doctors’s corner by Allen Weiss President and CEO, NCH HealthcareSystem
Associate Chief Nursing Officer Ilia Echevarria recently shared the following essay with me.
In the June 2017 Quick Safety newsletter, the Joint Commission deemed daily safety briefings, also called safety huddles or daily check-ins, as ‘hallmarks of high
reliability organizations.’ Safety huddles in healthcare have also been endorsed by a number of organizations, including the American Hospital Association, Institute for Healthcare Improvement, and Agency for Healthcare Research and Quality.
Daily huddles are used to keep the front-line staff informed and aware of ongoing organizational initiatives and outcomes. These gatherings have been shown to promote a culture of safety, improve clinical outcomes, and advance team dynamics. Huddles
at NCH have always been the norm, but these efforts were enhanced and maximized over the past year with support from our Lean Transformation Department, under the direction of Mustafa
All clinical units and related departments were educated on the most effective ways of facilitating daily huddles using meaningful and relevant information. Daily huddles occur at both hospitals in all clinical areas
and in non-direct patient care departments including Food & Nutrition and Environmental Services. All multidisciplinary team members including nursing, pharmacy, social work, physical therapy, respiratory therapy, and lab services conduct daily huddles in their respective departments.
Each area implemented whiteboards as a tool to facilitate huddles. The boards serve two purposes: to facilitate meaningful discussion and to promote the sharing and transparency of information. In most clinical areas, the huddle boards can be viewed by patients and visitors. Patients are taking notice of our transparency and team dynamics, as evidenced by a recent letter written to the nurse manager, RN Marcia Swasey on 5N Baker Campus, from a discharged patient: ‘ I stopped to read the large whiteboard with the unit’s quality scores/ patient satisfaction scores along with staff input, improvement suggestions, outcomes of interventions etc. Wow.
I found the transparency comforting. And I felt like I was being cared for by a staff that was a team working
together to give the safest and best care possible.’ Topics covered during the huddle include performance outcomes related to quality, service, and finance; staff recognition; safety related targets; and idea generation and discussion. The huddles in clinical areas are usually led by a charge nurse or another front-line
staff member on both days and nights. All front-line staff meet at the “huddle board” to discuss key huddle topics as well as the state of the unit as it pertains to any safety related issues, anticipated needs and challenges, and resources. The non-clinical departments also conduct huddles that are led by either leaders of those departments or front-line staff with similar topics covered.
While daily huddles are not new to healthcare, the manner in which we are conducting them at our organization by including both clinical and non-clinical departments, having them led by front-line staff with an opportunity to generate solutions to problems, and using transparent huddle boards viewable to patients
and visitors have added a new dynamic to this process that has been recognized and appreciated by both staff and our patients.”
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