Enhancing teamwork communication and patient safety responsiveness in a paediatric intensive care unit using the daily safety huddle tool

Abstract

BackgroundOpen communication between leadership and frontline staff at the unit level is vital in promoting safe hospital culture. Our hospital staff culture survey identified the failure to address safety issues as one of the areas where staff felt unable to express their concerns openly. Thus, this improvement project using the daily safety huddle tool has been developed to enhance teamwork communication and respond effectively to patient safety issues identified in a paediatric intensive care unit.MethodsWe used the TeamSTEPPS quality approach. TeamSTEPPS is an evidence-based set of teamwork tools developed by the US Agency of Healthcare Research and Quality to enhance teamwork and communication. We applied TeamSTEPPS using a tool called the Daily Safety Huddle, aiming at improving communication and interaction between healthcare workers and building trust by acting immediately when there is any patient safety issue or concern at the unit level.ResultsDuring the period from April to December 2017, the interaction between frontline staff and unit leadership increased through compliance with the daily safety huddle. Initially, compliance was at 73%, but it increased to 97%, with a total of 340 safety issues addressed. The majority of these safety issues pertained to infection control and medication errors (109; 32.05%), followed by communication (83; 24.41%), documentation (59; 17.35%), other issues (37; 10.88%), procedure (20; 5.88%), patient flow (16; 4.7%) and equipment and supplies (16; 4.7%).ConclusionsSystematic use of daily safety huddle is a powerful tool to create an equitable environment where frontline staff can speak up freely about daily patient safety concerns. The huddle leads to a more open and active discussion with unit leadership and to the ability to perform the right action at the right time.

Fidelity and the impact of patient safety huddles on teamwork and safety culture: an evaluation of the Huddle Up for Safer Healthcare (HUSH) project

“…Consistent improvements occurred including: briefings being seen by staff as common, the culture making it easy to learn from others’ errors and the overall patient safety grade assigned to units by staff. These findings align with other studies showing that huddles improved both the number and quality of communication opportunities [ 2 , 20 ]. However, that the improvement in overall patient safety grade was not reflected in improvements in other measurement items suggests the TSC may not reflect factors that staff consider when responding to this question.…”

Fidelity and the Impact of Patient Safety Huddles on Teamwork and Safety Culture: An Evaluation of the Huddle Up for Safer Healthcare (HUSH) Project

“…Consistent improvements occurred including: brie ngs being seen by staff as common, the culture making it easy to learn from others' errors and the overall patient safety grade assigned to units by staff. These ndings align with other studies showing that huddles improved both the number and quality of communication opportunities (2,14). However, that the improvement in overall patient safety grade was not re ected in improvements in other measurement items suggests the TSC may not re ect factors that staff consider when responding to this question.…”

“…The current ndings support studies showing that implementing huddles is feasible, effective, and huddles themselves are acceptable to hospital staff (4,6,14). Given the extensive barriers to successfully scaling up a quality improvement initiative -for example, the politics of organisations, user engagement and the role of the team ( 15)-the number of wards that achieved embedded status can be considered a success.…”

“…In addition, the few negative changes in some TSC items may re ect raised awareness of these factors. Aldawood et al (2020) (14) found that the use of patient safety huddles served to increase awareness of and improvements in safety culture. Critical care wards indicated an increase in frequently being unable to express disagreement; given the high-stakes nature of critical care wards, huddles may have increased perception of a necessarily highly hierarchical setting.…”

“…Nursing support staff reported a reduction in the perception that the hospital did not knowingly compromise safety. It may be that by taking part in regular huddles with a range of senior staff who are more familiar with addressing them, they may have become more aware of safety issues, how they occur and how they are managed (14).…”