A gaming application that uses quick quizzes repeated over a series of days or weeks is gaining favor in health systems across the country as a staff education tool.
Developed at Harvard Medical School and marketed by Qstream, the platform focuses on reinforcing on-the-job behaviors by delivering "Qstreams," or quick Q&A challenges that can be answered in three to five minutes. Company officials say the "spacing and testing" method has been shown to increase knowledge retention up to 170 percent.
"It's Jeopardy for docs," said Duncan Lennox, the Burlington, Mass.-based company's co-founder and CEO. "We've come to the realization that the way we've typically taught things isn't really effective. That isn't how memories are formed."
A better method, Lennox said, is learning in short, repeated bursts. And comparing quiz results with peers to form challenges. The quizzes can be accessed on mobile devices or at a computer at the user's convenience. When the quiz is completed, a score is tabulated and the quiz is modified (once a question is answered correctly twice it's replaced) for the next session.
That's what piqued Kevin Ban's interest. The chief medical officer for Beth Israel Deaconess Hospital in Needham, Mass., Ban found that staff education was always at the top of the list of things to do, but doctors and nurses don't want to spend their spare time in a classroom at the end of the day or some evening or weekend.
Using a grant from BIDMC's insurer, Crico, Ban launched an 18-month initiative to use Qstream to educate staff on Joint Commission safety standards. He expected to start with a small group and build up the program. He received 400 requests to join.
"It's been a useful tool for us," he said.
Ban said his staff enjoys the competitive nature of the quizzes, and he's been able to modify the questions to include photographs of staff members illustrating certain scenarios.
"People really like it when we use pictures," he said. "I was surprised by how much fun people had with this."
Ban said he's getting an engagement rate of about 75 percent – well above the 40 percent he'd probably get if he scheduled a workshop on the same issues. He's now preparing to launch a second Qstream, and sees this method as an ideal means to educate staff on everything from patient safety to Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) awareness.
Other health systems using Qstream include the University of California Health Quality Improvement Network, which has launched a five-part program in its six medical centers to improve transitions of care during hospital discharge. The first part of that program, "Enhancing Quality in Practice (UC EQuIP),” is being used by more than 600 front-line clinicians.
At Houston Methodist Hospital, meanwhile, administrators used a CMS grant to launch a Qstream program targeting delirium in elderly hospital patients. Studies have shown that 14 percent to 24 percent of patients over 70 exhibit signs of delirium upon admission, and 54 percent experience delirium during their hospital stay, yet delirium is often missed by clinicians and coded at low levels. Three Qstreams have been deployed to date, targeting physicians, nurses, nurse practitioners and speech and occupational therapists, with future Qstreams targeting non-clinical staff such as medical technologists and home-based caregivers.
According to hospital officials, of the 456 staff members who took the first Qstream in 2012, 78 percent called the process "enjoyable" or "extremely enjoyable," the top two choices on a five-part scale.
Lennox said he's seeing roughly 94 percent compliance among Qstream users. It's making a difference, he said, in reinforcing best practices, and in helping with "educational material that is fairly mundane, that people tend to think they know but really don't."
And if they're having fun doing it, so much the better.
