The prevalence of harm to patients in healthcare settings remains a critical global concern, with falls and pressure injuries being the most common yet preventable forms of harm. Various strategies, such as clinical audits, staff training programmes, and standardised protocols, can be employed to address these issues. Safety huddles stand out as a promising approach to mitigate harm by fostering collaboration and accountability within healthcare teams, advancing patient safety culture.
What is a safety huddle?
Safety huddles are brief focused meetings (usually 5 to 15 minutes) where health professionals discuss safety concerns, risks, and strategies to improve patient safety. Although these huddles are beneficial across various healthcare settings, they are especially important in nursing, where patient care and safety are paramount. The goal is to ensure all team members are aware of safety issues and aligned in addressing them. During a huddle, the team discusses high-risk patients, incidents or near misses, staffing levels, resource availability, and environmental factors such as equipment or space issues. Critical updates on patient conditions, admissions, transfers, or discharges are also shared. The primary objective is to identify and address risks early, improving patient outcomes and preventing harm.
Pressure injuries and falls
Pressure injuries (also known as pressure ulcers) and falls are significant concerns within hospital settings, impacting patient safety and healthcare quality. In the UK, it has been estimated that up to 700 000 people are affected by pressure injuries annually (Hope, 2014), leading to increased healthcare resource use and patient discomfort. The Agency for Healthcare Research and Quality (2014) estimated they are responsible for 60 000 deaths in the USA. These injuries, caused by prolonged pressure and shear on the skin and underlying tissues, are particularly prevalent among immobilised or vulnerable patients (Chaboyer et al, 2016), including those in critical care units, with global prevalence reported as high as 27% (Labeau et al, 2021). Furthermore, treating pressure injuries imposes a significant financial burden on healthcare systems, costing the NHS more than £534 million a year (Guest et al, 2017).
Falls also represent a major concern; within clinical and hospital settings falls are a significant cause of harm among patients aged 65 and over (Morris and O'Riordan, 2017). The incidence of falls in hospitals can vary between 1.3 and 8.9 falls per 1000 patient days, depending on the setting (Miake-Lye et al, 2013). These falls can result in severe complications, such as fractures and longer hospital stays, which in turn affect both patient outcomes and the overall cost of health care. However, the impact of falls goes beyond physical harm, they often lead to a loss of independence, increased morbidity, and, in some cases, mortality (Cameron et al, 2018; Hendrian and Tipton, 2020).
Implementing daily safety huddles has been shown to improve communication within teams, foster open discussions, and increase situational awareness (Lamming et al, 2021). This enhanced communication ensures that patient safety concerns, including risks for pressure ulcers and falls, are identified and addressed promptly. Safety huddles also provide an opportunity for healthcare staff to collaborate on solutions, creating a culture of safety that leads to better patient outcomes.
Overall, the high incidence and severe consequences of pressure injuries and falls in hospitals emphasise the need for effective safety measures. Safety huddles offer a practical, evidence-based approach to enhancing communication, identifying risks, and improving patient safety outcomes. This approach not only addresses immediate concerns but also contributes to long-term improvements in hospital safety practices.
A catalyst for positive culture change
In response to high-profile care failures, such as those highlighted by the Francis Report (2013), strategies such as incident reporting systems and SSKIN care bundles have been implemented within the NHS to reduce harm. However, a growing body of research underscores the transformative potential of safety huddles in enhancing team culture and promoting a shared commitment to patient safety. For instance, Rowan et al (2022) demonstrated how safety huddles encourage collaboration and team building among health professionals, creating a ripple effect of positive cultural change.
Having a patient safety culture is viewed as a vital aspect of any organisation and this can be related to teamwork, communication, reporting errors and organisational learning, according to Waterson (2014). The norms and values shared by each member of a team can be equally defined and have a positive impact on patient safety. Values are the principles that guide the behaviour of the interprofessional team members. Huddles can also enhance interprofessional relationships through improved communication, which in turn improves collaboration (Tielbur et al 2015).
For safety huddles to be truly effective, ongoing education is essential. Healthcare practices, technologies, and guidelines are constantly evolving, and continuous education ensures that staff members are equipped with the latest knowledge and skills to address emerging challenges. Without regular training and updates, the effectiveness of safety huddles may diminish over time, as staff may become complacent or miss important changes in best practices. Ongoing education also helps reinforce the importance of patient safety and supports the development of critical thinking skills, enabling health professionals to identify risks more effectively and respond appropriately. Combining the regular, collaborative nature of safety huddles with continuous education, healthcare organisations can foster a culture of safety, facilitating the exchange of best practices and knowledge (Croke, 2020). This ensures teams are not only motivated to perform at their best but are also well-equipped to meet the ever-changing demands of patient care.
Central role of nursing
Nurses comprise 50% of the global healthcare workforce, positioning them as essential contributors to patient safety initiatives (Vaismoradi et al, 2011). Safety huddles are valuable in any healthcare setting. However, for nurses in particular, safety huddles serve as an opportunity to actively engage with colleagues, address concerns, and identify immediate safety issues that may require attention. Nurses play a critical role in identifying risks, such as patient falls, medication errors, or potential infections, which can then be addressed in the huddle. Involving all members of the care team, safety huddles encourage open communication, facilitate problem-solving, and help ensure that any safety concerns are promptly addressed.
Incorporating safety huddles into the routine workflow helps to reinforce patient safety as a collective responsibility. These huddles are particularly valuable in dynamic healthcare environments where situations can rapidly change, and teams must be ready to adapt to new information or circumstances. Safety huddles also support a culture of continuous learning, where teams reflect on past incidents, learn from them, and develop strategies to prevent similar issues in the future (McKinnon, 2016). Furthermore, they offer a platform for new nurses, who may feel uncertain in fast-paced environments, to voice concerns and contribute to patient safety discussions, empowering them as safety leaders (Lamming et al, 2021).
Preregistration education is a critical starting point for cultivating the knowledge, attitudes, and skills necessary for safe practice. Nursing students were described by Francis (2013) as the ‘safety leaders of the future,’ and play a vital role in shaping a culture of safety. Integrating patient safety concepts into undergraduate nursing curricula ensures that newly qualified nurses are prepared to deliver evidence-based care while bringing a fresh perspective to the workplace (Murray, 2018).
Conclusion
The integration of safety huddles into nursing practice holds significant potential to reduce patient harm while fostering a collaborative and proactive safety culture. Using safety huddles provides an opportunity to address common risks such as falls and pressure injuries, therefore, safety huddles may be useful for enhancing patient outcomes as well as strengthening team cohesion and accountability. Nurse education, both at the undergraduate level and through continuing professional development, is key to sustaining this practice and ensuring the next generation of nurses are equipped to lead in patient safety.