Daily Huddle Research Articles

WHAT MATTERS MOST FOR PERSON-CENTERED DEMENTIA CARE: PERSPECTIVES FROM STAKEHOLDERS IN LOW-RESOURCE LONG-TERM CARE

Abstract One of the initial steps in supporting quality dementia care for residents living with dementia (RLWD) in low-resource long-term care (LTC) settings is to elucidate stakeholder perspectives on what matters most for providing person-centered dementia care in such settings. We conducted community-based, participatory research across four LTC facilities situated in federally designated medically underserved areas (two rural and two urban) to describe what matters most to key stakeholders in achieving person-centered dementia care in low-resource LTC settings through their own journeys. In-depth semi-structured interviews were conducted with administrative leaders (n=7), direct care staff (n=20), RLWD (n=16), and family/care partners (n=16), with transcripts thematically analyzed using NVivo14 software. Administrators and staff members acquaint themselves with dementia care principles, participate in daily huddles, and establish rapport with residents and families. As they progress, they acquire skills to observe residents’ behaviors, empathize with their experiences, cultivate trust, delivering intuitive care that honors individual preferences, routines, and past experiences. RLWD transitioning to LTC settings seek environments resembling private homes that foster self-advocacy and rely on staff members who understand their needs and promote a sense of belonging. For family members, the journey involves supporting their loved ones’ transition, advocating for their preferences, and maintaining open communication with staff. They play a crucial role in reinforcing resident preferences and ensuring the delivery of quality care. Throughout these journeys, stakeholders identify key quality measures, including odor, cleanliness, resident happiness, and the quality of relationships, as benchmarks for assessing person-centered care.

74 Reducing unplanned extubations in a level 3 neonatal intensive care unit - the nuts and bolts of UE bundle implementation

Abstract Background Unplanned extubations (UEs) are preventable adverse events that may lead to short term consequences (e.g. cardiopulmonary collapse) and long term sequelae (e.g. acquired airway injury, brain injury) for patients admitted to the Neonatal Intensive Care Unit (NICU). UE prevention care bundles have been demonstrated to reduce UE rates in NICUs; however, implementation of bundle elements is unit dependent. Objectives To describe the work of a UE Prevention Team in a Level 3 NICU with rising UE rates despite implementation of UE prevention bundle per Children’s Hospital Solutions for Patient Safety (SPS). Design/Methods A neonatologist / respiratory therapist pair was assembled in March 2022 to tackle rising UE rates in a 69 bed NICU. Contributing unit stressors included implementation of a new electronic health record, COVID-19 policies, and nursing shortages. Baseline UE rates were >3x the centerline for SPS network NICUs and likely underreported. Steps undertaken include: 1) daily audit to ensure reporting of all UEs, 2) structured post-event team debriefs, 3) unit education campaign to raise awareness of UE prevention and bundle elements, 4) prominent posting of last UE date and reporting on daily team huddle, 5) rapid UE case reviews and apparent cause analysis with reporting of findings unit-wide, 6) optimize endotracheal tube (ETT) securement methods, 6) enforce T2-T3 ETT tip position, 7) standardize x-ray frequencies and reporting, 8) trial of daily rounds ETT safety checklist. Results From rapid case reviews, apparent causes were determined to be incorrect ETT securement device sizing, taping method prone to loss of tape integrity in high humidity, high ETT positions, and inadequate ETT monitoring during high risk activities other than repositioning (invasive/painful procedures, diaper changes). Post-event structured debriefs and unit-wide vigilance increased reporting of UE events to 100%. UE rates fell from a peak of >4 UEs/month, >2.4/100 ventilation days to 1 UE/month, 0.465/100 ventilation days, a 80% reduction.(Figure 1) Most impactful interventions were standard x-ray reporting template in the electronic health record, reinforcing T2-T3 ETT tip positioning, correcting ETT holder sizing, and change in ETT method (Figure 2). Daily rounds checklist was not effective. UE reductions were achieved without changing patient ratios as nurse staffing shortages continued. Conclusion A nimble systems approach is needed to ensure success in implementation of UE prevention care bundles. Simple changes can be made to decrease UEs, guided by rapid case reviews.

Visual Management Board Implementation to Enhance High Reliability at a Large VA Health Care System.

The US Department of Veterans Affairs (VA) is committed to embodying principles of high reliability organizations and Lean management culture. The practice of making problems readily known to team members and leadership is called visual management, an important tool in the journey to becoming a high reliability organization. Visual management boards (VMBs), or huddle boards, can foster transparency, teamwork, and employee empowerment. A variety of health care teams at the Lieutenant Colonel Charles S. Kettles VA Medical Center within the VA Ann Arbor Healthcare System (VAAAHS) created and instituted VMBs. This article highlights the implementation in a large, diverse outpatient cardiology clinic. The incorporation of a VMB into the daily huddle of the outpatient cardiology clinic team led to increased problem identification among staff and leadership and fostered teamwork as issues were addressed. Feedback from teams across the VAAAHS noted how the boards were helpful in prioritizing areas for improvement, fostering teamwork, and increasing staff engagement, empowerment, and satisfaction. A VMB is a simple, inexpensive, yet potentially powerful tool to bring together diverse health care teams to identify problems in the workplace, engage staff in developing solutions, and enhance communication with leadership. Implementation of VMBs at the VAAAHS may serve as a model for other VA health care systems for the incorporation of visual management into daily workplace culture.

