Patient Safety Huddles, Part Two—Questions and Answers

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July 2013 Clinical Laboratory News: Volume 39, Number 7


 

Patient Safety Huddles, Part Two—Questions and Answers

In the April 2013 issue of Patient Safety Focus (1), I described the positive effects of a daily, highly-structured, 15-minute huddle of the lab leadership, including medical and administrative directors, managers, and supervisors of all lab sections. Each section supervisor, or their designee, gives a 1-minute report on patient safety issues that occurred over the last 24–48 hours and potential issues that may arise in the next 24–48 hours. To facilitate the brief meeting, the huddle uses a magnetic whiteboard as an aid to visualize the status of the individual sections with green, yellow, or red circles. Sections with a red status must announce their short term countermeasures or seek help to rapidly develop them.

I received a number of questions from readers about setting up and running laboratory huddles, so I wanted to share the answers with everyone here. I strongly encourage laboratory leaders to take a look at this model for improving patient safety.

Mike Astion, MD, PhD
Division Chief of Laboratory Medicine
Seattle Children’s Hospital
Editor, Patient Safety Focus

 

What time of day do you hold your huddle and do you recommend a particular time?
I recommend holding the laboratory huddle at the beginning of the workday. Our main huddle is a report of the key issues from the section huddles, so we do allow time for the sections to hold their own huddles. For us, this means the main huddle is from 9:45–10 a.m. Very large laboratories with sections that have significant staffing and test volumes on all shifts might benefit from section huddles at the beginning of every shift.

One other important point that I would like to add is that we always start on time. Starting on time, every time, has strongly encouraged everybody to be there on time, especially since latecomers must walk through the group to put their section’s status on the huddle board.

Is this a “just do it” or do we need to do a significant amount of planning before starting a daily huddle?
I recommend just doing it! It is relatively easy for supervisors to huddle for less than 10 minutes with the staff in their individual sections and to take a look at patient safety issues over the past and next 48-hour time frame. Patient safety issues that should be included are erroneous results, instruments that are down or at risk to fail, reagent recalls, computer downtime, and significant staff shortages relative to the workload. Supervisors can create any categories that they want to track. For example, lab information services, sendouts, and client services can come up with something equivalent to those mentioned. One thing to note is that supervisors should arrange for a substitute if they are unable to attend the huddles.

How hard is it to start the main laboratory huddle?
The main huddle is pretty easy to start. Supervisors simply report their staffing and any actual or potential patient issues from their section that they think other lab leaders should know about. I recommend having a feedback session one day a week right after the main huddle to discuss how to improve it. Eventually, these small improvements provided by staff will accumulate and the huddles will be fine tuned.

How important is it to have the right leader of the main huddle?
It is very important to have a leader who keeps the huddle on time, asks clarifying questions, and provides constructive feedback after the huddle. Our quality manager and her chosen designees have been able to do this quite well.

REFERENCE

1. Astion M. A new model for patient safety: Laboratory huddles—what a great idea. CLN 2013;39(4):13–4.

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Patient Safety Focus Editorial Board

Chair
Michael Astion, MD, PhD
Seattle Children's Hospital
Seattle, Wash.

Members
Nikola Baumann, PhD
Mayo Clinic
Rochester, Minn.

Corinne Fantz, PhD
Emory University
Atlanta, Ga.

James S. Hernandez, MD, MS
Mayo Clinic Arizona
Scottsdale and Phoenix

Brian R. Jackson, MD, MS
ARUP Laboratories
Salt Lake City, Utah