daily huddles

1. Module 2: Daily Huddles | 1
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Management Practices for
Sustainability
Module 2: Daily Huddles
AHRQ Safety Program for Ambulatory Surgery
AHRQ Pub. No. 16(17)-0019-4-EF
May 2017

2. Module 2: Daily Huddles | 2
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
A Frontline Management System To Promote
Safety Standard Work
Daily Safety Huddle
• Standard agenda
• Data review
• Problem tracking
Visual Management
• Outcomes over time
• Checklist compliance
• Problem log
Escalation
• Sentinel events
• Problems raised in
huddle
Safety Work by Staff
• Using surgical checklist
• Infection control
procedures
Observation of
Safety Work: unit
lead & senior leader
Problem Solving
• Compliance
• “Just Fix It”
• Investigate causes
• QI* project
Integration With Leaders
• Senior leader unit review
• Escalation from procedure
• Escalation from daily
huddle

3. Module 2: Daily Huddles | 3
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
What Is a Daily Huddle and Why Is It
Important?
3
WHAT? WHY?
• Short, standup meeting, typically once
per day
• Orients team to regular safety
standard work, concerns, and
improvement projects
• Gives you and your team way to
maintain focus on safety, day by day
• Opportunity to look back at
yesterday’s work to review safety
performance
• Opportunity to look ahead to patients
scheduled for today, flagging safety
concerns

4. Module 2: Daily Huddles | 4
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Who Is the Huddle For?
Consider these business units in your ASC:
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• Operating room team
• Preoperative team
• Postoperative team
• Front office and scheduling
team
• Sterilization team
Consider these staff roles:
• Staff nurses
• Charge nurses
• Nurse managers
• Administrators
• Anesthesia staff
• Technicians
• Schedulers
• Physicians

5. Module 2: Daily Huddles | 5
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
A Simple Huddle Agenda
5
1. Safety concerns observed in past
day
A. Patients
B. Staff
C. Physicians
2. Issues for today
3. Review of tracked issues
4. Input from staff
5. Announcements
AGENDA
Tips:
 Brief (5-10 min)
 Standard
 Stay on topic

6. Module 2: Daily Huddles | 6
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Apply the Model for Improvement To
Introduce Daily Huddles
6
Aims: Introduce daily huddle into
practice to promote safety
standard work
Measures: Are huddles supported
by staff? Do you see movement in
key measures like the patient
safety culture survey?
Changes: Introduce short standup
meeting for key units (e.g.,
operating room,
preoperative/postoperative)
Plan: Lay out the specifications of
your test
Do: Conduct the test
Study: Review how the test went
and what lessons were learned
Act: Integrate learning into your
next test or into daily practice

7. Module 2: Daily Huddles | 7
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Details To Consider for Your First Test
Select the
appropriate testing
unit
Determine who
should attend the
huddle from your
staff
Determine who
should lead the
huddle
Determine when and
where the test will
take place
Review the template
agenda
Identify a “recorder”
who will write down
problems
Plan to give
notification to all
relevant parties one
day before test
Schedule a 10-
minute “debrief”
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8. Module 2: Daily Huddles | 8
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Practical Tips To Remember for Your First Test
Time the test
Debrief with your staff
Follow up on issues
Debrief after the huddle
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9. Module 2: Daily Huddles | 9
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Additional Tests To Hardwire Huddles Into
Daily Practice
9
Five
consecutive
days
Four weeks
Additional tests to consider:
• Alternative staff lead huddle
• Introduce to more than one
department

10. Module 2: Daily Huddles | 10
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Testing and Implementation: Common
Problems and Tips
Problem #1: Huddles don’t
take place when facilitator
is absent or busy
Problem #2: Staff turnover
has made sustaining the
huddle difficult
Problem #3: Staff seem
not to see the benefit of
the huddle
Solution #1: Cross-train
multiple staff
Solution #2: Ensure that
understanding of purpose
and structure of huddle is
part of staff onboarding
materials
Solution #3: Be sure to
follow through on
problems identified during
huddle; over time, solved
problems will win staff
over
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11. Module 2: Daily Huddles | 11
AHRQ Safety Program for Ambulatory Surgery
Management Practices for Sustainability
Testimonials About the Benefits of Daily
Huddles in the ASC Environment
“Prior to the implementation of daily huddles our employees rated the
facility Safety Culture Survey as 82.5% (2014).
Two months after initiating the huddle format throughout our facility, we
surveyed our employees again and experienced a 10.83 percentage-point
increase (93.33%).
Daily huddles have given employees a role and a voice! Thank you, IHI, for
sharing your expertise in improving our facility safety culture!”
– ASC Quality Manager
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