Stop the Line: Interventions to Prevent Retained Surgical Items.

The surgical team works collaboratively to prevent the occurrence of retained surgical items (RSIs). The purpose of this quality improvement project was to increase compliance with facility policies and improve teamwork skills to prevent the occurrence of RSIs. The project team implemented an evidence-based communication protocol, updated hospital network policies, introduced just-in-time job aids, and facilitated leader support through a daily huddle to address identified practice gaps. The TeamSTEPPS Teamwork Attitudes Questionnaire was used to measure the change in staff members' attitudes about teamwork before and after project implementation. Additional process and outcome measures included the number of near misses and actual RSIs, compliance with the daily huddle, and completion of the communication training. Results included improved perceived teamwork attitude scores and zero reports of actual RSI events over 7.5weeks.

Meritus Health: Driving Data-Informed Decision-Making at Every Level.

With so much data available, health system leaders are challenged with sifting through it all to find the most useful information for decision-making. Meritus Health implemented effective approaches to understand, use, and communicate large amounts of data to alleviate some of this burden. These processes include system-wide daily huddles, dashboards, and standardized communication write-ups.

Impact of a Daily Huddle on Safety in Perioperative Services

Communication failures contribute to quality gaps and may lead to serious safety events (SSEs) in the operating room (OR). Our perioperative services team experienced an increased rate of SSEs in 2020. Event analysis revealed clustered causes: communication failures and lack of timely information to prepare for cases. Consequently, the team implemented a daily morning OR safety huddle conducted before bringing patients into the OR to reduce quality gaps and improve communication. The attending surgeon and anesthesiologist, circulating nurse, and scrub staff are required to be present. Cases are discussed using a standard format designed by the OR team with built-in time for questions and clarifications. The surgeon initiates the huddle; the circulating nurse leads and records the discussion. OR leadership initially performed daily audits but gradually reduced them when huddles became standard operating procedure (SOP). SSEs were recorded from December 2015 to September 2020 preintervention and October 2020 to July 2023 postintervention. Following the implementation of huddles, there were no SSEs for more than 900 days (2.0 SSEs/year preintervention vs. 0.0 SSEs/year postintervention). The first SSE during the postintervention period occurred in March 2023. Huddle compliance was consistently > 95%. No delays were observed in first-case on-time starts postintervention. The huddle is now SOP for all general OR teams and interventional radiology. Implementing the morning safety huddle contributed to a reduction in the rate of SSEs without introducing delays to first-case start-times.

Daily huddles in antenatal clinics: An effective tool to optimize quality of antenatal care.

SynopsisDaily huddles are 15 golden minutes in antenatal clinics which can aid in the reduction of maternal and perinatal morbidity as well as mortality.

Implementing a Respectful Maternity Care Guideline During Childbirth Experiences

ObjectiveTo measure the impact of an evidence-based guideline on respectful maternity care on nurses’ attitudes and beliefs about childbirth practices. DesignA quality improvement pilot project with a pretest/posttest design examining the attitudes and beliefs of intrapartum nurses about childbirth practices of respectful care. SettingHigh-risk intrapartum unit at a tertiary care center in the southeastern United States. ParticipantsA convenience sample of 130 registered nurses were invited to participate, and nine completed the pre- and posttests. Intervention/MeasurementsThe intervention included a recorded webinar, access to printed and electronic copies of the guideline, discussions in daily huddles, and a virtual journal club. Data were collected using the 42-item Nurse Attitudes and Beliefs Questionnaire–Revised. Lower scores are reflective of attitudes and beliefs that support a medical model of care, whereas higher scores are reflective of a physiologic model of care. Descriptive statistics and the Wilcoxon signed rank test were used to analyze changes in attitudes and beliefs based on the aggregate scores of the nurse participants. ResultsAlthough there was no change in nurse attitude and beliefs about childbirth practices after 3 months (p = .058), the aggregate scores on a scale of 42 to 168 increased by 5.6 points. Two subscales of the Nurse Attitudes and Beliefs Questionnaire–Revised—Medical Model of Conflict and Women’s Autonomy—had the greatest increase in aggregate scores. ConclusionUnderstanding nurses’ attitudes and beliefs can assist in identifying barriers to the provision of respectful care, particularly during labor and birth, when patients are most vulnerable. Measurement of nurse attitudes and beliefs regarding respectful maternity care may require a longer immersion in a respectful maternity care program to allow for changes over time.

Reducing Anxiety Among Nurse Leaders Through Virtual Animal-Related Engagement.

