Implementation of Situational Awareness in the Pediatric Oncology Setting. Does a ‘huddle’ Work and Is it Sustainable?

• Published in: Journal of pediatric nursing 2020-01, Vol.50, p.75-80
• Main Authors: Chapman, Laura RM, Molloy, Luke, Wright, Felicity, Oswald, Cecilia, Adnum, Kirsten, O'Brien, Tracey A, Mitchell, Richard
• Format: Article
• Language: English
• Subjects: Adolescent; Attitude of Health Personnel; Awareness; Child; Child, Preschool; Collaboration; Communication; Cooperative Behavior; Efficiency, Organizational; Group Processes; Hospitals, Pediatric - organization & administration; Huddle; Humans; Infant; Infant, Newborn; Interdisciplinary Communication; Medical Oncology; Models, Organizational; Nursing; Patient Care Team - organization & administration; Patient Safety; Quality Improvement; Situational awareness; Surveys and Questionnaires; Sustainability; Teams
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2019.10.016

Huddles are short, regular debriefings that are designed to engage clinical staff in discussions about existing or emerging safety issues. They allow a brief conversation to take place creating a ‘situational awareness’ about the complexities of the healthcare environment for that day. The huddle was implemented in a pediatric oncology service as an intervention aimed at improving patient safety and staff communication to enhance situational awareness. To ensure an efficient format for each huddle a huddle observational tool (HOT) was developed. An initial electronic anonymous survey focusing on safety and situational awareness was distributed to all of the multi-disciplinary (MDT) team. A second survey was disseminated 18 months post huddle introduction to scrutinize its effectiveness. Sustainability was assessed using staff attendance and huddle numbers. Four key areas demonstrated high situational awareness; safety awareness, incident management, communication and teamwork. Positive/negative pooled responses from both survey time points demonstrated a high percentage of positive responses, particularly relating to teamwork enhancement. The overwhelming finding was sustainability of the intervention of the huddle. The pediatric oncology services have now conducted over 700 huddles events over a three-year period. The initiation of the huddle has led to increased situational awareness and promotion of safety. It has been shown to be sustainable in the pediatric oncology setting, with durability and attendance of the huddle being the most significant outcome. •Huddles can promote patient safety and minimize preventable harm in the pediatric oncology setting.•Huddles are a powerful tool for team building, non-hierarchical information sharing and improvement of team cohesion and morale.•The use of the huddle is sustainable within the pediatric setting and has a direct impact on patient care.