AHRQ Safety Program for Ambulatory Surgery Management Practices

AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability AHRQ Pub. No. 16(17)-0019 -4 -EF May 2017 Module 2: Daily Huddles | 1

A Frontline Management System To Promote Safety Standard Work AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles | 2

What Is a Daily Huddle and Why Is It Important? WHAT? WHY? • Short, standup meeting, typically once • Gives you and your team way to per day maintain focus on safety, day by day • Orients team to regular safety • Opportunity to look back at standard work, concerns, and yesterday’s work to review safety improvement projects performance • Opportunity to look ahead to patients scheduled for today, flagging safety concerns 3 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles | 3

Who Is the Huddle For? Consider these business units in your ASC: • Operating room team • Preoperative team • Postoperative team • Front office and scheduling team • Sterilization team Consider these staff roles: • • 4 Staff nurses Charge nurses Nurse managers Administrators AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability • • Anesthesia staff Technicians Schedulers Physicians Module 2: Daily Huddles | 4

A Simple Huddle Agenda AGENDA 1. Safety concerns observed in past day A. Patients B. Staff C. Physicians 2. Issues for today 3. Review of tracked issues 4. Input from staff 5. Announcements 5 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Tips: ü Brief (5 -10 min) ü Standard ü Stay on topic Module 2: Daily Huddles | 5

Apply the Model for Improvement To Introduce Daily Huddles Aims: Introduce daily huddle into practice to promote safety standard work Measures: Are huddles supported by staff? Do you see movement in key measures like the patient safety culture survey? Changes: Introduce short standup meeting for key units (e. g. , operating room, preoperative/postoperative) 6 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Plan: Lay out the specifications of your test Do: Conduct the test Study: Review how the test went and what lessons were learned Act: Integrate learning into your next test or into daily practice Module 2: Daily Huddles | 6

Details To Consider for Your First Test 7 Select the appropriate testing unit Determine who should attend the huddle from your staff Determine who should lead the huddle Determine when and where the test will take place Review the template agenda Identify a “recorder” who will write down problems Plan to give notification to all relevant parties one day before test Schedule a 10 minute “debrief” AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles | 7

Practical Tips To Remember for Your First Test Time the test Debrief with your staff Follow up on issues Debrief after the huddle 8 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles | 8

Additional Tests To Hardwire Huddles Into Daily Practice Four weeks Five consecutive days Additional tests to consider: • Alternative staff lead huddle • Introduce to more than one department 9 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles | 9

Testing and Implementation: Common Problems and Tips Problem #1: Huddles don’t Problem #2: Staff turnover Problem #3: Staff seem take place when facilitator has made sustaining the not to see the benefit of is absent or busy huddle difficult the huddle Solution #1: Cross-train multiple staff 10 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Solution #2: Ensure that understanding of purpose and structure of huddle is part of staff onboarding materials Solution #3: Be sure to follow through on problems identified during huddle; over time, solved problems will win staff over Module 2: Daily Huddles | 10

Testimonials About the Benefits of Daily Huddles in the ASC Environment “Prior to the implementation of daily huddles our employees rated the facility Safety Culture Survey as 82. 5% (2014). Two months after initiating the huddle format throughout our facility, we surveyed our employees again and experienced a 10. 83 percentage-point increase (93. 33%). Daily huddles have given employees a role and a voice! Thank you, IHI, for sharing your expertise in improving our facility safety culture!” – ASC Quality Manager 11 AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 2: Daily Huddles | 11