7-minute Huddle Improves Patient Care and Employee Satisfaction

CLIENT INDUSTRY: Healthcare

SOLUTION: Operational Excellence

The Intensive Care Unit (ICU) is an area within a hospital that provides around-the-clock intensive monitoring and nursing care. In this case, the ICU at Salina Regional Health Center was experiencing low employee morale and significant daily overtime due to the extensive monitoring needs of the patients along with the way the mandatory shift transfer meetings were occurring at the end of each shift. For the ICU to run effectively, hospital leadership decided that a Lean Six Sigma project was warranted to improve both areas.

The Challenge

The ICU unit was experiencing significant costs associated with overtime premiums caused by the way the unit ran the mandatory shift transfer meeting.

During the process, all incoming personnel began their shift in a centralized meeting room.  The charge nurse from the prior 12-hour shift reviewed all patient information for the unit, and then the staff would pick the patients they would like to care for and their response duties. The meeting was mandatory for proper patient care and handoff, and it lasted an average of 38 minutes. The nurses on this unit work 12-hour shifts and because of the time involved in this shift meeting, the staff members were often late to the floor, delaying the alternative shift members’ departure.  The delay caused by this meeting was a contributing factor in the high department OT and the low employee morale scores in this area.

The Approach

Salina Regional Health Center started their lean transformation 7 years ago. The leaders have been trained on lean six sigma tools and were tasked to improve the department financials and employee morale.  The goal was to develop a “huddle system” with staff involvement that would take less than 7 minutes to complete. The huddle still needed to transfer critical information about the patients, so the staff would be aware of any issues. The time would also allow the charge nurse to add information about strategic goals and motivate the staff.

For 2 weeks prior to any action taken, the average time of these meetings was monitored and recorded.  The leadership team performed GEMBA’s and were involved in several of the huddles to get an understanding of the current issues. The staff was interviewed, and the results were as follows:

• Too much patient information was being shared.
• The Attendance Policy was not being followed.
• The staff was using this time to eat and relax in the breakroom prior to their shift starting.
• Oftentimes there were a lot of sidebar conversations during the meetings.

During the interview, the staff members were asked their thoughts about limiting the meeting to 7 minutes, and they were extremely excited about the opportunity to get home earlier.

To improve staff buy-in, informal unit leaders helped design a form that would be used to standardize the process. Possible barriers to the change were identified and potential scripted answers were developed. The focus of the meeting shifted to only presenting critical unit information, including patient safety and daily required education. Any additional information would be handled case by case, based on patient needs during the shift.

Additional improvements followed.  The huddle was moved to the middle of the ICU unit and was made a “stand-up” meeting.  The attendance policy was changed to mirror the hospital’s policy to address typical 3–5-minute tardiness.  Before, there was no accountability, and the charge nurses had to waste time repeating the necessary information. With the attendance policy and the new huddle, the leaders leveraged the factors of patient safety and improved education. As a motivator, the staff would be able to start their shifts sooner and go home sooner to their loved ones.

The process was implemented on the predesignated GO LIVE date.  The leadership team continued to conduct in-person interviews to gain insight, feedback, and buy-in from staff on the change. Within a short time, the barriers were addressed, and the normal culture shifted.  The complaints diminished, and the huddle time became even faster—completed within 4–6 minutes. The staff soon felt the positive impact of the change.

“Before the 7-minute huddle, I would not get home in time to see my kids before they went to bed.  Now, I get to put them to bed.  It is the most positive change I have ever seen.” — Night Shift Nurse

“I felt like I was always behind from the time the shift started; however, now I have time to get things done earlier and stay ahead of the curve.” — Day Shift Nurse

Many staff members shared positive reactions to the changes and enjoyed finishing their shifts sooner. They also appreciated the “early jump” they got on their shifts. The ICU leaders continued to push through the barriers and make small adjustments to both accommodate staff concerns and improve the process.

The changes continue to be sustained. Just recently, at staff meetings, the director showed the financial impact that the 7-minute huddle had on the department financials and how it helped turn the ICU budget from the red to the green. The impact of a better budget had improved the ability to buy needed equipment, update supplies, pay for more training, etc. The change showed the department leaders how important it is to use good communication strategies, process improvement, transparency and resilience to push positive change through to completion and sustainment.

Conclusion

The ICU had a goal of 7 minutes, and current huddles last an average of 4-6 minutes.  Now, the charge nurses can rapidly get information out to the staff, and many staff members have commented on how happy they are to be home earlier.  The ICU Director also adds that since the 7-Minute Huddle was implemented, the team has completed over 106 days without fail.  Aside from significant cost savings, the employees are simply thrilled with the improvement in work-life balance!

About Competitive Business Solutions

Competitive Business Solutions consultants are masters of world-class operating and lean sigma principles. Creative problem-solvers throughout the improvement process—from initial discovery and strategic solution development to implementation and knowledge transfer—CBS consultants take pride in their client relationships, working side-by-side with every member of onsite teams to identify performance issues quickly and effectively, with significant and sustainable business improvement as a result.

About Salina Regional Health Center

Salina Regional Health Center Enterprises (SRHE) is a full-service acute care hospital licensed for 373 beds.  It has almost 2,000 employees and a medical staff of 127 physicians, of which 67 physicians are employed by the hospital.  The hospital has invested millions to hire the most capable medical professionals and acquire the most advanced technologies and treatments, all supporting their many comprehensive medical specialties and clinics.  Salina Regional Health Center designates its geographic service area as a 28-county region located in north central Kansas.  About 40 percent of Salina Regional Health Center’s patients come from outside of Saline County, helping the hospital to live up to the “region” in its name.  Through affiliations with clinics and medical facilities in Salina and the surrounding communities, Salina Regional Health Center works to provide excellent medical care to the region.

To learn more, visit: www.srhc.com

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