The Importance of Games in the QI Process

The Importance of Games in the QI Process April 16, 2015 Kevin Garrett NQC Senior Manager Nanette Brey Magnani National Quality Management Consultant Jane Caruso NQC Consultant National Quality Center

Ground Rules • • 2 Please type your questions into the chat room Please do not put us on hold The webinar will be recorded If you need to leave the webinar for any reason you can get back in following the same procedure National Quality Center (NQC)

Learning Objectives At the end of this webinar you will: • Understand the thinking behind the use of games • Understand various learning theories • Understand how use a game to illustrate a concept. • Understand the roles of games in the quality improvement arena and how to translate the lessons into application 3 National Quality Center (NQC)

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Let’s talk About Game Types • • 5 Ice Breakers Process Games Boasting and Sharing games Games of Diffusion Games that teach skills in testing and making changes Instructional Games: Teaching & Training Team Building games Games that teach measurement skills National Quality Center (NQC)

Ice Breakers • Begins the process of building trust and respect if participants have not worked together as a team before • Focus on introducing folks to each other…. may yield info about personal skill sets, past experience or ice cream flavor preferences • Promotes initial team cohesion by putting all participants at ease • These types of games are key to getting your project off the ground 6 National Quality Center (NQC)

Ice Breaker Example The Skittles Game ü Respond to a question depending on the color Skittle/s you get. ie Everyone with a red Skittle answers the same question. ü Design the questions so they are appropriate to your group or project, and assign a color to each question. ü Examples: 7 § If you could move your facility to any location in the world, where would it be and why? § What is your biggest and still unachieved goal in life/work…. ? § Tell me something about yourself that I would never guess to be true about you! National Quality Center (NQC)

Games to Help Understand Process • Teaches that systems work only as well as they are designed • These types of games help us understand the importance of mapping the details in a process • They help us become mindful of designing plans that are clear, simply written, and concise, thus avoiding confusion or errors • They will guide a common understanding of where a process may bog down and where it works • The game helps us understand how complex a process can become 8 National Quality Center (NQC)

Peanut Butter and Jelly Game • Tips: § Use props § Divide into teams § Choose a facilitator • Remember: Each system is perfectly designed to get the results it gets 9 National Quality Center (NQC)

Boasting Games Share and Highlight Accomplishments • Use these games to shine your own stars • These games should be played with several groups of people, so that each group has the opportunity to share their own successes and learn about the successes of others • These games may help groups realize the depths of their own accomplishments and help them think about ways to broadcast them to other audiences 10 National Quality Center (NQC)

The Headliner Game • Played when there are multiple groups or project teams, or multiple subcontractors • Ask each group to think of their most significant accomplishment in quality improvement • Ask each group to turn their QI accomplishment into a catchy or attracting newspaper headline • A representative from each group can come to the podium, create a quick slide with their headline, and then share it when everyone has completed their task 11 National Quality Center (NQC)

Examples From Past Headline Players Like a Good Neighbor, The Cross Part is There! State HIV Providers Learn From the Best and Share With the Rest Survival of the Fittest! Fit HIV residents of the City EMA are living into their 6 th healthy decade! A Diamond is Forever…So is a Collaborative 40 HIV programs statewide, commit to sustainability plan 12 National Quality Center (NQC)

Diffusion Games How Spread Happens • How do you get new ideas to spread and catch on? • How do you identify your early adopters and laggards? • What happens when people consider pros and cons and make decisions about project implementation? 13 National Quality Center (NQC)

The Cell Phone Game: A Human Diffusion Curve • Goal: Promote Patient Adherence to Medical HIV Appointments • I am going to give all of your patients free cells phones so can call or text them about their appointments. • Dole out the information on the next slide bit by bit. • Ask providers to react to the information and move to a place on the Human Diffusion Curve. Set up numbered areas in the room such as: No way this is happening in my clinic! 1 14 I’ll watch & wait until someone else does it first. 2 Hmmm…got to think about this a little more! 3 OK, I’ll follow your lead! 4 Woo Hoo! Can we start it today? 5 National Quality Center (NQC)

