the QI Pathway. He has worked extensively with the Institute for Healthcare Improvement’s Open School; created and directs Radio Rounds, a non-profit which features interviews with leaders in health care; and was a plenary speaker at Quality Forum 2016.