As caseloads soar and new challenges related to the coronavirus keep emerging, efficiently sharing key information is crucial. Use the tips below to learn (or review) five ways to make safety huddles more effective.
Many organizations will have some version of a daily huddle in place for at least some clinical teams. While the typical huddle will focus on operational issues — such as needs for smooth hand-overs at shift changes — the best huddles integrate a focus on quality performance, including safety. We suggest teams integrate daily measurement into their huddle practice, complemented by the use of a visual management board that also helps drive sustained performance and continuous improvement.
A huddle is a short, stand-up meeting — 10 minutes or less — that is typically used once at the start of each workday in a clinical setting. In inpatient units, the huddle takes place at the start of each major shift. In ambulatory surgery centers, huddles occur once per day in each unit (for example, with the operating room staff). In primary care, staff can huddle in the morning to discuss scheduled patients as a team.
The daily huddle gives teams a way to actively manage quality and safety, including a review of important standard work such as checklists. Oftentimes, standard work will be the output of previous quality improvement projects, and the huddles provide a venue to ensure process improvements stick. Huddles allow teams to look back to review performance and to look ahead to flag concerns proactively.
How can you improve your huddles? Here are a few key steps in effective huddles, along with tips for how to do them successfully:
- Start at the designated time. Choose a consistent time to meet (e.g., 15 minutes before first procedure of the day), and make sure everyone is standing up. Consistency helps people plan their work and attend promptly, and standing makes the huddle go more quickly.
- Post the agenda on the visual management board. Point to the agenda; don’t read it. This gives the team practice with visual information.
- Prompt each team member to share one concern or success from the previous day; everyone else listens. Have a method to go through the team (e.g., go clockwise) to avoid fumbling for order, and try passing a “talking object” to each person in turn to encourage others to listen. Note issues for follow-up on the visual management board, and escalate concerns for resolution as needed. To keep the huddle brief, it’s important to only identify problems for later resolution, not to try to solve them in the huddle.
- Preview patients for the day. Identify patients who could have quality and safety issues arise; listing the patients and procedures on the visual management board makes this step more efficient. The goal is not to review every patient, but to plan for unusual patients and keep the meeting short.
- Close the huddle with announcements or other messages. Be sure to thank the team and say, “the huddle is now over.” Courtesy promotes respect, and closing words give a clear signal for the team to move to the next task.
Jeff Rakover is an IHI senior research associate.
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