Human Diffusion Curve Provide the info and watch to see who adopts and who rejects…. and then ask WHY! (Pros) • The phone also has texting capabilities if you prefer to send your patients text messages. You can send individual personal texts, OR mass “undisclosed recipient” texts with a date but no appointment time. • Comes with 24 hour technical assistance. You or your patient can call for help operating it at any time and speak immediately to a live person • Also has an alarm clock feature that can be set to remind the patient about medications • Also has a GPS chip in it, so that if the phone is “lost” we can locate it or disable it. (Cons) • Although the cell phone itself is free, there is a 5 dollar monthly usage charge • In order to get the phones, you must designate a staff member responsible for communicating with the patients • You must designate a staff member to measure how many calls are made and how many patients come to the appointments, so we have a pre and post activity rate. • You must have staff member on-call 24/7 to answer the patient’s phone if they have an emergency 15 National Quality Center (NQC)

Teaching and Training Games If It’s Fun, They Will Come! • These games are designed to impart information. • These games should send folks home with an improved knowledge base. • Sometimes these games can be used as a pre-test to see where folks are, and sometimes as a post-test to see what was learned. • They should be easy to play and fun! 16 National Quality Center (NQC)

Jeopardy! 17 National Quality Center (NQC)

Team Building Games • These games are deigned to promote teamwork • Completing the game requires input from all team members • Team members contribute to the finished product or the game solution according to their skill set • The value lies in observance. An outsider can watch as natural roles emerge among the participants: A “Leader” will start to organize the activity The “Naysayer” will announce that “its not possible to do”! A “Cheerleader” will light the spark and flame the fire A “Facilitator” will make sure everyone has what they need to do their part ü A “Recorder” might keep track of activity or take notes or report on progress ü etc……. ü ü 18 National Quality Center (NQC)

Team Building Examples Tower Construction Challenge 19 Man on the Moon Game National Quality Center (NQC)

Games That Teach Measurement Skills • Measurement is a critical component of QI. Data should drive QI activity, so using games to teach measurement concepts is truly beneficial. • These games need to include some fun, as many people struggle with numbers and math. • These games should not be intimidating, but should teach a concept applicable to participant’s HIV QI work. • There are games to teach very basic measurement concepts as well as games to addresses more complex concepts and higher learning needs. 20 National Quality Center (NQC)

The Red Bead Game Variation and Causes of Variation • Divide your group into 4 teams, or use 4 individuals • The task is to determine the number of white beads in a box of red and white beads in 5 minutes!. • TEAM 1: Tries to count every bead in the box • TEAM 2: Creates an estimate without ANY counting. • TEAM 3: Pulls 20 beads at random, counts white beads and projects an estimate for the whole box • TEAM 4: Pulls 100 beads at random, counts white beads and projects an estimate for the whole box. • Report the actual number of beads…. Who came closest? 21 National Quality Center (NQC)

Games That Teach Skills in Testing & Making Changes These types of games may help you: § Understand the PDSA cycle § Decide which change to make in a process to improve it § Understand resistance to change § Work as a team to solve a difficult problem by developing and testing a hypothesis § Develop and expand on pilot tests 22 National Quality Center (NQC)

The Tennis Ball Game • Form groups of 6 -8 persons, one of which will be the QI officer. The rest represent steps in the patient visit process. The tennis ball is the patient. • Sitting/standing in a circle, the participants pass the ball to each other, as different steps in the visit process. The ball must pass to each participant. Time the process. • Reflect on way to move the ball/patient thru the process/office visit more quickly. • Change the process, time it again. • Continue to reflect, change, and time until you are sure it cannot happen more quickly. 23 National Quality Center (NQC)

Additional Game Resources A gazillon available online! 24 National Quality Center (NQC)

Additional Questions? Kevin Garrett kfg 01@health. state. ny. us Jane Caruso janecaruso@comcast. net Nanette Brey Magnan breymagnan@aol. com 25 National Quality Center (NQC)