OR Manager - June 2020 - 27

AMBULATORY
SURGERY CENTERS
A CUT ABOVE
Providing exceptional outpatient surgical care
OR Manager's mission is to publish timely, relevant information
to help surgical services leaders and their staffs
provide the best possible patient care. A Cut Above is a
new forum in which to share best practices for care of the
ambulatory surgical patient. Peer-to-peer communication
is an invaluable way to gain insights into managing this
rapidly growing patient population, and OR Manager readers
are eager to hear from you!
To submit an article for A Cut Above, contact Elizabeth
Wood, Editor, OR Manager, at ewood@accessintel.com.
For specifics about our criteria, visit www.ormanager.com
and click on " OR Manager Abstract Submissions " under the
" About Us " tab.
Implementing safety huddles to improve patient outcomes
he fast-paced environment in an
ambulatory surgery center (ASC)
requires meticulous handoffs, and
daily huddles-brief (10 to 20 minute)
stand-up meetings-can raise awareness
of any potential safety issues. That has
been the experience at UnityPoint Health
in Des Moines, Iowa, and some of what
we learned might help others improve
communication in their facilities.
T
Why were huddles started?
Many units in our organization were conducting
daily safety huddles when we
launched the organization-wide huddle.
One of our UnityPoint affiliates was
already doing daily organization-wide
huddles, which were considered a best
practice to focus on patient and employee
safety. We formed a steering
committee with representatives from
nursing, public safety, facilities, behavioral
health, and employee safety.
How do the huddles work?
Each unit conducts daily huddles (8:30
am Monday through Friday; 10 am on
Saturday and Sunday) to discuss good
catches, things that happened in the
past 24 hours, and things to be aware
of in the next 24 hours. Pertinent information
for the day is cascaded up to a
service line leader, who then attends
the organization-wide huddles each day.
Staff may call into the huddle, but inperson
attendance is preferred. Followup
often occurs between departments
immediately after the huddle.
Shortly after all hospitals at UnityPoint
launched safety huddles, we crewww.ormanager.com
ated
a monthly system safety call. This
allows us to learn about safety-related
issues across the system. Huddles
have also been very helpful in planning
for patient placement and flow issues.
What role does a culture of
safety play?
Using a just culture algorithm for investigating
safety concerns has demonstrated
our belief in systems and processes. One
culture of safety survey showed an increase
in the number of events reported,
which illustrates how reporting and sharing
have improved our culture.
What is the role of leadership?
We rotate the huddle facilitator each
day. Some organizations have the same
senior leader " own " the huddles. We
decided that the administrator of the
day would facilitate the huddles and
send the reports. The reports are based
on a template and emailed each day.
Doing this has engaged all of our senior
leaders in a culture of safety.
What are the lessons learned?
The biggest " aha " from our senior team
facilitators was the extent of workplace
violence and public safety issues. We
took some immediate actions:
* personal badge alarms in select
areas
* increased public safety staffing
* reduced access to facilities during
certain hours of the day
* mandatory management of aggressive
behavior
care staff
training for direct
* creating a no-tolerance policy for aggressive
behavior that was communicated
to patients and visitors.
We learned that workplace violence
was a system concern, and we
launched a system team to create standard
approaches to prevent workplace
violence as well as a systemwide safety
committee, which I co-chair.
How can other ASCs implement
safety huddles?
Look at the literature. Identify processes
or risk areas such as concerns about
a new procedure, double checks of implants
before surgery, percentage of correct
counts, or bloodborne pathogen
exposures in the past 24 hours. This
becomes the format for the update or
debrief, and staff get used to gathering
at the beginning of each day.
Implementing a daily safety huddle
is one step toward creating a highly reliable
organization. Leaders and teams
continually focus on safety, and following
up on issues will promote trust and
willingness to improve safety. ✥
Debra J. Moyer, MPA, BSN, RN, NEA-BC,
is chief nurse executive at UnityPoint
Health in Des Moines, Iowa.
Amy L. Bethel, MPA, BSN,
RN, NE-BC, is an independent
consultant in Des
Moines, Iowa. She has more
than 35 years of experience
in surgical services leadership.
OR
Manager | June 2020
27
http://www.ormanager.com http://www.ormanager.com
OR Manager - June 2020

Table of Contents for the Digital Edition of OR Manager - June 2020
