Staff incentives help prepare for surveys

Is an unannounced survey from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) topping your "worry list" these days? All Joint Commission surveys will be unannounced as of Jan. 1, 2006, which means that you’ll need to be ready for surveyors to walk in at any minute.

To ensure continuous preparedness, the "I’m Rich" program was developed by ED nurses at Wake Forest University Baptist Medical Center in Winston-Salem, NC. "We wanted to find a fun way to educate staff on the current National Patient Safety Goals and our efforts within the ED to meet them," says James Bryant, RN, MSN, CEN, director of emergency and transport services.

"I’m Rich" is a mnemonic device:

I= Identification;

M = Medication safety;

R = Reconcile medication history;

I = Infusion pumps;

C = Communication;

H = Health care-associated infections and Harm from falls.

A bulletin board explaining the program was placed next to the ED’s time clock. During weekly rounds, nurses are quizzed randomly by managers, and they are "paid" for correct answers with paper "money. "The amount they are paid is based on the difficulty of the question," says Bryant.

At the end of two weeks, nurses tally up their winnings. The staff member with the largest amount receives a gift certificate of their choice for $50, paid for by the ED. "The program helps staff to become more comfortable answering questions on the spot and to be proud of the efforts made by our department and hospital to improve patient safety," says Bryant.

The program has increased the comfort level of nurses who might have been nervous about surveyors "putting them on the spot," says Ryan Oglesby, BSN, RN, EMT-P, educator for the ED and transport services. "It has been beneficial to question staff randomly and off guard as the case may be in future JCAHO surveys."

Nurses are enjoying this new way of learning the necessary information, says Oglesby. "Often, presentations and fliers just don’t have the desired impact in an physically and emotionally stressful environment where staff are already busy with life-saving interventions and handling urgent patient care needs," he says.

Day, evening, and night shifts are competing with each other to respond with the most correct answers, says Oglesby. "They started the competition on their own, without incentive, as friendly competition," he adds.

The program is not only more enjoyable — it’s also more effective, says Bryant. "It is a fun activity to get staff motivated and out of the handout and video world of inservice education we all too often are forced to use."


For more information, contact:

  • James Bryant, RN, MSN, CEN, Director, Emergency and Transport Services, Wake Forest University Baptist Medical Center, Winston-Salem, NC . Telephone: (336) 713-9055. E-mail:
  • Ryan Oglesby, BSN, RN, EMT-P, Emergency Department and Transport Services Educator, Wake Forest University Baptist Medical Center, Winston-Salem, NC. Telephone: (336) 713-9254. E-mail: