Category: clinical

Purpose: The purpose of this project is to show improvement in clinical functions, i.e., staffing, provider availability, and safety over a four-year historical overview. The evidence shows that clinical function improved over this period (from 2017 to 2021) reducing patient safety reports by 30% as well as improving staffing ratios and provider availability with a 35% progression. The need for introduction of team huddle was indicated by the inclusion of TeamSTEPPS within military treatment facilities (MTF).

Introduction: The PICOT question is do daily team huddles increase communication and collaboration between clinical team members, as well as preventing safety events? Daily team huddles including providers, nurses, case management, technicians, as well as other invited clinical and non-clinical resources have shown to improve clinical experiences qualitatively and quantitatively to improve patient care and staff resiliency.

Implementation: Using the TeamSTEPPS toolkit, molding the huddle format to a smaller-sized MTF, with a six-week trial of modification, this process had almost immediate effect. Facility staff were committed to this implementation and developing positive change. They were further supported by MTF commanders and executive staff. Improvements as well as dilemmas were presented and discussed at staff meetings as well as the executive staff presentations. Twice daily huddles implemented for first four weeks, then decreased to once daily as huddle process had fewer procedural corrections.

Evaluation: Utilizing a look-back review, data was compiled using completed yearly patient safety reports (PSR) obtained for the years 2017 to 2021. These were further separated into clinical and non-clinical areas. The clinical PSRs were assessed for the following clinical topics: similar patient names, procedural timeouts, wrong site, medication error, patient documentation error, and specimen error inaccuracy. PSR showed a definite decrease by 30% while staffing ratios and availability improved by 35%.

Conclusions/recommendations: It is recommended that engaging in morning clinical huddles be incorporated into all clinical and non-clinical areas for a continued improvement in communication and patient safety. Further recommendations include an afternoon team huddle at the end of the week to review lessons learned and team successes.

Deborah Taschner MSN, RN, CMGT-BC

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