Vol. 9 Issue 23
More Information, More Often
A med/surg unit uses huddles to keep staff in the know
Communication for a nurse manager of a unit that operates 24/7 creates unique challenges. During the past 3 years, the med/surg unit at Harris Methodist Northwest Hospital, Azle, TX, tried multiple ways to ensure information was being given to the employees, including monthly unit meetings at multiple times to catch both shifts, fliers in staff mailboxes or on bulletin boards, and e-mails.
None of these methods proved effective. Information often was being compiled over the course of a month for a unit meeting that would be poorly attended, with information that could be up to 30 days old. Feedback from staff indicated they were not kept up to date and, therefore, were not knowledgeable about changes, events and other issues happening on the unit, in the hospital and systemwide.
The idea for huddles came from a StuderGroup conference and was adapted to fit the needs of Harris Methodist Northwest.
The nursing unit holds huddles every Monday and Wednesday at shift change. Meetings are kept to 10-15 minutes to ensure staff is still able to get in and out of report in a timely manner.
Patient safety is always the first agenda item under which the team reviews falls, medication reconciliation, restraints and other applicable topics.
Huddles serve as an effective venue in discussing best practices in patient care for patients who have complex medical conditions. During a recent huddle, a case review was done on a patient who had become septic on the med/surg unit and had to be transferred to the ICU. The huddle focused on the severity of this patient's condition and early warning signs, and mapped out immediate steps required to care for the patient and preserve the patient's safety.
In another recent huddle discussion, staff shared concerns over an incident where they were attempting to get a suction setup quickly into a patient's room after the patient had aspirated while drinking water. Tackle boxes with suction equipment were located on the unit, but staff members were concerned about the amount of time it took to get the patient suctioned. While this patient had a positive outcome, the staff was concerned about future incidents. Based on this huddle, suction setups are now available in all rooms with appropriate equipment.
Other agenda items cover human resource updates, clinical indicators, system news, entity news, patient satisfaction and employee satisfaction. For example, Texas Health Resources, Harris Methodist's parent company, is currently conducting a benefits audit on dependent eligiblity. There was confusion among staff regarding time frames and required data that would need to be provided.
In the past, this type of information would have been discussed in a monthly unit meeting and often talked about retrospectively. Utilizing huddles, managers shared the information with the staff in a timely manner and were able to ensure everyone had a clear understanding of the process so there were no gaps in staff members' dependents receiving benefits.
Since the implementation of huddles, the nursing manager is able to have direct contact with at least 75 percent of his staff during the course of a month.
The unit's staff reports communication with their manager is much improved and they are aware of changes and events at the hospital. Senior leadership is impressed with the process and how quickly information can flow downward to the staff on this unit.
Kenneth Longbrake is nurse manager at Harris Methodist Northwest Hospital, Azle, TX.