GNDI Case Study: How Two Card Games Train 50,000+ Employees Annually

[IMAGE 1, hero] Alt text: “Physical materials of SkilLab’s two GNDI games: the Hospital Waste card game (with disposal type cards) and the Fire Safety card game (with scenario and action cards), both branded with Grupo NotreDame Intermédica identity” Filename suggested: case-gndi-50k-hero.jpg

TL;DR: GNDI (Grupo Notre Dame Intermédica) came to SkilLab with a clear brief: improve retention on mandatory annual safety-and-environment training. SkilLab co-created with the company team two distinct card games, one for hospital-waste disposal and another for fire prevention and response. Result: both games are used annually to train more than 50,000 employees. This case shows how gamification can become a recurring operational tool rather than an isolated event.

GNDI is one of the largest healthcare operators in Brazil, part of the Hapvida group. The operation involves thousands of employees across hospitals, clinics, administrative and operational centers. Mandatory annual training on safety and environment is part of corporate compliance, and low-retention training in healthcare practice translates directly into operational risk.

Client and Challenge

The initial request arrived with a clear symptom: “we need to improve our mandatory annual safety and environment training.” The operational problem behind that sentence is familiar to any corporate L&D function.

Mandatory annual training (compliance, workplace safety, environment) typically falls into three traps. First, employees see it as an “obligation” to be dispatched, not real learning. Second, the content is technical-regulatory and therefore easy to turn into a boring expository presentation. Third, the repetitive annual cycle erodes attention: by the second or third time the employee takes the same course, retention drops significantly.

GNDI specifically wanted to escape this pattern for two critical topics in the hospital environment: correct hospital-waste disposal (involving 20-30 distinct disposal bins in the operational environment) and fire prevention and response (involving quick identification of fire types and correct action).

Approach and Co-Creation

SkilLab structured the project in two parallel tracks because the topics have different natures even though both are annual compliance.

The first phase was technical immersion. GNDI shared internal standards, presentation videos, regulatory materials, and examples of medical equipment and brigade items actually used in operations. SkilLab conducted additional research to understand operational vocabulary and patterns of common errors from previous training cycles.

The second phase was co-creation. Rather than SkilLab delivering a closed product, the GNDI team participated in the design with suggestions about realistic scenarios, brigade vocabulary, equipment specific to operations. Co-creation has two benefits: it incorporates specificity that external research cannot capture, and it generates internal ownership of the product.

The third phase was prototyping and testing. Both games were tested internally with employees before scaling, with adjustments based on feedback.

The Two Games in Detail

Hospital Waste Game

The difference between 20-30 distinct disposal bins in a hospital environment is non-trivial. Infectious waste, sharps, chemical, radiological, common, recyclable, each category with specific disposal standards. In a real environment, errors can mean cross-contamination or exposure of professionals.

The Hospital Waste Game presents the player with a typical operational situation and requires choosing the correct bin. The card mechanic forces repetition with variation: the same concept reappears in slightly different situations, calibrating pattern recognition. The main challenge of the game is learning retention so that disposal always happens correctly in day-to-day operations.

Fire Safety Game

SkilLab designed a card game that simulates 4 fire types across 10 distinct scenarios. Each scenario brings a context (hospital corridor with flammable gases, administrative area with electronic equipment, industrial laundry, etc.) and the player must identify the fire type and choose the correct action among available cards.

Cards include actions that mitigate the fire and actions that aggravate it. The mechanic forces the player to practice rapid recognition of fire type plus correct decision under pressure, exactly the competencies required by the internal brigade in real situations. The game is designed for 3 to 7 players, replicating brigade team dynamics.

Result: 50,000+ Employees Trained Annually

Both games are used annually to train more than 50,000 GNDI employees. The metric is especially significant because it does not represent peak initial adoption followed by decline; it represents recurring use, year after year, as a consolidated mandatory-training tool.

The scale is also a validation. Corporate gamification programs are frequently piloted in small groups without clear proof that they scale to the entire operation. The GNDI case is an example of the opposite: what started as two prototypes became standard tooling for the annual program with thousands of executions.

What Makes This Replicable: The Annual Tool Loop Pattern

In more than a decade applying corporate gamification for Brazilian clients, we’ve observed that projects that become recurring annual tools (rather than isolated marketing events) share three characteristics. We call this pattern the Annual Tool Loop.

Trait 1: Solves a real obligation. The game does not compete with other options as “fun experience”; it replaces or complements mandatory training the company has to deliver anyway. This guarantees recurring demand independent of management changes.

Trait 2: Co-creation with the operational team. The area executing the training (HR, workplace safety, environment, compliance) participates in design. This ensures the product fits the existing operational flow and has an internal champion.

Trait 3: Repeatable with variation. Mandatory annual training repeats the same group of people. If the game works only once, it fails in the second year. The GNDI games work in annual cycle because the mechanic permits enough variation between rounds to sustain engagement.

[IMAGE 2, Annual Tool Loop diagram] Alt text: “SkilLab Annual Tool Loop: three traits that make a corporate game replicable on annual cycle, solves real obligation, co-creation with operational team, repeatable with variation” Filename suggested: annual-tool-loop-skillab-en.svg

What We Learned from the Project

The GNDI case is one of SkilLab’s strongest internal references for three reasons.

The first is the sustained-scale metric. 50K employees annually is a number few gamification projects in Brazil reach, and reaching it through a simple physical-digital product (cards plus light facilitation) validates that technical sophistication is not a prerequisite for scale.

The second is co-creation with the company team. The working model combining GNDI technical material, SkilLab research, and prototypes tested internally before scaling is a template we apply to many subsequent projects.

The third is longevity. Gamification products that become “annual events” decay rapidly. Products that become “annual tools” generate recurring revenue for SkilLab and recurring value for the client. Defining the product from the start as an annual program tool was critical.

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To understand how we integrate gamification into broader corporate programs, explore our corporate gamification practice. For other Brazilian cases in our portfolio, see the cases section or read our post with 20 examples.

The GNDI case shows that corporate gamification can be much more than a well-rated event. When designed as an annual mandatory-program tool, it becomes an operational training system that scales to tens of thousands of people per year without losing effectiveness.

By Ivan Prado · Founder, SkilLab · May 10, 2026