Theater based Learning - TBL

A unique and innovative methodology to learn and understand educational material

Medical Theater

Medical Theatre is the use of TBL for medical and healthcare topics.

 Hospital Soft Skills and Continuous Quality Improvement in NABH Vasan Eye Hospital, Jayanagar

August 2011

 National Accreted Board of Hospitals (NABH) maintains a rigorous set of rules and regulations that any hospital needs to possess in order to reach their standards. These rules were converted into theatrical outcomes in the form of a story narration and tableau games. This methodology turned out to be a very effective tool in communicating NABH content using medical theatre. The 85 participants enjoyed the experience and learnt through it effectively.

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  1. Procurement of medication pertaining to Patient needs– Doctor prescribes a medication and it should be available.
  2. Meeting laws and regulations – patient privacy if 2 or 3 are being seen at same time, patient files being accessible to strangers, patient confidentiality. Female pts should have a nurse or attender during examination.
  3. Monitoring risk Managements– risks related to electrical shocks, fire, patients fall down from beds if no rails present, radiation related. Laser beams, infections (sanitizing solutions with foot pedals at various places).
  4. Utilizations of space and man power– no seating available for pts and family members. Less equipment and more patients. Man power for investigations and scanning.
  5. Employee satisfaction– working hrs (8 hrs – every 2 hrs there should be a break), salary levels and upgrades. Doctors may shout at sisters and ward workers.
  6. Adverse events and near misses– wrong operation. On wrong side, or wrong medications. Allergies or reactions. Out dated eye dilatation medications can cause blindness.
  1. Data collation and support evaluation of the improvements – summaries, data/ audit, quality of documentation. 1 year data should be collected and kept. Data must be reviewed and analyzed.

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Medical Theatre for Hospital Administration and staff

Objectives – 1. To introduce an innovative methodology by which certain NABH  guidelines can be learnt and understood effectively.

Body – For these group of hospitals we mainly concentrated on NABH content, specifically on Continuous Quality Improvement (CQI). The National Accreted Board of Hospitals gives a set of guidelines that a hospital  needs to follow in order to receive accreditation of NABH. We conducted a half day intervention for a group of hospital professionals including doctors, nurses, customer care, housekeeping and administrative faculty. Between theatre games and timely breaks, the content of CQI was dealt with by facilitating the participants to create Tableau’s or still images using each other in groups. The rest of the participants tried to interpret which of the CQI content was depicted in these tableaus. They also experienced a story narration and created a short theatrical presentation  on certain soft skills such as punctuality, attitude, business mindedness and dedication. The group took some time to get comfortable as the hierarchy was intimidating, however as soon as the events started to get more and more interesting the group united together to experience a fun filled yet educational process.

Conclusion- At the end of these workshops we concluded that this process can be utilised to create awareness on NABH guidelines amongst hospital professionals from all backgrounds. The effectiveness of this methodology was demonstrated by reaching out to non- medical and administrative members creating importance of NABH in an effective manner. It turned out to be a useful methodology when it comes to learning and understanding a set of rules and regulations

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a)      Importance of Communication – A corporate office boss has an important meeting for a huge deal with another MNC in a few days time. Due to his short temperament and anger outbursts, all his employees are very terrified of him. He has fired many people from their jobs due this behaviour. His secretary has made all necessary arrangements for his talk with the MNC. She just receives information that the meeting has been preponed to today and her boss is expecting it to be a few days away. She is afraid to tell him but fears he might get angry at her for this. She tells a few of her friends to pass the message along. They try but due to his anger but do not gather courage enough to tell the boss. Finally 1 hour before the talk the secretary tells this to her boss. He is angry, furious and anxious as to why the secretary did not keep him prepared. He is furious and storms into the toilet. The MNC team begins to gather outside his office for a talk. He comes out in anger and takes his papers and rushes out to make his presentation for the meeting. The secretary is shocked but hesitates to tell her boss that he forgot to wear his pants… The deal is broken as the boss has been a laughing stock and the secretary is fired from her job. Moral – Communicate however bad the situation is, it will be worse if it is not communicated.

