Enhancing teamwork communication and patient safety responsiveness in a paediatric intensive care unit using the daily safety huddle tool

Abstract

Background: Open communication between leadership and frontline staff at the unit level is vital in promoting safe hospital culture. Our hospital staff culture survey identified the failure to address safety issues as one of the areas where staff felt unable to express their concerns openly. Thus, this improvement project using the daily safety huddle tool has been developed to enhance teamwork communication and respond effectively to patient safety issues identified in a paediatric intensive care unit.

Methods: We used the TeamSTEPPS quality approach. TeamSTEPPS is an evidence-based set of teamwork tools developed by the US Agency of Healthcare Research and Quality to enhance teamwork and communication. We applied TeamSTEPPS using a tool called the Daily Safety Huddle, aiming at improving communication and interaction between healthcare workers and building trust by acting immediately when there is any patient safety issue or concern at the unit level.

Results: During the period from April to December 2017, the interaction between frontline staff and unit leadership increased through compliance with the daily safety huddle. Initially, compliance was at 73%, but it increased to 97%, with a total of 340 safety issues addressed. The majority of these safety issues pertained to infection control and medication errors (109; 32.05%), followed by communication (83; 24.41%), documentation (59; 17.35%), other issues (37; 10.88%), procedure (20; 5.88%), patient flow (16; 4.7%) and equipment and supplies (16; 4.7%).

Conclusions: Systematic use of daily safety huddle is a powerful tool to create an equitable environment where frontline staff can speak up freely about daily patient safety concerns. The huddle leads to a more open and active discussion with unit leadership and to the ability to perform the right action at the right time.

Keywords: communication; complexity; continuous quality improvement; critical care; paediatrics.

Figure 1

Number of huddles exceeding 15 min. Project started on April which is the week number 14 of the year.

Figure 2

Percentage of monthly huddle compliance. *The green line represents our target.

Figure 3

Percentage of issues by category (procedure, communication, equipment and supplies, safety issue, patient flow, documentation and other).

Figure 4

Status of issues raised during huddle (closed after the huddle, closed during the huddle, open). Project started on April which is the week number 14 of the year.