Case study - Huddle

Midpark Hospital (NHS Dumfries and Galloway) Huddle is a daily briefing held each morning, seven days a week with key stakeholders, where MDT members rapidly exchange key information relating to patient flow, risk, clinical activity, staffing resources, staff governance and DATIX reporting over the 24hr period.

The hospital huddle was seen at an SPSP collaborative learning event, it highlighted the increased safety awareness, team working, improvement culture and improved wellbeing of all, the effective use of resources and reduction in adverse incidents.

Inspired by the presentation we brought this back to NHS Dumfries & Galloway, where we agreed goals, identified key stakeholders to engage with, held an awareness session, developed a communication strategy and agreed a structure for the huddle through the use of PDSA cycles and outcome measures.

We began with a daily meeting at 0830 Monday to Friday, which moved to seven days a week. Key stakeholders across the hospital were involved, this included – ward staff, domestics, porters, duty doctors, occupational therapists, hospital manager and senior chair. It was a 2-way discussion of patient flow, clinical activity, risks, resources and governance. Key priorities include – looking back, looking ahead and follow up.

We found that attendance at the huddle was at 95% or above, with the average length of time nine minutes. Staff found the huddle to be overwhelmingly helpful, with greater awareness. Resulting in resources directed towards the clinical need or risk and a more joined up hospital.

Our next step is to look at applying this model to ward huddles as well as afternoon and evening huddles.

A quote from David Hall
In NHS Dumfries and Galloway, at Midpark hospital, where I am a Consultant Psychiatrist we introduced a hospital wide huddle on a daily basis after seeing the positive effect they had after being introduced at ward level. You could say we did a small test of change and then scaled up. There were some things we anticipated that would happen when we introduced the huddle such as improved communication at transitions and improved identification of risks. But there were other positive outcomes that we didn’t expect such as being able to reduce the number of bank nurses, as we now know across the hospital where staff are and can move them to different wards where extra staff are needed. Another positive outcome is that Midpark has been highlighted by medical training authorities as having excellent medical handover which has helped our trainee doctors. In true SPSP style we have never stopped tweaking the huddle, we now hold an extra one on a Friday afternoon to ensure we are ready for the weekend, we include email updates from staff unable to attend which includes staff working in the community and after the huddle an email is issued informing staff of what was discussed." David Hall, Consultant Psychiatrist, National Clinical Lead for SPSP-MH