Team huddles improve communication and keep patients flowing at Concordia Hospital
Scheduled talking helps create a plan
It started when the previous Emergency Program Director Maxine Bryan viewed a webinar on bed huddles. She was so inspired by this concept that she brought the information she learned to the Emergency Leadership Team at Concordia Hospital.
The result? The concept of "huddling" or bringing the team together on a frequent and recurring basis came to life. It was decided the patient flow huddle would be held during weekday shifts at 10:45 am and 1:45 pm. The intent and benefits of the huddles were communicated with staff. Posters were created to provide information about the huddles, and in person discussions between direct care staff and leadership happened.
Here's how the flow huddles work: an announcement is made that the flow huddle will start in five minutes. The huddles are multidisciplinary and all health care providers (including nursing staff, physicians, support staff, allied health) participate. Everyone gathers around the main desk in the emergency department (ED). The clinical resource nurse (CRN) or team leader leads the huddle as each area in the department has an opportunity to discuss the status of each patient's state of illness.
The ED is unique in that there are multiple designated areas to care for patients, and a nurse is assigned to each area. The huddles provide an opportunity for each nurse who is assigned throughout the department to come together at a central location.
This information isn't specific - or personal - given the location of the meeting. As each patient is discussed there is opportunity for ideas and suggestions to be shared regarding their care needs. The flow huddles help share the patient's plan and what the potential challenges are as the patient flows within the department itself.
For example, the triage RN might say, "There are 10 patients in the waiting room. Three of them are for minor treatment and seven are for the main department. One needs a cardiac monitor, another needs a private area." Following this, each nurse assigned to every other area within the department providing an overview of the patients that they are caring for at that time.
The CRN then summarizes the huddle and makes a plan for patient movement within the department. This ensures that each treatment space is used appropriately and that patients are receiving safe and efficient care. For example, sometimes a patient waiting for a lab result can wait in an alternate space, allowing bed space to be used to care for other patients.
It's been two years since huddles were introduced, and as with any change, there was some initial pushback from staff. However, the huddles are so valuable, that they may be called at any time, if there is a need to regroup and make a plan for the department. While the structure and timing of the huddles are a little different on evenings, there is a plan to rollout the huddles out to all shifts, every day of the week.
"The flow huddle is a good opportunity to share information. Beyond patient flow, if someone has a heavy assignment, there is a chance to pitch in and work together. Educators may join us if there is a new initiative being rolled out," say Mike Pitura, CRN at Concordia Hospital.
"At the end of the discussion, we make a plan for the flow of our department."
Following the ED huddle, another bed flow huddle is held with hospital managers and senior leadership to identify what beds are available on the Family Medicine or Surgical wards. A plan is created to ensure that patients are admitted from the ED in an efficient manner, and to identify any challenges that the hospital is experiencing in regards to patient flow.
These huddles have been in place for approximately eight months and all participants feel that they have promoted teamwork, increased awareness around ED patient's needs and improved flow from the ED to an inpatient bed on either the family medicine or surgical wards.