Football theme helps motivate staff for quality
March 1, 2007 6 minutes read
Football theme helps motivate staff for quality
A medical center in Baltimore has come up with a unique way to encourage interest in patient safety and quality. It's a "football league" in which staff form teams and can gain points by taking steps to improve safety or improve patient care.
The program at Levindale Hebrew Geriatric Center and Hospital is called SCORE, which stands for Safe Care of Our Residents/Patients & Environment. Andrea Carr, RN, MSN, director of performance improvement, explains how the game works: Each of Levindale's units or departments forms a team. The team that achieves the most points quarterly receives a prize of $250 to spend on something fun, such as a staff party or outing.
Teams can earn points in two ways. The first way is with "good catches." A good catch is made by an individual team member who prevents unsafe conditions or accidents. Good catches not only help an employee's team, but also the individual who makes the good catch because the name of that person will be entered into a monthly drawing for a $20 gift certificate. These are some examples of good catches:
- notifying crucial people about worn pad keys and damaged screens on intravenous pumps;
- alerting the maintenance department to unauthorized use of electrical cords in a room;
- realizing lab results are mislabeled.
The second way to score points is with "offensive plays." An offensive play is when a whole department develops plans or performance improvement initiatives that quash potential risks. These are examples of offensive plays:
- giving flu shots to prevent influenza spread in the facility;
- starting a hydration cart program to prevent dehydration;
- beginning "quiet time" to minimize agitation of dementia residents.
The Levindale Safety Committee assigns point values to the good catches and offensive plays. Both are combined for one team score at the end of the quarter. Team standings can be checked at any time during the year on a scoreboard placed in a central location.
Carr says the SCORE program was developed two years ago to help staff identify more closely with patient safety and feel personally involved, as opposed to it being simply a task imposed on them. Football is popular among the staff, so the theme seemed a natural fit, especially as a way to engage front-line staff in positive, proactive behavior. The program is consistent with Levindale's commitment to a "just-culture" approach to patient safety, Carr says.
Results are hard to measure because it is difficult to pin down any safety improvements strictly to the SCORE program, Carr says. The same staff might have alerted someone to the problem without the motivation of the football league scores, but Carr says the overall impression among hospital leaders is that the program significantly raises awareness about safety issues.
"We've heard from pharmacy managers that they think significantly more medication errors are being reported because of SCORE," she says. "That's a good thing, and we think we're improving patient safety every time someone reports something, large or small."
Fliers and posters get the word out
The SCORE program is heavily promoted throughout the medical center with fliers, posters, paycheck inserts, and any other way the safety committee can think of to get the word out. A typical flier starts off reminding staff about the SCORE program and the football theme, then it provides this information about how to report potential problems:
"Let your fingers do the walking if you spot a patient safety issue not being addressed. Call Levindale's Patient Safety Hotline 24 hours a day, seven days a week. The phone number is (410) 601-7067. If you would like a response to your message, you can leave your name and a contact number. This hotline is listened to once a day Monday through Friday. For emergencies, contact a staff member immediately."
The hospital also provides free key chains to staff in the shape of a football, with the SCORE program name and the hotline number for reporting problems. Levindale bought 1,000 of the key chains from a local supplier for 57 cents each, including printing. (Levindale also has a patient safety effort involving poker hands. For more on that program, see article, below.)
Staff participation is consistently high, says Luna Barkley, environmental services manager. She notes that employees sometimes have to be reminded to report their good work and get their SCORE points because they often think they're just doing their jobs and can feel sheepish about asking for credit.
"That's where we depend on managers to reassure them that it's fun and productive to play the game, that there's nothing wrong with getting credit for even the small things you do during the day," she says.
Barkley notes that the SCORE program is a good way to get nonclinical staff involved in patient safety and to reward them for their willingness to help. An environmental services employee might alert a nurse that a patient is wandering off the unit, for instance.
"That interaction helps them buy in to the idea that they are part of patient safety," she says. "The SCORE program helps them see that we really want them to participate, that this isn't just something for nurses and doctors."
Staff collect quality cards to get best poker hand
If football isn't your favorite pastime, maybe you're more into poker. At Levindale Hebrew Geriatric Center and Hospital in Baltimore, a patient safety program with a football theme is supplemented by another with a poker theme.
Janine Boulad, volunteer coordinator at the medical center, helped developed the "Betting on Excellence" program by making decks of cards with questions from The Joint Commission taped to them. The idea was to get staff to study Joint Commission-related issues and gather the best poker hand by answering the questions correctly. Levindale ran the poker program for about a month recently, and Boulad says she plans to repeat it on a regular basis.
"Once they started drawing cards, it drew people over to see what they got and whether they could answer the question, too. If you didn't know the answer, you were allowed to ask someone for help," Boulad says. "Even when people didn't want to fully play the game and keep up with what hand they were getting still were being drawn in. It was very effective in getting people talking about some of these issues."
Here's how the game worked:
- A new game started every Monday from Sept. 11, 2006, to Oct. 1, 2006.
- Any employee could find a "dealer" during the work day and pick a card, for a total of seven cards per week. Dealers were unit managers and other designated people wearing "dealer" hats and aprons. For the aprons, the Levindale team bought 12 regular aprons for $4 each and sewed the bottoms to make them shorter like a dealer apron. A dozen caps cost $2 each, and Boulad added handmade "dealer" tags to them. Two decks were used: a blue deck for clinical staff with clinical questions, and a red deck for others with nonclinical questions. Each card had a question and answer written on it. The dealer read the question to the employee.
- If the employee answered the question correctly, he or she kept the card. If not, the employee could try one more time with that dealer that day. The employee still can go to a different dealer that day and try again, but he or she could collect only a total of seven cards during the week.
- The goal was to collect at least five cards during the week and make up your best poker hand with those cards.
- On the following Monday, participants with at least five cards submitted their hands, and the best poker hand won a small prize, such as a $10 gift certificate to Wal-Mart.
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