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b)       Attitude – A well-established restaurant called “fast food center” that has been doing moderately well now has a new manager who has taken over the business. He makes a new rule that all the waiters will address the customers by addressing them as brothers or sisters, mothers or fathers. The new rule also includes apologizing to the customer at the time a mistake has been made and replacing the dish free of cost. No tips will be accepted by any waiter. Hearing to this all the waiters are unhappy and make fun of these strange rules and regulations. A few of them hesitantly follow the rules but are ridiculed by their peers. Slowly all the waiters stop following any rules and continue to be their rude and irritable selves, always unhappy with their work and making their living out of tips. The manager notices this behaviour and decides to sell off the hotel to someone else as the staff is very un co-operative. He opens a restaurant called” home meals” in the Next Street and employs people who would to listen to him. Slowly people stop coming into fast food center and everyone in the hotel faces a huge loss. On enquiring a few customers they found out that home meals was a very homely and hospitable restaurant where all the waiters were friendly and more understanding. People loved that approach and it is now one of the leading hotels in India. Moral – No matter whose mistake, a positive and understanding attitude makes a huge difference.

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d)      Concept of Business – In a royal kingdom the king decided to set up an advisory board for common men to share their problems.

He paid the advisors well but for some reason not many common men found their satisfaction from the solutions given by the royal advisory board. As it turns out, one of the kings best ministers has his own advisory board in the village which was successfully solving all the problems of many common men in the king dom. The king disguised himself as a farmer and went to the minister’s advisory with a problem. To his surprise he found he was very well looked after, was given shelter, was well listened to and was given a very wise advising for his problem. The next day the king calls his minister and asks for the secret behind his success. The minister smartly explained that since his advisory runs on funds given by a few zamindars, he and his fellow advisors work to their best potential to ensure adequate returns so that more and more funding comes to his advisory. Also he uses the advisors houses, land and food as resources to help the needy , hence making a very effective problem solving team. The king realized that since his advisors were getting a fixed pay, they never tried too hard to do well and eventually led to the downfall of the royal advisory. Moral – even if you are employed by a company, to understand its business potential and help in generating revenues if very important for the sustainability of the company.

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e)      Punctuality and Discipline – The king of the jungle wanted a wooden throne to be made for the upcoming festival in the jungle kingdom. He called for the rabbits that were the best in business. He asked how long it would take for the throne to be made. The rabbit replied at the fastest it would take a week. A monkey from the crowd shouted that he knows someone who could make it in three days. The lion asked for that person be brought in front of him. The monkey brings the turtle in front of the king. The rabbit chuckles that a slow turtle can never make an entire throne faster than the rabbits. He mocks the king for listening to the monkey. The lion is annoyed but asks the rabbit to go ahead with his team to make the throne. He asks the turtle to make the throne as a back up. The rabbit gets his team together. He gathers his team together. It takes a day to get everyone as all have returned from a vacation. He sends a few to get the wood. And the rest to get the hammer and nails. He also calls for the polisher who would do the final finishing for the throne. His rabbit team takes their own time, laughing and cracking jokes on the turtle. Soon a week is over and the throne is almost done. It takes a couple of days extra but the throne looks fabulous. The rabbit takes it to the lion to watch his breath-Holding look. To his shock the king is sitting on a huge and magnificent throne. The rabbit is speechless.

The king explains how the turtles made the throne in just two days. The rabbit asks the turtle how they did it. The turtle simply replied that they work on time every day with punctuality and determination. The wood is stored in their backyard throughout the Year and basic wood pieces are cut out since months together. When an order is placed they only need to modify the shape and polish it.

Moral- Punctuality and discipline can make even the slowest, the most efficient and powerful.