Finding the 'QR' to Patient Safety: Applying Gamification to Incorporate Patient Safety Priorities Through a Simulated 'Escape Room' Experience
Finding the 'QR' to Patient Safety: Applying Gamification to Incorporate Patient Safety Priorities Through a Simulated 'Escape Room' Experience
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DOI：
10.7759/cureus.4014
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发表时间：
2019-02-05
影响因子：
1.2
通讯作者：
Papanagnou, Dimitrios
中科院分区：
文献类型：
--
作者：
Zhang, Xiao Chi;Diemer, Gretchen;Papanagnou, Dimitrios
医疗差错是美国第八大死亡原因，造成了100多万起可预防的伤害。为了防止医疗差错，报告系统是纵向检测患者安全事件和质量问题的宝贵工具。从历史上看，学员（即，学生和居民）很少提交遇到患者安全威胁的事件报告。作者提出了一种沉浸式的学习体验，利用游戏化理论，并利用日益流行的“逃生室”，以帮助住院实习生确定可报告的患者安全优先事项。所有130名新入职的实习医生在托马斯杰斐逊大学（杰斐逊）参加了患者安全逃生室研究，作为他们的居住方向的一部分（2018年6月）。居民被随机分为16组。每个团队都沉浸在一个模拟的逃生室中，任务是识别一组预先确定的严重患者安全隐患，并在分配的时间内成功手动将其输入杰斐逊事件报告系统，以通过“逃离房间”成功“赢得比赛”。在整个活动中植入了快速响应（QR）代码，以提供游戏中的说明;解决难题的线索;以及有关杰斐逊患者安全优先事项的关键信息。所有参与者都接受了正式的汇报使用反馈捕获网格方法，并完成了自愿的研究后调查，改编自布鲁克菲尔德的关键事件问卷（CIQ）。活动后CIQ调查（n = 102）的主题分析显示，实习生在沉浸式学习体验期间参与（n = 42），并特别参与独立识别患者安全威胁（n = 30）。参与者确定团队角色分配（n = 52）和有效的沟通（n = 26）作为成功完成活动所需的两个最有帮助的行动。总体而言，参与者对教育创新的成功感到惊讶（n = 45），并报告说，这改变了他们对患者安全威胁的看法。需要改进的地方包括更清晰的游戏说明和使用更精简的事件报告流程。逃生室患者安全活动允许实习生积极参与创新的定向活动，强调患者安全危害的重要性，并为他们提供实时记录事件报告的机会。下一步将包括纵向跟踪该队列输入的错误报告数量，以确定这种教育干预的有效性。
Medical errors are the eighth leading cause of mortality in the United States and contribute to over one million preventable injuries. In an effort to prevent medical errors, reporting systems serve as invaluable tools to detect patient safety events and quality problems longitudinally. Historically, trainees (i.e., students and residents) rarely submit incident reports for encountered patient safety threats. The authors propose an immersive learning experience utilizing gamification theory and leveraging the increasingly popular 'escape room' to help resident trainees identify reportable patient safety priorities.All 130 incoming intern physicians at the Thomas Jefferson University (Jefferson) were enrolled in the Patient Safety Escape Room study as part of their residency orientation (June 2018). The residents were randomly divided into 16 teams. Each team was immersed in a simulated escape room, tasked with identifying a predetermined set of serious patient safety hazards, and successfully manually entering them into the Jefferson Event Reporting System within the time allotted to successfully 'win the game' by 'escaping the room'. Quick response (QR) codes were planted throughout the activity to provide in-game instructions; clues to solve the puzzle; and key information about patient safety priorities at Jefferson. All participants underwent a formal debriefing using the feedback capture grid method and completed a voluntary post-study survey, adapted from Brookfield's Critical Incident Questionnaire (CIQ). The study was IRB exempt.Thematic analysis of the post-activity CIQ survey (n = 102) revealed that interns were engaged during the immersive learning experience (n = 42) and were specifically engaged by having to independently identify patient safety threats (n = 30). Participants identified team role assignment (n = 52) and effective communication (n = 26) as the two most helpful actions needed to successfully complete the activity. Participants were overall surprised by the success of the education innovation (n = 45) and reported that it changed how they viewed patient safety threats. Areas for improvement include clearer game instructions and using a more streamlined event reporting process.The escape room patient-safety activity allowed interns to actively engage in an innovative orientation activity that highlighted the importance of patient safety hazards, as well as providing them with the opportunity to document event reports in real-time. Next steps will include longitudinally tracking the quantity of error reports entered by this cohort to determine the effectiveness of this educational intervention.