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Friday Night at the ER

Students experience the rush of hospital management during the craziest 24-hours.

Problems are part of a hospital’s routine. Patients flood the emergency department. Nurses call out sick. A doctor delays one operation, and the schedule falls behind.

Master of Health Administration (MHA) students can’t understand what it takes to handle nightmarish situations simply by reading a textbook. That’s why William Ward, MBA, unpacks “Friday Night at the ER”—a board game created by Breakthrough Learning, Inc. that provides real-world experience without setting foot in a hospital.

Students enrolled in the course “Fundamentals of Managing Healthcare Organizations” play the game early in the term. Each person fills the shoes of a department manager working a 24-hour shift on a Friday evening. In teams of four, they must direct staff and the flow of patients through a hospital with four departments: emergency, surgery, critical care, and inpatient nursing.

“The idea behind this game is to learn without knowing that you’re learning,” says Ward, former director of the MHA program at the Bloomberg School.

During the 1-hour simulation, there’s a steady clatter of bingo chips—blue for patients, white for staff—as students make tough decisions, like calling in extra nurses or temporarily closing a unit to new patients. Individual leadership styles emerge and students learn as much about themselves as they do about hospital management. They realize the importance of communication between departments and feel the pressure of finding solutions in a time-crunch.

But every decision comes with a price. By the end, Ward scores them on both the quality of care and financial outcomes. Calling in extra staff, for example, incurs hundreds of dollars in overtime.

The game embodies what Ankit Patel, a first year MHA student, sees as the No. 1 goal of health administration: “Providing quality of care in a fiscally responsible fashion. That’s what I’m here to learn and hopefully implement in the industry,” he says.

For over a decade, Ward has traveled around the world with the game kit in tow, using it to teach professionals in Peru, Singapore, Hong Kong, China and Taiwan. One lesson has persisted: Admitting a patient into the emergency department and eventually discharging him is not as easy as it seems—especially on Friday night.

—Salma Warshanna-Sparklin