Standardizing nightly huddles with surgical residents and nurses to improve interdisciplinary communication and teamwork

Zhu, J.; Stadeli, Kathryn M.; Pandit, Kavita; Zech, Jennifer M.; Ludwig, Andrew; Harris, Kathryn L.; Naughton, Hannah R.; Yi, Jonathan; Davidson, Giana H.; Kritek, Patricia

doi:10.1016/j.amjsurg.2020.03.002

Cited by 6 publications

(7 citation statements)

References 12 publications

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“…The institute for health care improvement recommends using huddles as part of a quality management system. 2 Observational studies showed that daily huddle implementation could improve medical safety work, 3 problem identification and improvement, 4 situation awareness and teamwork enhancement, 5 the collaboration and communication between professionals and departments, 6,7 and patient safety and organizational quality improvement. 8 Two controlled prospective studies showed that high fidelity huddles, which were identified as high frequency huddle runs (≥75% working days) and monthly reporting ≥ median issues, reduce the excess length of patient's stay, 9 and reduce alarm rates of individual patients.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting

Lin¹,

Chang²,

Wu³

et al. 2022

JMDH

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Objective Huddles are short, regular debriefings that are designed to provide frontline staff and bedside caregivers environments to share problems and identify solutions. Daily huddle implementation could improve medical safety work, problem identification and improvement, situation awareness and teamwork enhancement, the collaboration and communication between professionals and departments, and patient safety. This study aimed evaluated the effectiveness of a hospital-based huddle at a general medical ward in Taiwan. Methods A Continuous Integration team was conducted by combining multidisciplinary frontline staff to huddle at a 74-bed general medical ward. Team Huddles started twice a week. A physical huddle run board was created, which contained four parts, including idea submitted, idea approved, working on an idea and standardizing. Problems were submitted to the board to be identified, and the solutions were evaluated through huddle discussion. We divided the problems into two groups: quick hits (resolved within 24–48hrs) and complex issues (resolved >48hrs). An anonymous questionnaire was designed to evaluate the huddle response. Results A total of 44 huddles occurred from September 9th, 2020, to September 30th, 2021, and 81 issues were identified and resolved. The majority issues were policy documentation (n=23; 28.4%). Sixty-seven (82.7%) issues were defined as quick hits, and the other fourteen (17.3%) issues were complex. The mean hours to the resolution of quick hits was 5.17 hours, median 3.5 hours, and range from 0.01–15.4 hours. The mean days to resolve completion issues were 19.73 days, median 7.5 days, and range 3.57–26.14 days. An overwhelming 92.9% of staff responded that huddles help to expedite the process to reach treatment goals, reduce clinical mistakes, near misses, reduce patient incidences, and help teamwork enhancement, with rating of 4.52 (on a 5-point Likert scale). Conclusion Implementing of multidisciplinary team huddle improved the accountability of issue identification, problem-solving and teamwork enhancement.

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Section: Introductionmentioning

confidence: 99%

The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting

Lin¹,

Chang²,

Wu³

et al. 2022

JMDH

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“…Several strategies for improving interprofessional communication between residents and nurses have been explored by others, including structured “huddles,” 44 simulation exercises, 45 and collaborative “time-outs” prior to patient discharge, 46 with variable efficacy. Further work is needed to understand, develop, and implement strategies for mitigating the negative impact of gender bias in interprofessional interactions; study participants suggested several possible interventions, which may warrant additional exploration through future research.…”

Section: Discussionmentioning

confidence: 99%

The Role of Gender in Nurse-Resident Interactions: A Mixed-methods Study

Manchanda

Chary

Zanial

et al. 2021

WestJEM

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Introduction: The role of gender in interprofessional interactions is poorly understood. This mixed-methods study explored perceptions of gender bias in interactions between emergency medicine (EM) residents and nurses. Methods: We analyzed qualitative interviews and focus groups with residents and nurses from two hospitals for dominant themes. An electronic survey, developed through an inductive-deductive approach informed by qualitative data, was administered to EM residents and nurses. Quantitative analyses included descriptive statistics and between-group comparisons. Results: Six nurses and 14 residents participated in interviews and focus groups. Key qualitative themes included gender differences in interprofessional communication, specific examples of, and responses to, gender bias. Female nurses perceived female residents as more approachable and collaborative than male residents, while female residents perceived nurses’ questions as doubting their clinical judgment. A total of 134 individuals (32%) completed the survey. Females more frequently perceived interprofessional gender bias (mean 30.9; 95% confidence interval {CI}, 25.6, 36.2; vs 17.6 [95% CI, 10.3, 24.9). Residents reported witnessing interprofessional gender bias more frequently than nurses (58.7 (95% CI, 48.6, 68.7 vs 23.9 (95% CI, 19.4, 28.4). Residents reported that gender bias affected job satisfaction (P = 0.002), patient care (P = 0.001), wellness (P = 0.003), burnout (P = 0.002), and self-doubt (P = 0.017) more frequently than nurses. Conclusion: Perceived interprofessional gender bias negatively impacts personal wellbeing and workplace satisfaction, particularly among female residents. Key institutional stakeholders including residency, nursing, and hospital leadership should invest the resources necessary to develop and integrate evidence-based strategies to improve interprofessional relationships that will ultimately enhance residency training, work climate, and patient care.

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“…44 Perceptions of 'interdisciplinary teamwork' were improved by nightly huddles. 57 'Interprofessional team experience' was described as beneficial by staff engaged in an obstetric patient safety programme. 47 Three studies 37 62 76 reported improved effects on teamwork.…”

Section: Objective 2: What Effects Do Interventions To Improve Safety...mentioning

confidence: 99%

Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature

Finn,

Walsh,

Rafter

et al. 2024

BMJ Open Qual

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BackgroundIn an era of safety systems, hospital interventions to build a culture of safety deliver organisational learning methodologies for staff. Their benefits to hospital staff are unknown. We examined the literature for evidence of staff outcomes. Research questions were: (1) how is safety culture defined in studies with interventions that aim to enhance it?; (2) what effects do interventions to improve safety culture have on hospital staff?; (3) what intervention features explain these effects? and (4) what staff outcomes and experiences are identified?Methods and analysisWe conducted a mixed-methods systematic review of published literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in MEDLINE, EMBASE, CINAHL, Health Business Elite and Scopus. We adopted a convergent approach to synthesis and integration. Identified intervention and staff outcomes were categorised thematically and combined with available data on measures and effects.ResultsWe identified 42 articles for inclusion. Safety culture outcomes were most prominent under the themes of leadership and teamwork. Specific benefits for staff included increased stress recognition and job satisfaction, reduced emotional exhaustion, burnout and turnover, and improvements to working conditions. Effects were documented for interventions with longer time scales, strong institutional support and comprehensive theory-informed designs situated within specific units.DiscussionThis review contributes to international evidence on how interventions to improve safety culture may benefit hospital staff and how they can be designed and implemented. A focus on staff outcomes includes staff perceptions and behavioursas part ofa safety culture and staff experiencesresulting froma safety culture. The results generated by a small number of articles varied in quality and effect, and the review focused only on hospital staff. There is merit in using the concept of safety culture as a lens to understand staff experience in a complex healthcare system.

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Standardizing nightly huddles with surgical residents and nurses to improve interdisciplinary communication and teamwork

Cited by 6 publications

References 12 publications

The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting

The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting

The Role of Gender in Nurse-Resident Interactions: A Mixed-methods Study

Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature

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