Safety Huddles in the Ambulatory Setting

By the Medical Insurance Exchange of California

Healthcare has a lot of moving parts that rely on multidisciplinary teamwork, communication, and process. When there is a disruption in anyone of these areas it can have a compounding effect that leads to frustration, workarounds, and sometimes patient harm. Communication failures continue to be one of leading cause of sentinel events, which brings us to safety huddles. Daily safety huddles, present an opportunity for staff to flag unsafe conditions and take proactive steps to solve for and eliminate matters that pose a threat to patient safety1. While safety huddles originated in hospitals, these meeting can occur in any clinic or ambulatory setting. The huddle lasts only 15 minutes and has the same standing agenda. 1) Look back – Share concerns that occurred in the last 24 hours. 2) Look ahead – Anticipate needs or disruptions in the next 24 hours. 3) Follow-up – Identify what needs to occur to mitigate newly identified safety issues. In a nutshell, safety huddles create the time and space for healthcare workers to discuss what they need to do their jobs safely. Whether it is a supply issue, equipment issue, staffing issue, IT issue, etc. this brief meeting provides the venue for efficient communication and problem solving.

Ideally, the people that attend the huddle are supervisors, charge nurses, managers, directors and at least one practice administrator or CEO who can escalate more serious concerns that require administrative action. It is also vital that staff see executive leaders at these meetings to show their commitment and support for patient safety. The safety huddle is typically facilitated by the CEO, Practice Manager or identified Safety Officer. Whoever holds the lead role in facilitating should take steps to ensure that the meeting remains on task and on time and does not become punitive. Each attendee is asked to report out needs/concerns for their respective departments. If longer discussions are needed to create a plan, the facilitator can identify who should participate in a post-safety huddle meeting to come up with a solution. This allows the meeting to be respectful of everyone’s time but still solution-focused.

The safety huddle provides continual awareness of the stress levels within an organization, and a mechanism for frontline staff to share concerns through their supervisors. As an added benefit to team cohesion, these meetings often naturally move towards celebrating successes. When a CEO or Practice Manager learns about a near miss event that a frontline staff escalates, the CEO can later personally thank or recognize the frontline worker for speaking up for patient safety.

The benefits of the safety huddle may not always be evident at the outset and carving out the time can be challenging. For this reason, leadership commitment is crucial in getting started but typically after 6 months staff begin to see the value. Persistence will pay off by improving risk identification, interdisciplinary collaboration, and increasing the organization’s proactive approach to risk reduction.

For more information about how to implement a safety huddle in your setting please reach out to MIEC Patient Safety Risk Management Department at patientsafetyriskmgmt@miec. com.

NOTE

1 Shaikh, U. (2020). Improving Patient Safety and Team Communication through Daily Huddles. Psnet.ahrq.gov. https://psnet.ahrq.gov/primer/ improving-patient-safety-and-team-communication-through-daily-huddles

ALEXANDER ROGERSON, MD (1922-2022)

Dr. Alexander Greenleaf Rogerson, a longtime Berkeley pediatrician, died peacefully in Walnut Creek, California on August 24, 2022 after a brief illness. He was 99 years old.

Born in 1922 in Milton, Massachusetts, Alex attended Milton Academy, Harvard University, and Harvard Medical School. He then did an internship at Boston Children’s Hospital, a residency in pediatrics at Bassett Hospital in Cooperstown, NY, and a Chief Residency at Philadelphia Children’s Hospital.

He served in the U.S. Army Medical Corps from 19431946 and again in 1950-53, rising to the rank of Captain. He then joined the Berkeley Pediatric Medical Group, where he practiced until his retirement. While in practice, he was an associate clinical professor at UCSF and spent 50 years teaching and attending at Oakland Children’s Hospital.

Alex was a serious athlete. In his younger years, he wrestled, boxed, and pole-vaulted. In California he took up competitive running, sailing, tennis, skiing, and rowing. He ran more than one marathon and was running more than seven miles a day when he was 75. At the age of 95 he set the U.S. record for 2,000-meters in men’s indoor rowing in the 95-99 age bracket.

He is survived by his wife, Britta, his children, Charles (Sharon Sagan), Janice, Lindsay (Zada Jan), Mark (Jan), and John, six grandchildren, and two great-grandchildren.

Dr. Rogerson was an ACCMA member for 47 years.

WILLIAM ELLIS, MD, FACS (1942-2023)

Dr. William Ellis unexpectedly left this earth on January 18, 2023, doing what he loved the most: flying his airplane. He was a man who loved adventure, taking up flying in his 50s.

William, called Bill by his friends and family, was born on December 28, 1942, in the Bronx. When Bill was 13, his family moved to the Bay Area where his father became a community college biology teacher.

Dr. William Ellis, MD, FACS dedicated his career to bringing innovative surgical techniques to the restoration of vision. He began his career by studying electrical engineering at the University of California, Berkeley. He then attended medical school at Washington University in St. Louis. Dr. Ellis completed a surgical internship at Duke University and residency at Stanford University Medical Center. He was then Board Certified in general ophthalmology. He was also certified as a sub-specialist in cataract, intraocular lens implantation, and refractive surgery.

Dr. Ellis was a leader and innovator in the field of refractive surgery. He studied radial keratotomy surgery with Professor Svyatslov Fyodorov in the Soviet Union. Dr. Ellis wrote three textbooks on Keratoplasty surgeries. Professor Fyodorov, who pioneered modern radial keratotomy, is a co-author of his last textbook. He is survived by his sons, Willian Benson Ellis and Charles Edward (Annie) Ellis, along with grandchildren Rose Ellis and Axel Ellis.

Dr. Ellis was an ACCMA member for 47 years.