Daily Safety Huddles prove effective in improving patient safety

At the Daily Safety Huddle, clinical and operational leaders gather for a brief, 15-minute focused meeting to identify obstacles to managing patient care and flow in a safe, timely manner. In just a few short months, these meetings have proved to be impactful, most often identifying and resolving daily patient flow issues. They are also proving to be an excellent forum for quick resolutions to patient safety issues

At one recent Daily Safety Huddle, Manager of Materials Management Jorge Villanueva raised an issue originally brought to his attention by the Respiratory Therapy team. “One of the respiratory techs found a deflated Ambu mask on one of the code carts,” he says. “If the mask is not properly inflated, it does not create the necessary seal around the patient’s mouth and nose, making the device ineffective.”

Villanueva and his team checked all the carts that they stock and found no more defective masks. But a few days later, another defective mask turned up on an RRT cart. He explains, “We now know that sometimes items get moved to other areas that we might not know about or do not have no access to check. At the Daily Safety Huddle I was able to ask everyone to check their areas for additional defective masks. Being able to present this at the Daily Safety Huddle was instrumental in getting masks that might have otherwise been overlooked and returning them to the vendor.”

At another Daily Safety Huddle, Clinical Nutrition Manager Shannon Vukosa, RD, LDN, addressed a lack of food tray scanners that resulted in a patient safety issue. “The patient had a regular diet order when the tray ticket printed in the kitchen and the tray included a variety of foods and beverages. However, the patient’s diet then changed to clear liquids after the ticket printed when the tray was in route to the room. Usually, the tray passer scans the tray upon delivery and if the diet has changed, they receive a warning and don’t deliver the tray until they check back with the diet office to be sure the tray is okay for the new diet,” explains Vukosa. “But on this particular day, we had several broken scanners so the tray passer who delivered the tray did not have a scanner and did not scan the tray upon delivery and the result was the patient received a tray with the wrong foods for their new diet order.”

Vukosa says, “We knew right away we had to order new scanners, but in the interim, we were able to communicate to the Daily Safety Huddle that due to a lack of scanners, diet orders that were changed after the tray was ordered should be verbally communicated to the diet office or tray delivery should be intercepted.”

As a reminder, all staff are welcome to attend a Daily Safety Huddle, which meets each Monday through Friday at 9:30 am in the Mary Ann Tynan Conference Center.