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Improvement Academy
Improvement Academy

Safety Huddles

The Improvement Academy is supporting frontline teams in a variety of healthcare organisations to use improvement science and evidence based interventions. Safety huddles are used as one of our main interventions to help reduce patient harm, improve communication, culture and overall patient safety in teams.

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What is the problem?

Estimates suggest that approximately 5–10% of hospitalised patients in high-income countries experience harm, and about one third of these harmful events are preventable.

To date, international patient safety initiatives that have been designed over the last decade have almost all failed to demonstrate significant sustained impact. Reducing harm across a hospital requires behavioural change at a ward team level.

The Yorkshire Contributory Factors Framework illustrates communication and safety culture as the common theme cross cutting all other causes of harm. Yorkshire Safety huddles allow the team to reflect on how they work together, and enhance team working and communication. Through implementation of Yorkshire Safety Huddles we can demonstrate reductions in a variety of harms, increases in overall staff morale and improved teamwork.

We have developed a unique approach to Safety Huddles through our HUSH (Huddle Up for Safer Healthcare) programme. Through learning what works well and what doesn’t, we have identified the basic principles of a Safety Huddle which can be easily adapted to suit any environment.

By applying these basic principles, we have been able to adapt Safety Huddles within many different environments including:

  • care homes
  • mental health teams
  • hospices
  • community teams and
  • non-clinical teams (portering team at St James’s University Hospital).

 

Watch our Huddling Up for Safer Healthcare (HUSH) video

here
.

Impact

One of the key ingredients of a Safety Huddle is data. Through measurement of a team’s data at ward level (usually through a ‘days since’ visual count) chart and providing a monthly SPC (Statistical Process Control) or “days between” chart, the teams can begin to see the impact huddles have had by seeing a reduction in harms.

At the end of 2023, there are a total of over 400 teams across the Yorkshire and Humber region who are huddling with a range of patient safety priorities.

Examples of patient harms that teams are addressing using our Safety Huddles are:

Acute hospitals: falls, pressure ulcers, cardiac arrest calls
Mental health: violence and aggression, self-harm, fire incidents, verbal abuse, missing service user
Care homes: deterioration, pressure ulcers, nutrition and hydration, medication errors
Community teams & hospices: falls, pressure ulcers

 

Evaluation of Safety Huddles using HUSH principles

Key Learning

As part of the HUSH project funded by The Health Foundation, The University of Bradford carried out an impact evaluation of 92 wards. Key results included:

  • More than two thirds of wards across five hospitals successfully embedded Safety Huddles using HUSH principles.
  • Yorkshire Safety Huddles were associated with positive feedback from frontline staff, enhanced teamwork and safety climate: out of 150 staff questioned, 124 (83%) said they would miss the Yorkshire Safety Huddle if it was stopped tomorrow.

 

Watch a video summarising our work on the HUSH project

here
.

A visual capturing our key learning about how to successfully implement safety huddles can be downloaded at the bottom of this page.

Return on Investment (RoI)

As part of an evaluation (2018) undertaken by the University of Bradford in Partnership with York Health Economics consortium and funded by the Health Foundation, a return on investment of 30% was demonstrated (based on falls avoided). The evaluation concluded that Safety Huddles implemented using the principles demonstrated through HUSH are a cost effective intervention to address patient harm.


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Improvement Academy has  worked collaboratively with patients, clinicians and academics to refine our approach and develop expertise in disciplines that are essential for successful improvement in contemporary healthcare.

Based on Deming’s Principles of Improvement, our flexible approach is applied in partnership with patients, clinicians and academics to tackle the most difficult areas of healthcare improvement.

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