Want to improve patient care and staff morale? Take 10 minutes for a shift meeting and a special game of cards

Two experts from the Netherlands are touting what some might regard as an unorthodox way for hospitals to improve patient care and boost staff morale: a special game of cards played during morning or start-of-shift huddles that reveal staff members' state-of-mind and reinforces knowledge of safety and patient care principles.

At the start of each shift, the team members meet up and rate their own mood by a color coding system: Green means "I'm good"; orange is "I'm okay but I have a few things I'm concerned about"; and red means "I'm under stress." Your co-workers may not need to know the private details of why you're stressed, but knowing your overall state helps them understand how you need to be treated.

Next, a shift leader can poll the staff present to see if there are any overarching issues like a public transportation snag that might make other staff, or patients with appointments, late. It also might cover something like a particular patient in-house who has special needs or a delicate situation.

Then just before the meeting wraps, the leader asks two staff members to draw a card from a deck invented through a collective staff effort. The cards are split into two categories: Cards that test a person's knowledge and those that ask staff to observe something during the shift and then share the findings at the next team start meeting.

The knowledge cards should change every month and review an operational protocol or policy. Examples would be "List the five steps in hand hygiene." An observation assignment might be "Observe your colleagues and report back on how well they follow hand-hygiene procedures."

WHY IT MATTERS

The card game produced real results according to its inventors, Roel van der Heijde and Dirk Deichmann, who wrote about it in the Harvard Business Review. Dirk is an assistant professor at Erasmus University's Rotterdam School of Management. Roel is a partner at Patient-Centered Care Association in The Netherlands. He previously worked as a senior consultant and trainer at the Rotterdam Eye Hospital.

THE TREND

The game was initiated at Rotterdam Eye Hospital and introduced in 2015. The hospital's performance on its patient-safety audits rose, as did caregiver job satisfaction, from 8 to 9.2 on a 10-point scale. Other more qualitative gains surfaced too. The game compelled staff to get to know each other better and that can be reassuring to patients who see staff members interacting who clearly are familiar with each other.

Staff members also gained a deeper understanding of the reasoning behind certain protocols as well as the significance of their own jobs. There was also more sharing among staff members, including those who did not often cross paths.

"One case in point: A question from the card game about what someone should do if he or she found medicine lying around prompted a cleaning person to mention that she kept finding pills in a patient's bed, alerting the doctor to the fact that the patient was not taking the prescribed medicine," the authors wrote.

The game requires that hospital staff design their own game based on your protocols, culture and challenges. Staff must commit to playing the game seriously and regularly, gauging results. Finally, all staff must be required to participate from clinicians to maintenance.

ON THE RECORD

"We sometimes act as if healthcare organizations are big machines. But the fact is that the quality of healthcare depends ultimately on the collective performance of many small teams. The 'team-start' huddle and patient experience card game suggests that performance can improve once we take into account the full perspective and emotional needs of the people who are actually delivering that care. The game is a great first step toward building that awareness," Deichmann and van der Heijde said.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com