References
Sustaining the commitment to patient safety huddles: insights from eight acute hospital ward teams
Abstract
Background:
A recent initiative in hospital settings is the patient safety huddle (PSH): a brief multidisciplinary meeting held to highlight patient safety issues and actions to mitigate identified risks.
Aim:
The authors studied eight ward teams that had sustained PSHs for over 2 years in order to identify key contributory factors.
Methods:
Unannounced observations of the PSH on eight acute wards in one UK hospital were undertaken. Interviews and focus groups were also conducted. These were recorded and transcribed for framework analysis.
Findings:
A range of factors contributes to the sustainability of the PSH including a high degree of belief and consensus in purpose, adaptability, determination, multidisciplinary team involvement, a non-judgemental space, committed leadership and consistent reward and celebration.
Conclusion:
The huddles studied have developed and been shaped over time through a process of trial and error, and persistence. Overall this study offers insights into the factors that contribute to this sustainability.
Patient safety remains a key priority for health care globally. In the UK, efforts to reduce adverse events through patient safety and quality improvement initiatives have increased (Vincent and Amalberti, 2015). Serious incidents (Berwick, 2013; Francis, 2013), higher expectations and unsafe staffing levels have led to quality improvements in NHS hospitals. A recent study found that one-quarter of NHS wards routinely operate at unsafe staffing levels that threaten patient safety (Ball et al, 2019) making such initiatives imperative.
A recent initiative, predominantly in the USA, but increasingly in the UK, is the patient safety huddle (PSH): a brief multidisciplinary meeting involving discussion of patient safety and action to mitigate identified risks. PSHs are intended to enhance situational awareness of safety concerns on the hospital ward in real time, and thereby reduce adverse events. They draw on the practice of high-reliability organisations (HROs) such as the nuclear and aviation industries (Weick et al, 1999). PSHs are reported as versatile, relatively low-cost interventions that have a positive impact on patient safety (Larsen et al, 2011Sikka et al, 2014). A major impetus for initiating the huddle is often to reduce patient harms—falls and pressure ulcers for example—although the evidence varies. More consistently, PSHs are reported as promoting improved communication, awareness and teamwork and have been shown to improve safety culture (Goldenhar et al, 2013; Glymph et al, 2015).
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