GridlockED. The Game Crafter, 2018. Project leader: Teresa Chan. $89.99.
Back in 2016 PAXsims reviewed Healthy Heart Hospital, a rather tongue-in-cheek hobby boardgame about managing staff and treating patients in a for-profit hospital. GridlockED is also about patient management in a busy hospital, but with a rather more serious purpose. Developed by a team of faculty members, researchers, and students at the Division of Emergency Medicine at McMaster University, it is designed to teach medical students and others serious lessons about triage, patient flow, and treatment. This article from the journal Academic Medicine explains the thinking behind the game.
The goal of the game is to survive 8 turns and accumulate 500 points (from admitting and discharging patients) without suffering more than two patient safety adverse events. A number of patient cards are drawn randomly each turn. Each present a patient’s symptoms, and the medical steps necessary to address these so that they can be sent home or admitted for ongoing treatment. CTAS (Canadian Triage and Acuity Scale) Category 1 and 2 patients must be stabilized quickly before additional examination or treatment can occur. CTAS 3-5 patients can wait in the Waiting Room until staff and appropriate beds are available. The patient descriptions are excellent—we certainly learned a great deal about emergency room procedures.
The players start with a four nurses, a doctor, resident, radiologist, and consultant. Points can be expended on additional staff or beds as ward upgrades. Random events in the patient deck through unexpected challenges (for example, a needle-stick injury to a staff member) and the occasional bonus (such as a grateful former patient bringing treats!).
The game includes the main game board and waiting room; patient, event, and staff cards; dry erase markers; and staff pawns—all very nicely produced. A brief quickstart guide explains some key game procedures, and an online video (below) provides a longer introduction.
The absence of a comprehensive rule set was our only major quibble with the game. The printed guide omits some key information, and it is awkward to advance through the video in search of a rule explanation which may or may not be there. We had a few specific questions:
Must a staff member complete all their actions before another staff member may act? Or can you switch back and forth between staff until all staff actions have been expended? (They may swap back and forth.)
When rolling for additional patients on some turns, do you simply add d6 patients to the base number indicated? (Yes, just add the score of the die.)
When spending an action to move a patient, must the nurse token move with the patient? (No, just move the patient.)
Card E15 mentions a “Observation Zone,” which doesn’t exist on the game board. (This should read “Intermediate Zone.”)
The video seems to show the players with 300 points on Turn 1. Do they start with some points? (No they don’t—the video is a little ambiguous.)
However, as you can see from the answers above, Teresa and the GridlockED team were quick in responding to our email queries—clearly they are used to dealing with emergencies. Revised rules are in the works, and will appear in a future version of the game.
All-in-all, GridlockED has much to offer as a pedagogical tool for medical training. It also nicely illustrates how a relatively simple board game can be used to explore practical real-world challenges.