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Serious Game Approach for Improving Healthcare Logistics

Time: Wed 2020-10-14 09.30

Location:, (English)

Subject area: Technology and Health

Doctoral student: Chen Zhang , Hälsoinformatik och logistik

Opponent: Assistant Professor Marcin Wardaszko, Kozminski Univeristy, Warzawa, Polen

Supervisor: Professor Sebastiaan Meijer, Hälsoinformatik och logistik

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Although serious games are central to corporate learning of needed skills for industrial operations sectors, their use for managing healthcare logistics has rarely been discussed from the perspective of game mechanics in terms of motivation, engagement and the achievement of the desired objectives. This thesis discusses serious games as a method for improving healthcare logistics with a case study in paediatric emergency medicine. This case is also exemplary for many other situations in the hospital sector. To understand the methodological state-of-the-art, in the first study, a systematic literature review of the simulation and gaming methods used to address logistical issues in healthcare was first of all performed based on eliciting two-hundred-and-seventy-three identified journal articles. The review found that the simulation studies focused on the modelling of work system mechanisms, whereas the introduction of game elements specifically designed for promoting desired behaviours, although pertinent, remained unexplored. Consider the type of problems that are addressed using simulation models, these models may be ideal candidates for addressing a wide variety of logistical issues. Intrigued by these findings, the second study explored a serious game design based on a simulation model representing patient flow characteristics and systemic resource configurations. The results indicate that the participatory allocation of resources would improve pure simulation-based predictions; nevertheless, the players felt challenged for a total management of the simulated emergency department. The simulation with a participatory aspect provides a challenging environment flexible enough to account for the demand-andprovision balance, preferences from actors, and the use of relevant game mechanics to reflect logistical aspects. This led to the third study incorporating the roles of the managers responsible for patient flow stratification in a parallel functioning healthcare production system and the specially designed scoring-based feature on top of healthcare production logistics to facilitate desirable behaviours in favour of overcoming access blocks and to monitor learning progress in corporation training situations. These features were tested in game-based learning activities under different modalities. Scores for the Game Experience Questionnaire and the data of in-game learning behaviours were collected to allow quantitative research to evaluate the experience, acceptance and effect of learning. The serious game in this thesis contrasts with that of previous applications in health which tend to be less challenging and of low difficulty levels. Scores and transitions of learning behaviours stems from a game design aiming to achieve the expected outcomes in learning the logistical management principles of healthcare and the delivery of the production decisions in a meaningful manner. In order to understand the effect of environmental stimuli on decisionmaking processes, in the fourth study, behavioural aspects were investigated in a more detailed level. Choice modelling of the revealed data from most of experiments was conducted to further estimate the efficacy of game elements as factors potentially influencing healthcare production decisions. The results showed that the effectiveness of the proposed scoring system is approximately identical to that of the contingent game elements, whereas the diminution of resource utilization is detrimental for choosing the patient transfer alternative. Certain suggestions on game design were also made. This thesis showed that a serious game, if rightly designed, could be a valuable tool in the case of practising decision making processes in health systems and understanding the impact of environmental parameters in a simulated environment with real operational data. The thesis might also serve as a reliable source of reference for game designers who wish to model and simulate complex social-technical systems that can be dictated by operational circumstances