BAUMHOLDER, Germany -- All across the globe, escape rooms have become the latest craze in team building and group recreational fun. In order to escape from the room into which the team is locked, players must work through sets of clues and hints to uncover the keys that will unlock the doors.The U.S. Army Health Clinic Baumholder has put a tweak on the escape room set-up in order to prepare for an upcoming survey by The Joint Commission (TJC), an independent organization that accredits and certifies nearly 21,000 healthcare organizations and programs in the United States. Rather than placing clues to escape the room, teams must identify ten pre-positioned clinical deficiencies in an exam room in two minutes, with an additional two minutes given to record what was found."[I did] a walkabout through our building after taking command and went through the [Army Substance Abuse Program] area where they have a mock barracks room set up to train leaders on where to look for drugs," said Lt. Col. Elizabeth Gum, commander of the Baumholder Clinic. "It looked like a great concept to apply hands-on training to help staff members know how to look for Joint Commission standards and deficiencies."Deficiencies in past Tracer Escape Room scenarios included an unsecured Common Access Card, expired medication left out, a mock patient's private health information written on a white board and an open Cavi-wipe lid. In the true essence of competition, teams could earn more points by identifying additional deficiencies on top of the 10 required to "escape," such as expired gloves, sharps containers over three-quarters full, or missing approved personal device safety stickers. Bonus points are awarded to teams when they correctly identify chapters or Elements of Performance for each deficiency of an extra item according to The Joint Commission's handbook.Gum's plan is to conduct a new Tracer Escape Room every two weeks."We divided the entire clinic into five multi-disciplinary teams who take turns designing the dedicated escape room with any kind of deficiency for the other teams to find and earn points," said Gum. "The more experienced members of the team are able to point out deficiencies based on their experiences in other [The] Joint Commission training or survey events, and they learn by researching the regulations to find creative deficiencies when it is their turn to design the escape room."Gum said that feedback on the escape room activities has been positive, with several staff members wanting even more time to spend in the room as a team. The staff has taken considerable measures to learn more about The Joint Commission standards, build morale as a team, and it gave Gum another avenue to firmly cement quality and safety initiatives into every action in the clinic.Although The Joint Commission survey will take place at Landstuhl Regional Medical Center, the parent organization for the Baumholder Clinic, all subordinate commands -- including the six U.S. Army Health Clinics in the Landstuhl footprint -- are eligible for inspection.