Healthcare Huddle Boards – Collaboration for Care Team & Hospital Quality & Safety

More and more hospitals and hospital systems are instituting “daily huddles” or “huddle boards” to quickly align and re-align care teams around the most important healthcare tasks and actions. Collaboration can make the difference between high quality care and serious challenges to healthcare delivery.

A recent Harvard Business Review article highlights the typical approach:

In the spring of 2013, Advocate Health Care, one of the largest U.S. health systems, banished all meetings between 7:00 AM and 9:00 AM and instead instituted mandatory hospital-wide leadership “huddles” to discuss safety issues. Most of these huddles take just 15 minutes and allow hospital leaders to develop situational awareness — a collective understanding of the state of operations — and report and anticipate safety events such as falls, medication errors, and delays in care. With the introduction of huddles, reports of safety events across Advocate’s 12 acute-care hospitals increased by 40% (indicating improved detection) as staff members responded to leaders’ commitment to safety and transparency, while safety events  have continued to dramatically decrease. Problems that were previously unknown or unresolved are now addressed in a day or two under the direction of the hospital president. Today, huddles occur seven days a week, 365 days a year.

The concept of a “huddle” is simple: get people together, discuss what’s going on, and assign owners and actions to make things better.  It’s not rocket science, but it requires process discipline.

Most care teams in the hospital setting use physical boards to highlight and track progress with their healthcare delivery. These boards can be white boards, chalk boards, or even flip charts, but the intent is the same: keep everything visible at all times.

Whatever you discuss, track, capture, or celebrate in the hospital or within a care team, can usually be tracked and managed with a huddle board.

Huddle boards help care teams define different activities or project tasks, usually across different phases a process. For example, a huddle board might contain several columns categorized into process steps like things to do, things being done, and things completed.

The most powerful healthcare huddle boards focus care teams around the hospital’s metrics that matter most, such as:

• Safety
• Quality
• Delivery
• Costs
• Budgets
• Inventory
• Team Recognition
• Etc.

Many huddle boards are structured around processes or steps in a process.

Huddle boards don’t have to be organized around work processes however. They can also serve as living dashboards for teams and organization that simply display metrics. Many boards contain daily or monthly goals, along with progress reports like graphs or pie charts.

The previously mentioned HBR article outlined an optimal process for engaging the organization in the huddle process:

Implementing huddles requires planning, practice, and culture change. At Advocate, each operating unit’s executive leaders engaged in a one-hour training session which included a video that describes the huddle process and shows a huddle in action. These executives then brought the training to their site leaders. The daily huddle was initially held only on weekdays, but after a few months, as all operating units came to appreciate the benefits, we expanded huddles to seven days a week.

In addition:

Two implementation challenges particularly stand out: encouraging non-clinical areas like supply chain or environmental services to report in huddles, and anticipating future safety and quality issues. To get non-clinical functions on board, leaders need to convince them that their support areas and the issues huddles address are connected in material ways. For example, room cleaning by environmental services has a dramatic impact on hospital-acquired infections. To help huddles anticipate future issues, we ask leaders to identify at least one patient who they think could deteriorate in the next 24 hours, or whose status is tenuous. This can lead to discussions that identify potential future issues, and it helps make this sort of forward-looking thinking more routine.

In most hospitals, it’s difficult to get everyone in the same place at the same time – which makes “huddling” itself a big challenge. In today’s digital age, various online tools can help create “virtual huddles” anytime and from any place.

With processes, goals, and metrics available anytime online or via mobile phone, care teams can achieve the benefits of physical huddle boards without having to be face to face sitting in front of the huddle board itself.

All of this is exactly what we’re creating at upBOARD – delivering online huddle boards to hospitals, hospital systems, and care teams to help dramatically improve quality of care and patient safety.  That’s the future of health care.

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