University of Michigan hospitals are using a classic team tactic—huddles—to make things safer and more efficient for patients and staff.
These huddles are safety huddles—daily morning meetings that prep staff on necessary information, including patient admissions and discharges, problems with equipment, medication changes, support services, supplies and more. They run Monday through Friday, from 8:45 a.m. to 9 a.m.—a brisk 15 minutes—right after bed briefing.
Although the safety huddles have never been mandatory, “everybody wants to come,” says Scott Marquette, intermediate project manager at U-M C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital. A typical meeting includes charge nurses, ambulatory care bed managers, laundry managers, support staff, biomed, Office of Clinical Safety and MCIT (Medical Center Information Technology)—in short, everyone with information to give to others and/or a need to know. Marquette sends information gleaned from the huddle to 190 managers and staff across Children’s and Women’s via email. Staff who want to be added to the email list should email Marquette.
“Like all hospitals, we have safety concerns,” says Chris Dickinson, M.D., professor of pediatrics and the architect, with Marquette, of the safety huddles. “To get people thinking about safety, you really have to change your culture. The safety huddles get people thinking about safety all the time. We talk about all sorts of error prevention strategies.”
The huddles started in January 2013 and work so well that more people are asking to attend. About 40 to 70 people attend each meeting, and about 96 percent of all patient care and support department areas are represented.
“What makes it work is that we have ownership from frontline staff and engagement from leadership,” Marquette says. “We know we’re more aware of safety because our patient safety reports have increased by 21 percent. To some, this may seem like we’re going in the wrong direction, but to us it means we’re keeping an eye on things and we are encouraging reporting. In addition, we’re seeing more near-misses than actual events.”
Patient safety reports are the reports of medical errors or near misses. In medical terms, a near miss is an unplanned event that did not result in injury, illness or damage but had the potential to do so.
Marquette says that, in addition to safety, the huddles help coordinate the whole flow of patients within the hospital by gathering information from the bed briefing that occurs just before the safety huddle. “Every day, we get a sense of how many discharges we have, whether our ICU is jam packed and how we need to maneuver our patients to get the best possible coverage for them.”
A few months ago, University Hospital and the Cardiovascular Center asked Dickinson and Marquette to help them get their safety huddles off the ground. The UH and CVC safety huddles began this week.
The Mott and Children’s hospital safety huddles will expand to the weekends in the near future. “As we all know, safety is not just a focus Monday through Friday,” says Marquette.