An Innovative Escape Room Format Used as an Evaluation Tool in an Ambulatory Care Setting to Identify Staff Knowledge Gaps of Joint Commission Quality Standards

Purpose: The aim of this presentation is to describe the plan our education team developed to prepare staff for the upcoming Joint Commission quality survey.

Description: A professional practice gap in knowledge was identified following a mock Joint Commission survey to prepare staff for their impending scheduled visit. The clinical education team was approached to create an innovative evaluation of the knowledge gaps identified and offer additional learning opportunities.
Through the support and knowledge of our ambulatory care nursing director, the format of a Joint Commission escape room was created. Our focus was on the top 10 areas identified by the mock surveyor as areas for improvement. These areas became the focus of escape room stations and included hand hygiene, look-a-like sound-alike medications, instrument handling, and environment safety. Puzzles were created to spark the minds of all skill levels to work as a team to solve. Our team collaborated with our ambulatory care quality director and quality program manager to provide input as each area was developed to maintain alignment in the education provided to the staff.
Participants represented 33 of our 68 ambulatory care sites. Each team had members which included management, clinical, medical office associates, and social workers. Each team was given a bag of provisions needed to assist them within the escape room. The room was divided into a light section and a dark section. The teams were given 45 minutes to work to solve each puzzle that lead to the escape route. Each team was debriefed and given additional resources to share within their practice site.

43 escape room sessions were conducted over a 5-month time period that reached more than 225 participants. Twenty teams escaped within the allotted 45-minute time frame. Our follow-up surveys and feedback were extremely positive and word spread quickly within our institution. The escape room was acknowledged by the president of our health system as a best practice for regulatory review which encouraged visitors from our college of medicine, human resources, and inpatient nursing education department to observe our innovative education design.

Implications for practice: The Joint Commission sets the quality standards for patient care. Our institution which includes the ambulatory care practice sites strives to meet these standards. Creating an innovative format for evaluation of knowledge of these standards was the design of the escape room. This format of evaluation engaged all levels of staff in preparation for the impending survey visit. The final outcome of only 20 teams escaping revealed the need for additional educational efforts related to Joint Commission standards. Our education team was able to provide additional learning opportunities through a Jeopardy game. Participant evaluations revealed that the escape room format was fun and interactive while improving communication and teamwork skills.