Abstract
Background:
Lean Six Sigma processes are gaining ground in health systems worldwide. The concepts of huddles have been used to increase patient safety and facilitate efficiency in problem-solving. Daily huddles can help promote optimal patient outcomes and reduce poor communication between leaders and staff.1 Our Respiratory Care Department (RCD) implemented twice-daily shift huddle in 2015 and became proficient in the process in 2018. This study evaluated the number of issues that our huddle process resolved annually and its impact on employee engagement.
Methods:
This study was performed at a 200-bed pediatric hospital (Level 1 Trauma Center, Level 4 NICU). The RCD leadership team and staff were trained in the utilization of a lean huddle process to resolve issues and identify process improvement opportunities. Huddles were performed at the beginning of each shift before the RTs were dispatched to their assigned clinical areas. Issues were raised by the RCD bedside staff and leadership using the following categories: Safety and Service, Methods, Equipment, Supplies, and Associates. Opportunities were placed within three categories; quick hits (1-3 day resolution), complex problems (3-7 day resolution), and projects (> 7-day resolution). All opportunities included a problem statement, immediate countermeasure, problem leader, and due date on a dry erase board for transparency. Items requiring interdisciplinary support were escalated to the organizational patient care services huddle. Once the opportunities were resolved, they were placed in an excel spreadsheet that was emailed to all RCD employees. Feedback about the process was obtained via the Press Ganey Employee Engagement Survey performed in October 2018. The number of opportunities resolved was tracked from January 1st through December 31st, 2018.
Results:
The RT department has 112 employees, including management and support associates. Average daily census 143. A total of 366 opportunities for improvement were identified and resolved. Average of 30.5 (± 7.68) issues were resolved monthly. All feedback from the engagement survey was positive.
Conclusions:
By utilizing huddles, RCDs can handle both quick and complex problems in a more timely fashion. This process allows for direct and timely communication to staff and transparency that can aid in increasing employee satisfaction. Reference: Di Vincenzo P. Team huddles: a winning strategy for safety. Nursing 2019;47(7):59-60.
This graph displays the 366 opportunities for improvment surfaced in the Respiratory Care Department huddle in 2018 broken down by month.
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