Dr. Bonnie Clipper, DNP, MA, MBA, RN, CENP, FACHE

Gamification is the use of game-like elements such as competition, scoring, and status in a non-game environment to encourage participation, such as to complete a task (or improve compliance) (Merriam-Webster, 2019). There are many common gamified platforms that are already part of our daily lives, you may even be using them. Some examples of these applications (apps) include Starbucks, frequent flyer accounts, hotel chains, retailers and even some of your favorite restaurant providers.

An app or platform designed with gamification is a tool that can be used to change behaviors and improve a variety of unique challenges, and in healthcare, this means both patient and non-patient scenarios. Use cases for patients may include using a gamified platform to improve daily glucometer readings or medication regimens. In the case of a gamified platform that improves medication compliance, the “behavior” is taking all the prescribed medications at the right time, and as a result of completing the desired behavior, the patient may be rewarded with points or a higher status which is visible on the dashboard.

Non-patient use cases could include using gamified, technological platforms to mitigate the impact of clinician burnout or improving employee engagement. Utilizing a gamified platform to reward for the desired behaviors is a way to encourage behavior changes. Over time, engagement in a gamified platform can lead to small behavior changes as end-users learn how to modify their behaviors in order to “perform better” in the platform. For example, patients sharing gratitude, recognition and positive comments allows end-users (nurses, physicians, and other health care professionals) to attain a “better” status and achieve more points so naturally, end-users learn to modify their behavior to earn the points and rewards displayed in the dashboard. Integrity in a system such as this is always paramount to ensure the authenticity of feedback and not a literal “gaming” of the system, like reliability and validity testing.

The goal of a gamified approach is to engage staff in a platform/app that has identified goals/objectives so that the micro-behavior changes provide the desired outcomes. In the example of improving the patient experience or increasing employee engagement, when team members check into a gamified platform, the experience for them should be as positive as possible. This means that notes of gratitude from patients and positive comments from peers generate more points or propel them towards a “higher” status in the platform. In turn, the notes of gratitude and positive comments really do impact the user’s overall sense of being appreciated and valued. Behaviors can change even faster when people see tangible benefits in conjunction with those visible in the dashboard, such as if a certain number of points or if a specific status can provide access to a free coffee or drink in the cafeteria, VIP parking, or something of perceived value. The blend of seeing improved performance in the gamified platform dashboard and the impact of a concrete token of appreciation is a combination that drives behavior in a favorable way.

Because this technology is relatively new in healthcare, there is a learning curve for organizations that use it. This learning curve is dependent upon the comfort level of individual users, patients, and staff, with technology in general. Speaking from our own experience, we tend to see younger staff who are more tech-savvy feel more comfortable jumping into a gamified platform and beginning to use it in their workflows on a regular basis fairly quickly, while the other staff has to develop a comfort level with the technology before using it on a regular basis. Gamified platforms do not have to “de-humanize” the experience, but rather they can be used to supplement or enhance it. If gamification can improve the patient experience and employee engagement, consider giving it a try.

Merriam-Webster. (2019). Definition of gamification. Accessed on January 30, 2020. Accessed at https://www.merriam-webster.com/dictionary/gamification.