Key evidence suggests that as hospital systems in the US reach a crisis point – involving the transition to value-based purchasing and tying Medicare and Medicaid dollars to performance – quality of care must improve. In many ways hospital employees have become the most important piece of the puzzle to improve efficiency, lower costs and improve outcomes. Disengaged employees in the US who turnover, for example, are estimated to cost as much as $11 billion annually due to lost productivity and poor results. As hospital leadership faces a new domain of uncertainty and demands, and must use innovative technologies to better understand and improve engagement and performance of employees, two gamers think they have the answer: real-time evaluation, fun gaming interaction and a culture of positive reinforcement. The team at AMPT Health is gambling that their new SaaS solution will revolutionize performance evaluation. In the words of CEO Clint Carlos, “AMPT’s mission is to enrich the lives of patients by keeping health care workers happy and productive.” And they believe they can.
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An Unmet Need
As the Obama Administration is learning through implementation efforts of the Affordable Care Act, quantifying productivity, efficiency and satisfaction in a hospital setting is exceptionally difficult. Although the importance of doing so is validated by research indicating the contentment and commitment one feels for one’s work is directly related to the effort invested in fulfilling one’s duties.
Gallup argues that talent maximization for productivity within a company can be calculated as simply as:
Per-Person Productivity = Talent x (Relationship + Right Expectation + Recognition/Reward)
Reiterating that strategies such as positive reinforcement and trust building within an organization increase individual-level performance, which in a hospital translate directly to patient health outcomes.
The need for near real time performance evaluation exposes a significant void within current health care practices and technology. Presently, these evaluation systems fail to deliver timely feedback on the high and low performers within a system, usually giving only aggregated data with little granularity on actual nursing and physician performance.
Given that work performance is inherently a reflection of an employee’s competencies, efficiencies, cultural buy-in, accountability and personal habits, these key metrics need to be monitored on a frequent basis. The key items to be better understood and assessed are employee happiness, engagement and productivity. Further, these metrics should be collected using data directly from the employees – individuals and peers – via user-friendly platforms.
The ACA Drives Financial Fears
Hospitals are under financial constraints that challenge every previous strategic plan. Greater productivity, efficiency and safety are required; all while reimbursements and budgets are decreasing without an end in site. Moreover, the ACA has introduced a series of new penalties associated with patient length of stay, readmissions and potentially avoidable admissions that make growing hospital revenue difficult and physicians accountable in unprecedented ways. In the hospital setting, disengaged employees are more dangerous to patients, which in turn, could increase the likelihood of unnecessary length of stay and readmissions.
Further, economists tracking a 10-year longitudinal cohort of nurses suggest that there is a potential 2% loss in reimbursements for hospitals that cannot meet specific patient satisfaction and quality outcomes beginning in 2015, meaning that the Administration’s focus on quality is growing.
Sadly, in today’s hospital systems, most leaders lack reliable performance insights to properly recognize individual performance in a timely and authentic way. Yet, in settings like a hospital, where nurses are the backbone of day-to-day operations, it is vital that their performance be evaluated in objective and individualized ways.
AMPT Founder Collin Caneva argues, “Nothing else interacts with more patients or has greater influence over desired outcomes than health care workers; yet most health innovation ignores the role of human nature.” He further contends that the best way to objectively measure real time human behavior is to get employee buy-in that is partnered with a user experience that allows for seamless integration of new cloud-based software with existing operating systems, and even fun.
A method that is gaining popularity among those seeking to understand productivity and engagement is peer-to-peer feedback. Nursing schools have already embraced this method of colleague evaluation as a method to prepare future RNs for peer evaluation. The practice is also recognized and recommended by the Institute of Medicine (IOM) and the National Institutes of Health (NIH) as a method of more unbiased performance metrics.
One risk of peer-to-peer feedback and other performance evaluations is the breakdown of collaboration that occurs in situations where feedback is predominately negative. Circumventing this risk, AMPT catalyzes only positive feedback in the form of praise or recognition for activities that are proven to enhance health outcomes.
As most organizational psychologists have observed, positive encouragement is proven to be more effective than criticism, and AMPT wants to use that human behavior to help hospitals and employees perform better at their jobs.
Is AMPT The Answer?
Because employees innately work harder and smarter when they are invested in the mission and culture of an organization, employee engagement and productivity measurement can no longer be overlooked.
Beginning immediately, health-related executives have to move past high-level, aggregated analysis and reporting to deeper dives via near real time metrics of employee-level performance, and make the most of forthcoming health reformation. Because health care employees are relied on for the successful implementation of every major health initiative the need for AMPT could be undeniable.
Time will tell whether services like AMPT – that focus on positive psychology and game mechanics – are compatible with industries that rely heavily on compliance through protocol.
So far AMPT has been implemented within only a few health care organizations. However, AMPT CEO Clint Carlos presented early validation research at OneMedForum earlier this year and at the Forbes Healthcare Summit in late 2013, and boasts of having a backlog of hospital commitments for 2014 implementation.
If innovative startups like AMPT can succeed in making health care workers happier and more productive, then this could call attention to the role of human nature in other health related areas such as: avoiding readmissions through patient compliance; reducing the risk of obesity through activity and diet; or deterring adolescent tobacco use.