Implementing Daily Safety Huddles in a Radiotherapy Department

Abstract

Safety huddles (SHs) are an effective communication tool in healthcare, allowing front line staff the opportunity to raise awareness with issues relating to quality and safety. The purpose of this evaluation was to determine the feasibility of implementing SHs in a large radiotherapy (RT) centre. There was a 3-phase implementation process. Firstly, a working group comprised of leadership and front-line radiation therapists proposed a preliminary design for the SH process, designed a huddle board to facilitate SH discussion, and brainstormed potential challenges. Secondly, 10-minute SHs were piloted in selected clinical areas that represented diverse RT expertise, equipment and tasks (e.g. CT/MR simulation, treatment planning/delivery and specialized work areas such as brachytherapy). SHs were held daily for one week. Frontline staff were mentored and supported by “huddle champions.” Thirdly, post-implementation interviews were used to evaluate the huddle process and generate lessons learned prior to widespread departmental implementation. Benefits included: improved team communication through a protected pause in the day; a standard method for identifying, documenting and escalating issues relating to clinical quality, safety, delivery and efficiency; and an organizational commitment to promoting safety culture. Challenges included: logistics of gathering team members from various practice areas; difficulties working with the analog huddle board; staff reluctance to “stop and pause”; reduced frontline capacity; and the need to adjust huddle timing to accommodate patient and team needs. Design of the visual huddle board was validated, logistics of huddle timing and coordination were determined, and staff buy-in for the huddle process was established. This evaluation confirmed that huddles could be implemented across a large RT centre with different practice environments. Future considerations for refinement of the process included development of a method to track, communicate, and resolve issues identified by huddles, with staff favoring a digital solution.