PlayDecide: Patient Safety – A “serious game” learning tool to discuss medical professionalism in relation to reporting and patient safety

• Published in: International journal of integrated care 2019-08, Vol.19 (4), p.183
• Main Authors: Hsiao-Feng Macdonald, Stephen, Egan, Karen, Ní Shé, Éidín, O'Donnell, Deirdre, McAuliffe, Eilish
• Format: Article
• Language: English
• Subjects: educational interventions; error reporting; multidisciplinary teams; patient safety; professionalism
• ISSN: 1568-4156; 1568-4156
• DOI: 10.5334/ijic.s3183

Introduction: In Ireland, and internationally, healthcare errors and incidents are frequently under-reported(1-3), undermining the utility of reporting systems as a source of meaningful learning for policy formulation and behaviour change. Common barriers to reporting include fear, deferred responsibility, and a belief that reporting would not lead to improvement(2-4). To address this challenge to patient safety, it is necessary to build shared understanding that reporting improves service quality, and aids professional development. Description of policy context and objective: Ireland’s Health Service Executive and Health Information and Quality Authority emphasise supportive organisational cultures, and sustained commitment to improvement by all actors within the health and social care services(4,5). This is not yet fully realised across institutions, and under-reporting remains a challenge. Our objective was therefore to create a tool for healthcare teams to openly discuss patient safety and error reporting. We used an inclusive co-design process to adapt the PlayDecide “serious game”(6), which tasks players with exchanging and discussing perspectives and information, then working towards a shared group policy position. Targeted population: The game initially targeted junior doctors, and was then revised for multidisciplinary healthcare team members and management staff. Highlights (innovation, impact, and outcomes): Patient representatives, academic researchers, hospital staff, and state actors were involved throughout the co-design process. Anonymously-contributed personal accounts of patient safety issues were adapted into short case stories for use in the game. A major strength is the game’s embedded learning approach, using educational content that is contextual to the targeted population’s work. The game was initially played by over 100 junior doctors. 98% of participants supported the policy position that staff should report all concerns. However, it was felt that the current environment did not support this – only 32% of the participants who had recently witnessed an incident had reported it – and previous training around incident reporting was insufficient. We also tested the game among members of acute care teams, including nurses, speech and language therapists, and others, who also found the experience valuable, and emphasised the need for error reporting to become more normalised in hospitals. Comments on transferability: Game content is bro