Implementing Daily Leadership Safety Huddles in a Public Hospital: Bridging the Gap

Abstract

Background: A Leadership Safety Huddle was instituted in efforts to improve communication and make safety culture a priority at our institution. The Huddle is a transparent, regularly recurring forum of clinical and administrative hospital leaders, in which safety issues and concerns are identified, shared, and swiftly addressed. Methods: Metrics regarding huddle effectiveness in 3 areas are studied: information technology (IT) services ticket resolution time, bladder catheterization, and one-to-one inpatient monitoring. Results: Analysis revealed effectiveness of the huddle on quality of inpatient care and cost savings. Survey revealed 75% or higher favorable responses to huddle improving communication, transparency, time to resolution of issues, ability to voice concerns, and patient safety. As a result of huddle implementation, metrics showed 46% reduction in IT ticket turnaround time (P = .0001), 28% reduction in non–intensive care unit bladder catheter days (P = .011), and 10% decrease in continuous observations (P = .008), allowing a 24% reduction in cost (P = .001) with quarterly savings of $139 107.00. Conclusion: These metrics demonstrate how huddles are instrumental in infusing and sustaining a culture of patient safety in hospitals.

Safety huddles improve patient safety and quality of care

“…On the wall in the meeting area there was a template highlighting all the areas required to give a report; the huddle leaders used it as a reminder of the reporting order. When called on, each unit representative provided a report in 60 seconds or less; topics included staffing, patient volume, clinical quality indicators, environmental issues, major events occurring in the past day, and safety or service concerns 3 . Clinical issues were directed to the department chairperson to address and nonclinical issues were directed to senior administrators.…”

“…Issues that required immediate follow‐up were announced by the huddle leader. The leader also assigned an owner for each of the issues in real time, with a resolution typically expected at the next huddle 3 …”

“…Clinical metrics assessed, such as indwelling catheter days, also improved after huddle implementation. The authors concluded that the huddle was effective and cost‐efficient, required no additional resources to initiate, improved situational awareness, and helped ensure a shared focus and priorities for each day 3 …”

“…Although the focus is typically on patient and personnel safety, huddles also can address other aspects of operations and care (Sidebar 1). 3 “You can use a huddle approach to address any problem that has occurred or any type of high‐risk situation in an organization,” Vis said. “Huddles provide almost real‐time data, which allows leaders and staff members to mobilize and resolve any issue quickly.” Regardless of their format or scope, huddles provide multiple perspectives and levels of experience and knowledge in one place 3 …”

“…The formats, scopes, agendas, and attendees of safety huddles tend to vary among facilities, but there often are common characteristics, including that they are short (usually less than 15 minutes) and routine (e.g., held at the same time each day) 2,3 . Although the focus is typically on patient and personnel safety, huddles also can address other aspects of operations and care (Sidebar 1).…”