International Journal of Healthcare Simulation

Background:

Failings in human factors are a significant contributory factor in accidents/incidents in aviation, energy and healthcare. There is no ‘one thing’ that will address human factor failings- it requires multiple interventions; including developing human factor awareness and skills to influence behavioural change. Local research in the Northern Health & Social Care Trust ^[1] substantiates this. Six months after accessing face-to-face human factor training 70% of attendees confirmed they had made changes to their practice. Through the acquisition of human factor skills staff can ‘get up stream’ of adverse incidents and poorly designed systems, which can reduce patient harm and increase the quality of care.

Aims:

This project deployed the application of Gamification to human factor learning in healthcare. Feedback from face-to-face Human Factor training is positive, but it is challenging in an organization of 13,500 staff to meet the capacity for this training. More recently, response to COVID-19 has challenged us all to think about how we make training more accessible outside of traditional methods.

Method/design:

The Gaming Strategy is centred around Dupont’s Dirty Dozen (Figure 1) – the 12 most common human factor elements which degrade a person’s ability for them to perform effectively and safely, which can lead to errors.

Figure 1:

Dupont’s dirty dozen

Through a series of missions ‘gamers’ follow a patient (Joe) as he journeys through the healthcare system, and experiences a series of human factor errors. The five missions below, each incorporate Dupont’s Dirty Dozen:

communication and team working

lack of knowledge and assertiveness

situational awareness

complacency and norms

pressure and lack of resources

Each mission introduces characters and is scenario-driven, depending upon gamers’ responses they will either be successful in their mission (in which case they can proceed to the next step), or unsuccessful and have to restart the mission. At the end of each mission ‘gamers’ must complete a quiz, after which they are rewarded with access to the next mission. The gaming App includes additional learning resources, opportunity for reflection and generation of a completion certificate to support professional development. Psychological and behavioural experiences of gamers’ is captured by the App via quizzes at the start and completion of the Game. The project deployed Quality Improvement and Agile development methodologies. All scenarios and characters were developed by the NHSCT project team, with software development commissioned externally.

Implementation outline:

The Game is accessible via mobile phone from the App Store. Project testing completed in June 2021, with the launch of the Game in NHSCT thereafter. The App has potential for scale-up across NI and the UK.