Monday, 15 February 2016

Safety daily huddle meetings

I had the opportunity to visit the Scottish NHS hospital group Ayrshire & Arran in the context of a professional event. The meeting, as expected, was very helpful, and one of the things that I took home was a working tool that for me, was as novel as it was simple: "Hospital Daily Safety Huddle," which roughly means the daily meeting of "circle time" for the patient’s safety. The management of the Crosshouse Hospital, the largest in the group, satisfied with the functioning of the experience, invited us to attend their huddle, that since June 30, 2014, they hold every day at 8:15.

What is a huddle?

According to Wikipedia, the huddle concept comes from the world of team sport. It’s joining in a circle, in the same area, standing, concentrated and often intertwined with the aim of remembering together the strategy and tactics that they have learned but also with the purpose of becoming more motivated for the game. Therefore, you see that "circle time" meeting is an approach of the concept of huddle.

What is a "Hospital Daily Safety Huddle"?

It’s a meeting of at most 15 minutes, which in some places is performed with people standing in a circle, although as seen in the photo, was not the case in Crosshouse. The meeting that I attended was directed by the Nurse Director and Medical Assistant and summoned the management of the emergency department, the chief guard, nurses responsible for all hospital wards, officials of the admissions service, the hospital discharge planner, central diagnostic services, general services, security services, etc. In our huddle, 45 professionals of a 600-bed hospital attended. 

What is the agenda of the "Hospital Daily Safety Huddle"?

The Director was asking each manager to explain in a systematic way (they have a specific tab), the availability of beds in their units, the high forecast, and the patients without an assigned bed, ectopic patients and the incidence of both circuits and of clinical safety, such as staff failures.

What is expected of the "Hospital Daily Safety Huddle"?

The huddle instrument applied to hospital management is expected to produce the following results:
  1. Reduction of the number of patients with adverse occurrences.
  2. Increasing hospital admissions before noon.
  3. Reduction of emergency stay time for patients to be admitted.
  4. Reduction in the number of patients awaiting beds.
  5. Reduction of the number of ectopic patients.
  6. Improving the patient experience.
  7. Improving the experience of professionals as a result of improved coordination.

You may ask, as I did during the meeting, if it’s necessary to meet every day to discuss patients, beds and circuits. But at the end of watching the dynamics of that huddle in Crosshouse, I realized what its added value was. I observed that at being conducted in public, in a quick meeting, which in most hospitals is done with computer support and phone calls, a climate of collaboration was created which ensured that all participants returned to their units with a good knowledge of the overall situation of the hospital. There, in the huddle, the weaknesses in the day and risk situations for patients were detected; they had also discussed specific solutions. In short, an atmosphere of collective responsibility was created. Everyone felt they were working for each hospital patient, beyond the boundaries of their unit.

As Crosshouse’s slogans say: "If we keep doing what we have always done, we’ll always get what we always got." A morning huddle, they think, and now I almost subscribe, is a new way to start the day full of energy, to put the focus on the relevant issues, to reinforce team spirit and to ensure that messages during the day issued by those responsible for the organization are consistent with each other.  And with all this, they are confident that the results of "forever" will improve. 

Jordi Varela



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