Gamification to Cut Costs, Promote Engagement and… Save Lives?

San Francisco’s UCSF and Detroit’s LevelEleven are finding out whether gamification can save lives.

Up to 100,000 deaths in the U.S. annually are attributed to hospital-acquired infections, or infections that patients catch between check-in and check-out. The team at the UCSF Benioff Children’s Hospital in San Francisco wants to change that. So they injected gamification into their health system.


The infection-prevention picture

In a world where enterprise gamification typically motivates key sales and consumer behaviors, UC San Francisco (UCSF) will use it to motivate nurses. Through LevelEleven’s gamification app, hospital leadership will create competitions around care. A key area of focus will be the kind of care that can prevent a core category of hospital-acquired infections – those of the bloodstream, which come with estimated costs of approximately $16,500 each.

More specifically, UCSF will target prevention of Central-Line Associated Blood Stream Infections (CLABSI), which occur when an IV line inserted into a large vein (typically in the neck or chest) leads to infection. An estimated 41,000 CLABSI occur in U.S. hospitals each year. Nurses play a vital role in taking care of these patients.

Dr. Arup Roy-Burman, medical director of the Pediatric Intensive Care Unit and of Pediatric Transport, Access and Outreach for UCSF Benioff Children’s Hospital, explained: “We can do, from a doctor standpoint, all that we can to keep the line sterile when it goes in. But really, the key to minimizing these infection rates is taking care of it day in and day out; that comes down to nursing.”

Slide1 2Complying with the quality care standards necessary to prevent CLABSI – such as ensuring dressings are sterile and keeping lines fresh – requires staying on top of relatively mundane tasks. Educating staff isn’t enough; for long-term results, nurses must be engaged to complete these quality processes, too.

After researching several options for attempting to accomplish this, Arup said it simply: “One solution may be gamification.” And here’s how he and his team will implement it: UCSF Nurses will receive incentives for filling out a module with questions around quality care. They’ll get points for logging certain care tasks in that module – like checking to see if a wound is oozing and changing dressings.

Competitions around completing these modules will not only incentivize nurses to maintain quality of care, but also encourage them to self-report. This in itself offers potential for a significant advantage at UCSF, where additional nurses are employed to conduct internal audits.

The larger plan 

When it comes to gamification, UCSF won’t limit its aim at infection prevention. In fact, quality care goals comprise only part of the plan. The UCSF-exclusive pilot actually began in February, when UCSF partnered with LevelEleven to implement competition in four phases, each targeting a different goal. LevelEleven brought its gamification technology and advising, UCSF its gamification goals and expertise in intensive-care nursing and hospital safety. Together, they collaborated to turn the following ideas into a carefully planned reality:

Phase I: Improve peer recognition and collaboration through Salesforce Chatter adoption

  • Only around 25% of UCSF nurses who have access to Chatter have ever used it. Arup and his team hope that promoting Chatter adoption will in turn improve communication and peer recognition.
Dr. Arup Roy-Burman, a leader in UCSF's gamification efforts.
Dr. Arup Roy-Burman, a leader in UCSF’s gamification efforts.

Phase II: Increase effective communication and promote engagement through a weekly unit newsletter

  • This will enhance distribution of a newsletter that centers on quality care, strengthening communication and education between units.

Phase III: Encourage self-reporting and quality care through a CLABSI maintenance module

  • This will help with quality care improvements and encourage self-reporting.

Phase IV: Promote educational modules

  • Especially geared toward millennial staff, this phase will allow nurses to access education when and where they want it and then incentivize them.


Arup says each of these four phases contributes to one mission: “We want to bring nurses closer together, we want to get them more excited about what they’re doing and we want them to perform better as a team.”

If that happens, he and his team will look at expanding gamification to not only the entire nursing staff of 2,400, but ultimately also the entire medical team (doctors, respiratory therapists, pharamacists, etc.) to motivate even more unique behaviors and inter-professional collaboration. And one goal will remain constant: UCSF will continue to work toward saving as many of those 100,000 lives as it can.


Stay tuned to the LevelEleven blog for updates, as UCSF moves forward in using gamification to achieve its goals. 


*Statistics obtained courtesy of UCSF.


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1 Response
  1. Wow! Can’t imagine one of the initial objectives of LevelEleven was to save lives, but its ability to model behaviors of any group combined with innovative thinking of people like Dr. Roy-Burman is a beautiful thing. Look forward to seeing updates on the quality of care rising and number of infections declining as a result. Best wishes for success in this endeavor.

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