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What is the challenge your project is going to address and how does it connect to your chosen theme?

Most NHS employees have been admitted to hospital or know someone who has. Many staff will have (or had) roles that interact with patients on their journey through hospital. However, few understand the complexities of how patient flow are actually managed. Our challenge is to create a greater appreciation and understanding of patient flow and how all staff can support improvement.

Further related challenges to be addressed:

·         Traditional training techniques have become staid and overly formulaic. As a result the learning experience can often be sub-optimal, and sometimes forgettable.

·         Other than certain elements of mandatory training there is a dearth of opportunities for any member of staff to undertake shared learning with others from any staff group, irrespective of job roles and/or grades.

·         Training sessions tend to be rigid in format with little capacity to be tailored to the recipients’ specific requirements in terms of either content or learning outcomes.

What does your project aim to achieve?

Game of Flow was created at the Royal Bournemouth Hospital and launched in 2018. It has been further refined during sessions undertaken with various wards, teams and departments.

We have created a fully inclusive learning platform suitable for both clinical and non-clinical staff.

Game of Flow uses a fresh and exciting approach, making the learning more effective, memorable and appealing.

In a table-top format, teams compete over a series of rounds – requiring them to manage hospital flow, given realistic scenarios and unpredictable admission demands. Teams decide how to deploy available staff, and whether to invest in employing agency staff or opening up additional bays on the wards etc.

Game of Flow is extremely adaptable – the scenarios being readily adapted to suit participants’ role(s) and any specific learning requests.

Our aim therefore is to spread and share this unique learning opportunity with other NHS organisations and to enable their in-house delivery capabilities.

How will the project be delivered?

In order to be capable of independently delivering in-house Game of Flow sessions, the recipient organisations need their own set of Game of Flow training materials and a pool of fully briefed trainers.

The project will be delivered by scheduling a programme of monthly 2-day visits to up to 12 recipient organisations.

Day 1

AM: Presentation and Q & A session with the recipient organisation’s sponsor(s); deliver ‘train the trainers’ session. (Face to face training will ensure that all our experience of effective session delivery can be optimally discussed/conveyed).

PM: Lead a 2-hour Game of Flow session with recipient organisation participants (trained trainers act as referees), followed by leading a ‘lessons learned’ & feedback session.

Day 2

AM: Oversee the trainers as they lead their first in-house session.

One complete set of training materials is left with recipient organisation at the end of each visit.

What and how is your project going to share learning throughout?

Delivery of the project will enable recipient organisations to share the learning experience with all staff.

Following the first year, it is hoped that further NHS organisations will arrange self-funded training visits of their own.

Excellent feedback* has been received in reaction to the ‘gamification’ of hospital flow. It has inspired the designers to begin to develop ideas around other NHS processes and practices, eg the management of complex outpatient waiting lists. Once such ideas have been fully tested, the learning experience and in-house delivery capability could again be shared with other NHS organisations.

*Testimonials received to date include: “What a fantastic Governor training session it was today.  I have never seen or heard such a buzz at a training session before and I have been in my role for over ten years! I thought the game was superb and made everyone aware of the difficulty that the Trust faces on a daily basis, and bought the problems to life.”

How you can contribute

  • The success of the project depends on identifying 12 recipient NHS organisations.
  • Two Q members have contacted us so far:
  • Breid O’Brien, Director, Digital Transformation, Health Innovation Network (HIN).
  • The vision of the HIN is to ‘aspire to a future where health and care innovation spreads fast’. They do so by ‘connecting people with great ideas… and giving them practical support to do something new’.
  • We are very excited that Breid (perhaps in also exploring potential digitisation) and her network colleagues can help us to promote Game of Flow.
  • Natalie Jones, NHS England Better Care Fund Manager, South East (HIoW and TV).
  • The Better Care Fund is a programme spanning both the NHS and local government which seeks to join-up health and care services.
  • The support of Natalie and colleagues will be immensely helpful to our project.
  • We are extremely grateful for the interest expressed so far, and we also hope to link with other Q members to help us to share and spread our work.

Plan timeline

25 Jul 2019 Submit detailed proposal to Q Exchange
30 Aug 2019 Start to establish list of potential recipient organisations
20 Sep 2019 Q Exchange shortlist announced
30 Sep 2019 If shortlisted continue to identify recipient organisations
13 Nov 2019 Q Exchange winners announced
31 Dec 2019 If successful, agree KPI(s) with Q Exchange
31 Dec 2019 If successful, arrange monthly visits (Jan 2020 onwards)
31 Mar 2020 Provide first three month's activity report to Q Exchange
30 Jun 2020 Provide first six month's activity report to Q Exchange
30 Sep 2020 Provide first nine month's activity report to Q Exchange
31 Dec 2020 Provide first year's activity report to Q Exchange
31 Jan 2021 Review and plan next steps


  1. Hi Geraldine,

    it was lovely to hear about your idea on the webinar last week. Love the fact you want to make QI fun.

    How’s it going? Need any help?

    best wishes



  2. Thank you for your interest. Ian Neville has responded to your NHS email addresses and looks forward to hearing from you

  3. I'd be interested to find out more

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