Rates of ICU Transfers After a Scheduled Night-Shift Interprofessional Huddle

Newman, Ross; Bingler, Michael; Bauer, Paul; Lee, Brian; Mann, Keith

doi:10.1542/hpeds.2015-0173

Cited by 15 publications

(36 citation statements)

References 21 publications

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“…In particular, nurse and resident communication strategies improve teamwork, and hospitals that promote a culture of empowerment to all members of the interdisciplinary team are models that reduce failures and ultimately patient harm. 7 We did not include actual measurements of provider situation awareness in the study of our intervention, but we used its components of perception, comprehension, and projection by having the members of the watcher huddles work together to reconcile watcher patients and devise a plan, expected outcome, and time frame for the expected outcome. The key to situation awareness is understanding the information at hand and recognizing patterns so that plans can be made for safety events before they unfold.…”

Section: Discussionmentioning

confidence: 99%

“…5 Vigilance and monitoring require that these elements are clearly identified, defined, and supported in practice. 7 Decreasing patient harm is related to enhanced situation awareness among health care providers, but objectively proving this relationship is challenging because most validated measurement tools are exercised in simulations. 8 Conversely, decreased situation awareness is a predictor of adverse events and poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Watcher Initiative Associated With Decrease in Failure to Rescue Events in Pediatric Population

Smith

Chumpia

Wargo

et al. 2017

Hospital Pediatrics

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BACKGROUND AND OBJECTIVES: Improved situation awareness may prevent unplanned ICU transfers. Transfers with serious safety issues may be classified as unrecognized situation awareness failure events (UNSAFE) and are associated with intubation, vasopressors, or .3 fluid boluses within 1 hour before or after ICU arrival. Our aim was to decrease the proportion of unplanned ICU transfers that met UNSAFE criteria by 50% in 1 year. METHODS: We adapted a previously described huddle-based intervention. In May 2015, we started a daily safety brief with hospital-wide representation; concurrently, nurses and residents separately identified watcher patients (ie, patients at risk for UNSAFE transfers) to be reported in the daily safety brief. Watcher patients frequently differed between the groups, so in July 2015, we started twice-daily watcher huddles on a pilot floor. During these huddles, nurses and residents jointly identified watcher patients on the basis of defined criteria and deployed mitigation plans. By March 2016, we implemented these huddles hospital-wide. We reviewed the electronic medical record to categorize all unplanned ICU transfers as safe or UNSAFE. Our outcome was the proportion of unplanned ICU transfers that met UNSAFE criteria. RESULTS: In the 16-month pre-intervention period, 49 of the 322 unplanned ICU transfers were UNSAFE (median 15.5%); in the 12-month post-intervention period, 13 of the 329 unplanned ICU transfers were UNSAFE (median 3%). These findings represent an 81% reduction in the proportion of UNSAFE transfers. CONCLUSIONS: Watcher huddles incorporated into the daily inpatient routine can significantly decrease UNSAFE transfers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Watcher Initiative Associated With Decrease in Failure to Rescue Events in Pediatric Population

Smith

Chumpia

Wargo

et al. 2017

Hospital Pediatrics

View full text Add to dashboard Cite

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“…The bedside rounding also empowers the patients and their families to ask questions and be involved in their care plan (Gausvik et al., ). Numerous studies have focused on examining the effects of IP team interventions on team functioning and patient outcomes (Bahr et al., ; Bunnell et al., ; James, Page, & Sprague, ; Jones & Jones, ; Newman, Bingler, Bauer, Lee, & Mann, ). However, despite increasing interest in IP collaborative practice (IPCP) to improve teamwork, nursing outcomes and quality of patient care, there has been little research that focused on exploring clinical nurses’ practical experiences, perceptions and subsequent changes after IP team interventions.…”

Section: Introductionmentioning

confidence: 99%

Clinical nurses’ experiences and perceptions after the implementation of an interprofessional team intervention: A qualitative study

Baik

Zierler

2018

Journal of Clinical Nursing

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“…This type of huddling involves brief, standup meetings that facilitate e cient, collaborative information exchange about speci c topics, concerns, or resident needs. Frontline staff huddling promotes communication across clinical roles (42)(43)(44) and improvements in clinical outcomes across residents (45)(46)(47). More broadly, consistent huddling can help improve quality of care and sustain changes individually and systematically by directly involving frontline health care workers (41).…”

Section: Huddling and The Lock Programmentioning

confidence: 99%

Enhancing Sleep Quality for Nursing Home Residents with Dementia: A Pragmatic Randomized Controlled Trial of an Evidence-Based Frontline Huddling Program

Snow

Loup

Morgan

et al. 2020

Preprint

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Background Disturbed sleep places older adults at higher risk for frailty, morbidity, and even mortality. Yet, nursing home routines frequently disturb residents’ sleep through use of noise, light, or efforts to reduce incontinence. Nursing home residents with Alzheimer’s disease and or related dementias—almost two-thirds of long-stay nursing home residents—are likely to be particularly affected by sleep disturbance. Addressing these issues, this study protocol implements an evidence-based intervention to improve sleep: a nursing home frontline staff huddling program known as LOCK. The LOCK program is derived from evidence supporting strengths-based learning, systematic observation, relationship-based teamwork, and efficiency. Methods This study protocol outlines a NIH Stage III, real-world hybrid efficacy-effectiveness pragmatic trial of the LOCK sleep intervention. Over two phases, in a total of 27 non-VA nursing homes from 3 corporations, the study will (1) refine the LOCK program to focus on sleep for residents with dementia, (2) test the impact of the LOCK sleep intervention for nursing home residents with dementia, and (3) evaluate the intervention’s sustainability. Phase 1 (1 year; n = 3 nursing homes; 1 per corporation) will refine the intervention and train-the-trainer protocol and pilot-tests all study methods. Phase 2 (4 years; n = 24 nursing homes; 8 per corporation) will use the refined intervention to conduct a wedge-design randomized, controlled, clinical trial. Phase 2 results will measure the LOCK sleep intervention’s impact on sleep (primary outcome) and on psychotropic medication use, pain and analgesic medication use, and activities of daily living decline (secondary outcomes). Findings will point to inter-facility variation in the program’s implementation and sustainability. Discussion This is the first study to our knowledge that applies a dementia sleep intervention to systematically address known barriers to nursing home quality improvement efforts. This innovative study has future potential to address clinical issues beyond sleep (safety, infection control) and expand to other settings (assisted living, inpatient mental health). The study’s strong team, careful consideration of design challenges, and resulting rigorous, pragmatic approach will ensure success of this promising intervention for nursing home residents with dementia. Trial registration: NCT04533815, ClinicalTrials.gov, August 20, 2020.

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Rates of ICU Transfers After a Scheduled Night-Shift Interprofessional Huddle

Abstract: Implementation of an interprofessional huddle may contribute to decreasing high-risk transfers to the ICU. Initiating a daily huddle was well received and allowed for open lines of communication across all provider groups.

Cited by 15 publications

References 21 publications

Watcher Initiative Associated With Decrease in Failure to Rescue Events in Pediatric Population

Watcher Initiative Associated With Decrease in Failure to Rescue Events in Pediatric Population

Clinical nurses’ experiences and perceptions after the implementation of an interprofessional team intervention: A qualitative study

Enhancing Sleep Quality for Nursing Home Residents with Dementia: A Pragmatic Randomized Controlled Trial of an Evidence-Based Frontline Huddling Program

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