How Mass General used gaming to fix nurse documentation burnout

As Director of Nursing Services for Clinical Informatics at Mass General Brigham, Christine Sucheki had been watching her frontline staff struggle with what seemed like an impossible workload. Between patient care, documentation, and the endless cascade of alerts and forms, nurses were burning out faster than the system could replace them. The head-to-toe assessments alone were consuming precious minutes that could have been spent with patients. 

“We had this massive documentation burden,” Sucheki shared at CHIME’s inaugural CompassionIT Summit. “Nurses were clicking through 25% more flowsheet rows than they actually needed. But nobody wanted to hear another complaint about the EMR. We needed to prove we could do something about it.” 

Gamification meets clinical reality 

Mass General Brigham launched Project Drop Clicks,  Suchecki’s ambitious initiative to restructure how nurses documented their head-to-toe patient assessments.  

In order for the initiative to be successful, nurses had to go through training to learn the new approach. But traditional training sessions were poorly attended, and complex workflow changes like Project Drop Clicks required more than a simple PowerPoint presentation. 

Working with a third-party platform called C3 Softworks, the team developed concise, interactive mini-games that could educate nurses and immediately assess their understanding of key concepts.

“We adopted gamification to increase staff engagement and knowledge retention, especially as we are getting younger and younger nurses,” informaticist Adrian Aucoin shares. 

The initiative eliminated 25% of flowsheet rows from head-to-toe assessments while dramatically improving the clinical value of the remaining documentation. The streamlined approach not only reduced nurses’ documentation burden but made it much easier for other clinicians to quickly identify what was unique, abnormal, or preventing patient progress. 

The technical build itself wasn’t complex—they used existing EMR frameworks. But the real innovation was in how they approached the human side of the change. 

“We could do immediate feedback loops,” Aucoin says. “We could see exactly where the gaps were and where nurses needed clarification. Then we could either do targeted games in the future or mini rounding sessions to make sure they understood it.” 

As Mass General Brigham dove deeper into nursing workflows, they discovered something that would transform patient safety across the enterprise. When nurses sense that their patient may be decompensating, there’s a change in their documentation patterns. They increase the velocity of their documentation and alter what they’re documenting. 

The team built a predictive AI tool that evaluates these documentation patterns and returns a risk score for clinicians to view within their workflow. 

The impact was immediate and measurable: decreased risk of death, decreased length of stay, and decreased risk of sepsis—all by simply leveraging documentation patterns that nurses were already creating. 

“Just having this risk score within the clinician’s workflow has really improved patient outcomes,” Sucheki notes. “We’re re-leveraging the documentation that nurses are currently doing.” 

Find out more information about CHIME’s CompassionIT Summit here, or watch the full recording here.