Using Shift Huddles to Empower Leaders

By Erin Shipley, RN, MSN

As a coach with Studer Group, I have the honor of traveling all over the country and seeing the incredible work happening in our medical centers and clinics. Wherever I go, the passion and drive that I see in the healthcare community is the same – healthcare leaders want to create the absolute best place for employees to work, physicians to practice medicine, and patients to receive care. With that determination for creating an organization-wide culture of excellence in mind, executives are focusing more and more on ensuring leaders at all levels receive proper training and development.

As managers, directors, and executives, we rely on our supervisors, team leaders, and charge nurses to carry critical messages of change to the front line, yet many of the leaders have never been trained in communication or leadership. In healthcare, we tend to select leaders because they have the best clinical skills or the most experience in their current positions. I’ve met charge nurses who have fewer than 6 months experience as a nurse. Does this make them bad charge nurses or leaders? Certainly not. However, it does mean that we have an opportunity to commit to their leadership development, particularly when it comes to communication and accountability.

With HCAHPS, CG CAHPS, and other patient experience surveys and changes in reimbursement, we are constantly striving to achieve zero harm for our patients, increase quality outcomes, and decrease the variance of care that CAHPS surveys measure. However, we still see many front line leaders scratching their heads to find new and innovative ways to impact their results on patient experience surveys.

How can front line supervisors, charge nurses, and team leaders learn to drive change and impact results on a daily basis? What are the best tools to help leaders communicate results, set expectations for their shift, and hold staff accountable for the expectations set by the leader? One of the best tools for both new and experienced leaders is a huddle at the beginning of the shift. While the concept of a shift huddle is not new, the content of the huddle is where we have opportunity for improvement.

Standardizing Shift Huddles

Standardizing shift huddles within departments helps to hardwire new or desired behaviors across the organization. Shift huddles align staff to department goals and allow us to communicate the department’s progress on their patient experience efforts. Huddles also provide a set time every shift to thank our teams, reward and recognize accomplishments and share information that connects staff back to their sense of purpose for the work they do every day.

Utilizing a standard agenda in shift huddles allows us to expose front line leaders and staff to best practices and empower them to apply these ideas to their daily practice and workflow. The shift huddle agenda includes the following components and is applicable to all departments, not just nursing departments:

  • Wins/Recognition — we want to always start with the positive!
  • Review of current daily dashboard/key results
  • Review of the safety and patient experience tactics that are a priority (e.g. AIDET® or Hourly Rounding®)
  • Other information that the staff needs to be aware of to provide the best care and/or service

While we can create the perfect shift huddle agenda for our teams, true breakthrough in results comes when we recognize key points in implementation of huddles. Ensure shift huddles have these key elements:

  • Shared responsibility. Shift huddles should be led by managers at the beginning of the week with a supervisor/charge nurse leading huddles for the remainder of the week. Remember, this is about developing leaders’ communication skills!
  • Mandatory attendance. Include all care delivery staff. Staff should not be able to “opt out,” as they will miss critical information about how to have a successful shift.
  • Active discussions. Rather than dictating the goals for the day, an effective huddle facilitator tries to garner thoughtful responses from the team on HOW they will achieve the goals for their shift. For example, a facilitator might say “What will we do differently today to ensure patient safety and quality?”
  • Standardized agenda. Utilize the standardized agenda and keep the huddle to no more than 5-7 minutes.
  • Open concept. Hold the huddle in an open area where everybody stands up and is ready to go!
  • Inclusive of all staff. Include care physicians, mid-level providers, and EVS when relevant. Think about all of the staff who come in contact with our patients and families. From first touch to last, it takes all of us to achieve ALWAYS.

Shift huddles should be standard for both clinical and non-clinical departments. In fact, at Studer Conferences our faculty and facilitators take time to role play both a clinical shift huddle for a nursing/clinical department and a shift huddle for a non-clinical department.

In order to develop an accountable culture in our organizations, we have to mentor our front line supervisors to clearly and efficiently communicate the vision we have for excellent patient care. By implementing effective, standardized shift huddles, we begin to develop urgency in a critical mass of front line leaders and empower them with an effective tool to create change in their departments.

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