Safety at play: a systematic review on the adoption of gameful approaches for implementing patient safety goals

Abstract

Introduction: Despite ongoing efforts to improve patient safety by adopting innovative strategies, specifically gameful approaches, the evidence regarding the design and implementation of these interventions remains fragmented. This systematic review synthesizes current evidence on the design of gameful interventions for promoting patient safety across healthcare settings. Objective: To provide a comprehensive summary of the adoption and design of gameful approaches for patient safety. Methods: A comprehensive literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to answer four research questions. From 1,582 eligible peer-reviewed articles, 180 underwent full-text review and 82 were included. Results: Effective communication was the most targeted goal, nurse / nursing education is the area most identified for the application of gamification in patient safety, create, test, or validate innovative games, apps, escape rooms, and educational resources are the objectives most identified and feedback is the most used game element in the interventions. Conclusion: This systematic review confirms that gamification adds educational value to patient safety, particularly in effective communication. However, pedagogical efficacy is not enough for broad clinical adoption. The future challenge is clinical translation: conducting rigorous research that demonstrates a real reduction in adverse events, moving from prototypes toward evidence-based health interventions.