Management Simulation:
Friday Night at the ER©

Friday Night at the ER® is a fun, engaging learning activity that has helped hundreds of people in organizations learn the key principles of systems thinking, collaboration and teamER game learning. Developed by Bette Gardner, an experienced health care professional and President of Breakthrough Learning Inc., the simulation works for groups of 8 to 80. You can find more information about Friday Night at the ER® at

How It Works

Friday Night at the ER® uses a board game format, with each participant playing the role a department manager in a hospital. The game simulates the challenges of managing a hospital department on a typical day. During successive rounds the managers make decisions regarding patient flow and use of resources. After 12 rounds they total their scores and learn how well they performed. Then each hospital team meets to discuss their performance and look for ways to get "out of the box" and improve. They play a second set of 12 rounds, again total their scores, and debrief the exercise. The great majority of teams do much better in the second session, as they learn that the hospital performs better if they collaborate. During the debrief, participants discuss what helped and hindered their efforts to think systemically (rather than in a "stovepipe" fashion), to learn as a team, and to apply that learning during the game.


The simulation works well for business, government, non-profits and health care groups. It takes about 2 hours to run, plus a minimum of 2 hours for the debrief and discussion of back-home applications. It has been used as a stand-alone activity, for team building, as part of a larger retreat of strategic planning session, to support quality management and re-engineering initiatives, and as part of a workshop on systems thinking and learning organization principles.

For More Information…

Russ Linden is licensed to lead the game, and has used it with dozens of public and private organizations. The simulation may be purchased from Breakthrough Learning, Inc., an organization development consulting firm: (408) 779-0701.