Patient Safety Huddles to Improve Teamwork and Communication: Frontline Staff Perspectives

Document Type : Original Article

Authors

1 Assistant Professor in Health Studies, Faculty of Health Studies, University of Bradford, Bradford, UK.

2 Research Fellow, Faculty of Health Studies, University of Bradford, Bradford, UK.

3 Evaluation Programme Lead, Salford Royal NHS Foundation Trust Manchester, England, United Kingdom.

4 Professor of Healthcare Quality & Effectiveness, Faculty of Health Studies, University of Bradford, Bradford, UK.

5 Professor of Digital Innovations in Healthcare, Faculty of Health Studies, University of Bradford, Bradford, UK.

6 Consultant Physician, St James’s University Hospital, Leeds Teaching Hospitals Trust, Leeds, UK.

7 Director of Nursing, The Improvement Academy, Bradford Institute for Health Research, Bradford, UK.

8 Improvement Academy Director, The Improvement Academy, Bradford Institute for Health Research, Bradford, UK.

Abstract

Introduction:
The Patient Safety Huddle (PSH) is a daily brief multidisciplinary meeting to discuss patient safety threats and actions to mitigate risk. This paper reports on frontline staff perspectives from five UK hospitals across three National Health Service (NHS) trusts (provider organizations) on the impact of PSHs on communication and teamwork. Perspectives were collected at two points– before and after PSHs had been embedded.
Material and Methods:
Frontline teams from 25 wards were invited to complete a paper-based Evaluation Survey. In the first survey, 21 wards participated, generating 137 responses, and in the second survey, five wards participated, eliciting 32 responses. Additional group interviews with five ward teams were conducted (n=19 participants).
Results:
PSHs improved teamwork and communication, both in terms of quality and quantity. The evaluation survey reported improved teamwork (108/137 answered positively) and communication (121/137). In facilitating a non-hierarchical, easily accessible, and fear-free space for discussing patients at risk of harm, the PSH was perceived as engendering a supportive environment for all staff and contributing to an enhanced safety culture.
Conclusion:
Patient Safety Huddles – at both pre and post-embedded stages - were perceived as improving communication and teamwork, resulting in a safe and collegiate environment that facilitates successful information sharing, improved multidisciplinary working, and the development of collective situational awareness. These factors may contribute to enhanced patient safety and quality of care.

Keywords

Main Subjects

References

  1. Franklin BJ, Gandhi TK, Bates DW, Huancahuari N, Morris CA, Pearson M, et al. Impact of multidisciplinary team huddles on patient safety: a systematic review and proposed taxonomy. BMJ quality & safety. 2020;29(10): 1-2.
  2. Reis CT, Paiva SG, Sousa P. The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions. Int J Qual Health Care. 2018; 30(9): 660-77.
  3. improvement n. NRLS National Patient Safety Incident Reports: Commentary. 2019.
  4. Vincent C, Amalberti R. Safety in healthcare is a moving target. BMJ Quality & Safety. 2015; 24(9):539-40.
  5. Goldenhar LM, Brady PW, Sutcliffe KM, Muething SE. Huddling for high reliability and situation awareness. BMJ quality & safety. 2013; 22(11):899-906.
  6. Weick KE, Sutcliffe KM, Obstfeld D. Organizing for high reliability: processes of collective mindfulness. 2008. p. 31-66.
  7. Sikka R KK, Sacks L. How Every Hospital Should Start the Day. 2014.
  8. Larsen D, Peters H, Keast J. Using real time patient feedback to introduce safety changes: Debra Larsen and colleagues describe how the use of a process based on the ‘plan, do, study, act’ model has raised staff morale and improved care.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Nursing management (Harrow, London, England). 2011;18(6):27-31.
  9. Burgener AM. Enhancing Communication to Improve Patient Safety and to Increase Patient Satisfaction. Health Care Manag (Frederick). 2017;36(3):238-43.
  10. Gluyas H. Effective communication and teamwork promotes patient safety. Nurs Stand. 2015;29(49):50-7.
  11. Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13 Suppl 1(Suppl 1):i85-90.
  12. Weller J, Boyd M, Cumin D. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgrad Med J. 2014; 90(1061):149-54.
  13. Dingley C, Daugherty K, Derieg MK, Persing R. Advances in Patient SafetyImproving Patient Safety Through Provider Communication Strategy Enhancements. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.
  14. Crosswaite K FM, Craig J, Marsh C, McDonach E, Mohammed MA. Final Report of the Evaluation of the Huddling Up for Safer Healthcare (HUSH) Scaling Up Project. 2018.
  15. Mullan PC, Macias CG, Hsu D, Alam S, Patel B. A novel briefing checklist at shift handoff in an emergency department improves situational awareness and safety event identification. Pediatr Emerg Care. 2015;31(4):231-8.
  16. Newman RE, Bingler MA, Bauer PN, Lee BR, Mann KJ. Rates of ICU Transfers After a Scheduled Night-Shift Interprofessional Huddle. Hosp Pediatr. 2016;6(4):234-42.
  17. Provost SM, Lanham HJ, Leykum LK, McDaniel RR, Pugh J. Health care huddles Managing complexity to achieve high reliability. Health Care Management Review. 2015;40(1):2-12.
  18. Pannick S, Archer S, Johnston MJ, Beveridge I, Long SJ, Athanasiou T, et al. Translating concerns into action: a detailed qualitative evaluation of an interdisciplinary intervention on medical wards. BMJ Open. 2017;7(4):e014401.
  19. Martin HA, Ciurzynski SM. Situation, Background, Assessment, and Recommendation–Guided Huddles Improve Communication and Teamwork in the Emergency Department. Journal of emergency nursing. 2015;41(6):484-8.
  20. yan S, Ward M, Vaughan D, Murray B, Zena M, O'Connor T, et al. Do safety briefings improve patient safety in the acute hospital setting? A systematic review. J Adv Nurs. 2019; 75(10): 2085-98.
  21. Venkataraman A, Conn R, L Cotton R, Abraham S, Banaghan M, Callaghan B. Perspectives of Multidisciplinary Staff toward the Improvement of Communication and Patient Safety by Safety Huddles. Journal of Patient Safety & Quality Improvement. 2018;6(1):644-9.
  22. Pimentel CB, Snow AL, Carnes SL, Shah NR, Loup JR, Vallejo-Luces TM, et al. Huddles and their effectiveness at the frontlines of clinical care: a scoping review. J Gen Intern Med. 2021;36(9):2772-83.
  23. Cooper RL, Meara ME. The organizational huddle process--optimum results through collaboration. Health Care Manag (Frederick). 2002;21(2):12-6.
  24. Stockmeier C CC. Daily Check-In for Safety : From Best Practice to Common Practice. 2010.
  25. Montague J, Crosswaite K, Lamming L, Cracknell A, Lovatt A, Mohammed MA. Sustaining the commitment to patient safety huddles: insights from eight acute hospital ward teams. British journal of nursing (Mark Allen Publishing). 2019;28(20):1316-24.

 

Journal of Patient Safety & Quality Improvement
Volume 11, Issue 4
October 2023
Pages 189-197

Files

Share

How to cite

Statistics