Are you familiar with the game of Leela, played in 16th century India to teach moral values? It was the inspiration for the children’s game, Chutes and Ladders. How about Chaturanga, used to teach noblemen the strategies of war during the Middle Ages? It was the precursor to chess. Have you ever heard of Nice Catch, played by health care workers in this millennium? It’s an example of a “safety game!”
Why play safety games in the hospital? Because patient safety is a top priority in health care. Each year, over 400,000 people die in the United States due to preventable medical errors,1 and over 1.5 million people are harmed by medication errors.2 Reducing those numbers requires a workforce knowledgeable about the causes and processes that contribute to error and harm and that is empowered to make improvements. A culture of safety is foundational to such improvement work, and the concept of safety games represents a creative way to help achieve such an environment.
Games Improve Processes
Games have been used successfully in industry to support process improvement, as well as in health care in areas such as anesthesiology and pharmacy. Dimensions common to a safe culture include leadership commitment to safety and open communication based on trust. Organizational learning and teamwork also are important, as is a non-punitive approach to reporting; analysis; and discussion of safety concerns. The goal of safety games is to provide visual reminders that safety is a top priority. These games encourage sharing uncomfortable topics in a comfortable environment while promoting teamwork and collaboration.
Games are effective teaching tools because they employ active learning strategies. They are consistent with adult learning theory, which reminds us that adults learn best by doing and not merely by listening. Safety games can be knowledge- or application-based, and can be tailored to almost any safety topic of interest. The games can be used to introduce information, heighten awareness, or to complement other teaching methodologies.
How It Works
Each game requires a champion, or coach, who is responsible for game design, kickoff, interim coaching, ending the game, and post-game follow-up.
Potential coaches include the medication safety officer, a management or staff member, a resident, or a student. The coach begins by creating an educational plan tailored to a specific audience. One way to achieve this is to think about the objectives and content that would be used in a lecture or slide presentation. The next step is to add active learning strategies and determine how they can be achieved through a game. Pre-game huddles for group brainstorming can be helpful.
Features of Successful Safety Games
Effective games share common characteristics. By design, safety games should be:
See CHECKLIST: How to Create a Safety Game.
An example of a successful safety game that took place at Valley Health/Valley Physician Enterprise in Winchester, Virginia, is discussed in the SIDEBAR.
Capture the imagination of your staff and co-workers with safety games and watch them become your best safety champions while your safety culture flourishes.
Additional examples of safety games will be presented in future issues of PP&P. We hope you will play along, and welcome your safety game stories. If you are a game coach, and would like your game to be considered for publication in the magazine, please send it to Senior Editor Jennifer Karpinski at firstname.lastname@example.org, or contact Jennifer at 201-670-0077 x340.
Deb Saine, MS, RPh, FASHP, FSMSO, is senior lean management engineer at Valley Health/Valley Physician Enterprise in Winchester, Virginia. She has authored numerous articles and has presented internationally on the topic of medication safety, and served in ASHP leadership positions. Deb received her BS in pharmacy from the University of Toledo and an MS in management from Antioch University.
It’s Time to Make a Nice Catch!
A Nice Catch is a circumstance or event that has the capacity to cause error; a near-miss is an error that occurs, but is caught before it reaches the patient. Sometimes a Nice Catch results from a conversation that starts with: Why don’t we do x-y-z this way? Some examples are listed below, but do not limit your thinking to just these:
Who Can Play?
What Do I Win?
How Do I Join the Game?
Participate – Have Fun – Make an Impact on Safety!
90% participation is our goal. Encourage your coworkers to play!
After the Game Is Completed
Conduct a wrap-up meeting and share the results of the game.
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