Increasing hospital patient throughput: A gamification case study

Abstract

Unpredictable activity in nursing units hindered patient discharges at a 328-bed Texas hospital. The delays consequently interfered with timely admittance of patients from the emergency department. Several earlier initiatives to address the concern resulted in marginal performance improvement, but notable delays persisted. This case study describes activities and outcomes of a gamified nursing intervention to address the persistent delays. A gamified initiative expedited discharges in six nursing units (179 beds, n = 6,955 patients), where more than 70 per cent of nursing staff were Generation Y age cohort members. The initiative was led by first-level unit managers, two-thirds of whom were also Generation Y (Gen Y) members. The proportion of medical-surgical discharges completed in less than 2 hours increased by more than 54 per cent: χ2(1,N = 6,955) = 115.785, p < .001. The improvement embodied a moderate effect size and was linked to a 44.7 per cent decrease in the proportion of emergency department patients who awaited beds for 1 hour or longer. Nontraditional initiatives may positively affect caregiver behaviours in demanding areas of care where Gen Y cohort members make up a majority of nursing staff. Change management in Gen Y nursing populations should consider employee age demographics as a relevant factor when motivating and leading new change initiatives.