Friday Night at the ER®

A simulation that…

Friday Night at the ER

  • Enables your people to experience the principles of Systems Thinking, how…
    • the parts (e.g. unit, department, function) of a system are interdependent
    • decisions that may be optimal for one department can reduce the full system’s potential to generate results.
  • Prepares them to think beyond their own area and across silos.
  • Sparks collaboration across units, departments, functions and even the entire organization.
  • Fosters a mindset of individual accountability for the success of the entire system
  • Awakens an intact team to the barriers preventing it from maximum its results.

The Setting…

It is noon on Friday and the managers of several key departments of a local hospital are about to guide their units through a 24-hour cycle that encompasses Friday night, the busiest night in the Emergency Department.

Tasked with managing the flow of patients through their respective units, Emergency, Surgery, Critical Care, and Step Down, they will have to make quick decisions under time pressures. The challenge is to make the entire system work through the ups and downs of a frenetic Friday night, where the actions they take individually can have a major impact on the quality and financial outcomes of their fellow departments.

The Learnings…

Systems Thinking
The complexity of modern organizations, businesses, and markets require us to look at–and operate–our team, unit, or department as both a system in itself, as well as a part of a larger system. Working with this broader perspective is a key factor for success.

To make any even somewhat complex system work optimally, collaboration is key. You can increase the degree of inter-unit collaboration from (1) minimal communication, through (2) shared information, (3) treating one another as customers, and (4) jointly planning, to (5) sharing responsibility for the success of the whole operation.

Unleashing Teams
Our mental models and assumption become, in effect, “rules” that determine our behavior and decisions within our team. Therefore, there is great value in the team challenging its conventional ways of thinking and operating that stand in the way of achieving a higher level of performance. In the process, team members gain personal insight about the effectiveness of their own way of participating.

Innovation & Improvement
When system performance hits a ceiling, it is often because we are operating on limiting assumptions and mental models. You must go beyond the boundaries of conventional thinking and adapt the processes of a system to meet the needs of all the participants and stakeholders

Learning and Adapting
The most successful systems consistently measure performance and seek feedback from the system’s players as to what they need and customers/stakeholders as to what they value. This data and knowledge then drives better decisions, going forward,  for the system as a whole.

How underlying structural elements in teams and organizations can drive people’s behavior

Friday Night at the ERThe Event…

Friday Night at the ER is played at separate tables, four participants to a table. Each table group represents a hospital and the four players are the managers of the four key departments.

The event works can be held with as few as four participants or groups up to 60 or more. Including the explanation of the game rules and process, the play itself, and a customized debrief, time required to do it justice is 3 1/2 to 4 hours. We build in some time pressure to replicate the real work environment.

This is a very effective way to have your managers and/or staff experience, first-hand, operating in a system where the parts are connected and therefore which calls for a more complex approach to the work. The lessons from the experience transfer very well back to the participants’ work world.

It is an ideal activity for:

  • Departmental or team building retreats
  • Newly formed cross-functional or project teams
  • Strategic planning meetings
  • As part of a change management initiative


Call Ian now, at 571-226-6610