More than rewards: insights into a hospital infection prevention and control gamification strategy

Traditional infection prevention and control (IPC) education and training of healthcare workers (HCWs) is expensive and rarely sustainable. Gamification strategies support behavioural change by capitalizing on psychological drivers such as intrinsic and extrinsic motivation. However, little is known about which type of reward presentation best supports the engagement of HCWs.

To examine which reward strategy can best facilitate engagement and acquisition of IPC knowledge.

This study was performed in three gastroenterology wards, and a palliative care ward served as the control. Data on bed occupancy and consumption of alcohol-based hand sanitizer (ABHS) were collected over a 2-month baseline period, and the number of correct answers was gathered during the intervention phases. Surveys on expectation and satisfaction were conducted pre and post intervention. Twice-weekly knowledge quizzes used loss aversion, standard reward and in-game reward strategies. Multi-variate analysis was used to analyse data on ABHS consumption and IPC knowledge.

In total, 105 HCWs participated in this study. A 170% increase in mean ABHS consumption was observed between baseline and the last phase of gamification. This represents a significant effect of gamification (P<0.05). However, no significant difference in ABHS consumption was observed between the gamified wards (P>0.05). Furthermore, gamified strategies showed higher engagement than the control strategy, but strategies of loss aversion and standard rewards did not display higher ABHS consumption or game engagement compared with gamification alone.

The intervention effectively engaged medical and non-medical staff in IPC topics, positively influencing HCW work flow and increasing ABHS consumption. These findings highlight gamification as a promising approach for IPC education.