Medical Safety Huddles in Rehabilitation: A Novel Patient Safety Strategy.

ABSTRACT

OBJECTIVE: To describe the implementation process, outcomes, and lessons learned in the implementation of medical safety huddles, a novel patient safety monitoring strategy that promotes physician engagement with patient safety. DESIGN: Single-center observational study. SETTING: Brain and spinal cord injury rehabilitation program at an urban, academic adult rehabilitation hospital. PARTICIPANTS: Physicians associated with the program (N=18). INTERVENTIONS: Weekly physicians' safety huddles were implemented to review, anticipate, and address patient safety issues. MAIN OUTCOME MEASURES: Main outcome measures were the number and nature of identified and anticipated patient safety incidents, actions taken, and physician attendance during huddles. The number of adverse events in the program before and after huddle implementation were secondary measures. RESULTS: Over a 7-month period, average physician attendance at medical huddles was 76.0%. There were 1.0±0.8 patient safety incidents and 3.2±2.1 anticipated patient safety issues identified in each weekly huddle. Most patient safety incidents identified were clinical administrative and clinical process related, which differed from information gathered from the organization's preexisting patient safety monitoring strategies. A total of 79 actions, or 3.3±1.8 actions per huddle, were taken in response to improve patient safety for the program. Adverse events decreased from 31.2 (95% confidence interval [CI], 27.0-35.3) to 22.9 per month (95% CI, 19.3-26.5) after implementation. CONCLUSIONS: Medical safety huddles are a novel strategy to engage physicians in patient safety and organizational quality improvement. They have the potential to enhance organizational anticipation of safety risks by supplementing existing methods. Other rehabilitation settings may wish to consider implementing and evaluating similar huddles into their existing patient safety and quality improvement frameworks.