Playing the LTC lottery

Dr. Eleanor Feldman Barbera
Dr. Eleanor Feldman Barbera

After reading a recent New York Times Opinion piece about the uses of lotteries to solve social problems, I began contemplating their potential application to long-term care.

According to “For Better Citizenship, Scratch and Win,” lotteries have been used to encourage voting, reduce speeding and even to attend to health needs such as getting tuberculosis screening, practicing safer sex and keeping medical appointments.

In one example, to combat tax evasion on small purchases, the Chinese government encouraged people to obtain receipts by turning them into scratch-off lottery tickets — leading to tax revenue amounting to 30 times the cost of the lottery prizes!

The theory is that lotteries are appealing because people want rewards and they enjoy playing games. As the CEO of a company that designs games for businesses put it, “They could… have everyone get an incentive for $15. But they'd get better results for the same average price by having variability — some get $10, some get $100.”

An element of fun might be a welcome addition to what's typically the very serious business of long-term care. Presenting awards with humor and the thrill of winning a game could help offset the strain of coping with the ongoing losses inherent in direct care.

In addition, offering a lottery might appeal to a larger pool of workers. I often hear about the challenges of inducing less-engaged employees to improve their performance. Typical rewards, such as “employee of the month” programs, tend to honor those who are already committed and doing their best. Perhaps a lottery would engage disenfranchised workers in a way that other incentives have not.

Here are some playful ideas for applying lottery-style encouragement to long-term care:

1.  The Show Up on Time Game: In the SHOUT Game, all employees who arrive to work on a timely basis for the week get entered into a lottery, which takes place at the end of the month. Each employee therefore has the opportunity to enter four or five times, depending on their timeliness and the number of weeks in the month. Winners of the drawing would get various prizes, which could be monetary, gift certificates to local enterprises or perks such as a good parking spot.

2.  The Perfect Attendance Lottery: PAL would be run similarly to the SHOUT game, giving the chance of rewards to those who fill all of their assigned shifts for the week.

3.  The FLU SHot (FLUSH) Prize: It's the time of the year when all of us who work in healthcare are given the choice of getting a flu shot or wearing a mask over our faces. While avoiding illness and the mask alternative are probably enough motivation for most employees, perhaps a few more folks could be persuaded to get their flu shot with a FLUSH Prize.

4.  SUPervisor on the Unit Lotto: Why should upper management be excluded from lottery fun? In the SUP U Lotto, direct care workers can enter their supervisors and managers into the lottery whenever they see them engaging in tasks that support the team, such as responding to a call bell, answering a telephone at the nursing station or moving a “wet floor” sign over a spill and notifying a porter.

5.  Above and Beyond the Call of Duty Sweepstakes: The ABCD Sweepstakes gives residents and family members a way to reward workers who go the extra mile, such as taking the time to reorganize a messy closet or helping to set up a video chat with a distant relative.

6.  Resident Activity Raffle: In my last column I wrote about the benefits of a strong resident council. Receiving a raffle ticket could be one way to encourage attendance at resident council meetings and other activities.

Some implementation tips: Modify the humorous tone used in these examples so that it suits your organization.

Increase staff buy-in before the launch by asking for suggestions for lottery prizes and/or voting on the title of the raffle. Try one lottery idea for a limited time as an experiment, keep track of before and after results, and adjust as necessary.

Who knows? Perhaps a lottery could be just the, um, ticket for what your organization needs to jumpstart a flagging employee recognition program.

Eleanor Feldman Barbera, PhD, author of The Savvy Resident's Guide, is a 2014 Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the 2014 American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with nearly 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.

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