What You Should Know About Gamification In Healthcare

By:  David Kashmer, MD MBA FACS (@DavidKashmer)


Why bother with gamification?


Did you know there is an engagement crisis on in America? It turns out that more than $500,000,000 in revenue are lost every year to the fact that employees are simply not engaged with their jobs (1). In fact, Gallup reports that 70% of American workers are either disconnected (emotionally) from their work or are actively seeking to hurt their company (1).


This crisis extends across America, and the worst part is it is insidious. The fact that employees often aren’t engaged leads to all sorts of missed opportunities, exaggerated costs, and unrealized revenues…and it does it so slowly. It happens in ways that are difficult to perceive. Gamification is one potential solution to the employee engagement crisis and it’s one that’s worked very well for me.  Let me share some stories and thoughts about gamification as I’ve applied it in healthcare.


A story


Once upon a time a section of Surgery was attempting to engage residents in a dramatic culture change. There were certain critically ill patients and administrative issues that were unrealized, and didn’t translate easily to the residents or daily work at the front lines of medicine.


There were different philosophies of care circulating in the department, and it was challenging to get through to a culture that had been in place for some time. The solution the team used? Gamification.


Deploying a comprehensive gamified system facilitated culture change and increased the rate of improvement for the section substantially. The resident (and attending) staff involved experienced increased job satisfaction as measured by a standardized tool.  Look here for more information.


Here is a little bit about gamification to let you know what the team did and how it succeeded.


Gamification is more than just points, badges and leader boards


You may already know that gamification is the use of game dynamics, techniques, and themes to improve staff engagement. One of the most commonly used techniques includes points, badges, and leader boards.


Points are awarded to participants for certain actions according to what the designers feel is important. Similarly, badges highlight special achievements and levels reached by the participants. These external signs of “leveling up” assist in providing social proof for culture change and reinforce aspects of compliance. A leader board uses peer benchmarking and peer motivation to help participants understand where they are relative to others in their group. Gamification, however, is much more than just these points, badges and leader boards (so called “PBLs”).


Although PBLs may be some of the external signs of gamification, there are other important techniques that can be utilized. One, for example, is often called the appointment dynamic. The appointment dynamic is the idea of giving positive reinforcement to the participant for returning to the same spot, location, or scheduled event at a certain time. (Works well to reinforce morning sign-out!) Rewarding this behavior with points can be an important dynamic to help culture change and improve such as improving the function of a healthcare department.


Another technique for gamification is unlocking new skills. When the participants “level up” this can be interpreted as achieving competency to a certain level within the system. This leveling up and unlocking new techniques can allow participants to unlock new abilities. It is a much more intriguing way to achieve competency-based training.


For example, in the story of the surgery department above, participants gained a new skill when they achieved certain point levels. For example, surgical residents gained the ability to examine and clear the cervical spine for injury in trauma patients. They achieved a certain level of points, took a brief test and interview, and were validated to clear cervical spines which is a very important skill in trauma and emergency surgery


Gamification uses powerful themes and motivators to engage


Did you know that the millennial generation is a larger bulge in the population plot than the baby boomers?  There are many more Millennials around than boomers, and it’s a fact that there are many more Millennials currently than other segments in the United States. These Millennials gravitate towards clear social interactions that can evolve from techniques like using game dynamics. As we mentioned above, gamification uses peer benchmarking, and indirectly positive peer pressure, to achieve excellent results.  It seems to resonate especially with generations other than the ones who are typically in admin positions nowadays.  In other words, the technique is for them not for us.


That can make it tough to understand for administrators, but no less effective for the staff who execute the organizational goals at the front lines.


Can be inexpensive to deploy


A gamification system does not need to cost tens of thousands of dollars to deploy at your hospital or business. Techniques like the gamification model canvas allow you to design a comprehensive game that can work well for your system. Look here.


Questions about gamification or how to deploy it at your center?  Send me an email at dmkashmer@thesurgicallab.com because I’m always happy to help.


Questions or comments about gamification particularly that applies to health care? You may wonder how staff react to the term gamification. You may wonder how we use leader boards and specifically how everyone reacts to having their name on a visible point tally. I’m happy to share these and other specifics for how we’ve successfully employed gamification in healthcare settings. Particularly, it’s good to share how gamification has improved job satisfaction among participants in statistically significant ways.



(1) Ed O’Boyle and Jim Harter, State of the American Workplace (Gallup, 2013), http://www.gallup.com/strategicconsulting/163007/stateamerican-workplace.aspx