This project explored the relationship between virtual animal-related engagement (ARE) and anxiety in nurse leaders. A quality improvement project used a valid and reliable visual analog scale from 0 to 100 for self-reporting of anxiety in nurse leaders. Baseline and intervention group data were collected for 2 weeks at 15 and 5 minutes before the daily leadership huddle. Differences in anxiety levels 5 minutes before the huddle for baseline with the use of the intervention were significant. Within the intervention group, anxiety levels at 15 and 5 minutes were significant. Project outcomes suggest a difference in self-reported anxiety of nurse leaders based on ARE.

The Alfred Health Covid Community Pathway (AHCCP): development of a multidisciplinary, collaborative, and integrated model of care for supporting covid positive patients in the community during the Covid-19 pandemic.

Background: The second wave of Covid-19 in Victoria in July 2020 revealed health system vulnerabilities including access to primary care and community readiness to provide care in the home to large numbers of Covid-19 positive patients. The health system risked being overwhelmed, and patients risked deteriorating at home with unmet clinical and psychosocial needs. The requirement for isolation of positive cases necessitated a rapid switch to remote and virtual models of care. In response to a successful pilot in Northwest Melbourne [1], the Department of Health (DH) implemented the Covid Positive Pathways program, which directed health services to provide a similar service in their local catchment areas.
 Purpose of this report: To describe the design, implementation and evolution of the AHCCP, including challenges, lessons learnt and opportunities for use of such an integrated model of care in future epidemic/pandemic situations, as well as to support broader health and social care needs beyond covid.
 Methods: This descriptive study describes the model of care developments and changes, and commentary with descriptive statistics from the cohort of patients who were referred to the pathway, and key learning points.
 Service aim, stakeholders and implementation: In September 2020, the AHCCP was established with the aim of providing comprehensive care to patients in isolation with Covid-19. The service was established as a partnership between several stakeholders, including:
 
 Alfred Health, a quaternary hospital in south-east Melbourne.
 Connect Health and Star Health, community health orgsanisations.
 South East Melbourne Primary Health Network.
 Victorian DH, and the South East Melbourne Public Health Unit.
 South East Melbourne Health Service Partnership, Monash Health and Peninsula Health.
 
 Patients referred from the Victoria DH were triaged and risk-stratified. Clinical monitoring was provided by the health service (medium pathway) or community health team in partnership with GPs (low pathway), with clear escalation pathways for management of acute deterioration. Support for psychosocial needs was also provided, including for those unable to safely meet isolation requirements.
 Results: 91 patients were referred in the first nine months of the pathway’s operation, however subsequent surges in cases have resulted in 172,306 referrals as of 31st August 2022. Rapid upscaling, changing public health directives, and the availability of vaccination and treatments led to major challenges and need for constant redesign. Significant developments included: the introduction of web-based symptom surveys, risk stratification modifications incorporating vaccinations and variants of concern, streaming lower-risk patients to usual care outside the pathway, and use of logistics services to aid distribution of monitoring equipment and medications. Significant opportunities for hospital avoidance were observed, along with minimal adverse outcomes and a high level of acceptability for patients and carers as well as staff.
 Learnings: Collaboration across the partner organisations, including daily huddles with a non-hierarchical structure, was key to the success of the program. Virtual care, including use of information systems (Covid Monitor platform) emerged as essential to scalability. The pathway was successfully decentralised and integrated within community health and Alfred Health’s core models of care in September 2022 to ensure sustainability.

Assessing Knowledge, Usage, and Perceptions of the Frazier Free Water Protocol: A Pilot Study

IntroductionDysphagia is very common among hospitalized patients and is associated with increased length of hospital stay, morbidity, and mortality. Diet restrictions for dysphagia cause dehydration and discontent. The Frazier Free Water Protocol (FFWP) was developed to improve hydration and quality of life in dysphagia patients by establishing the safety of allowing sips of water between meals. Despite these potential benefits, we hypothesized that the FFWP is not widely utilized. We sought to determine barriers to utilization by assessing the familiarity, usage, and perceptions of the FFWP among health-care providers at our institution. MethodsWe distributed an anonymous questionnaire to a convenience sample of nurses in the hospital during daily huddles. The questionnaire was adapted from a validated framework to assess provider acceptability of health-care interventions. ResultsOf the 66 surveys distributed, we had 58 completed (88%). Only 10 nurses (17%) had heard of the “FFWP” by name. For those that were familiar with the indications, benefits, and risks of giving free water to patients with dysphagia (n = 18), less than half (39%) reported doing so. No nurses that had less than 10 y of patient care experience gave water to dysphagia patients, even if they knew the indications, benefits, and risks. Similarly, less than a fifth (19%) of all nurses surveyed were comfortable giving water to dysphagia patients, but comfort increased for some if the protocol was recommended by a speech-language pathologist (33%) or physician (13%). Nursing experience of >10 y or in intensive care settings did not yield significant differences in knowledge, usage, or comfort level than those with less years or nonintensive care experience, respectively. ConclusionsNurses are essential to the implementation of the FFWP, yet many are unfamiliar and uncomfortable with utilizing it. Education about the protocol is necessary to improve patient outcomes and quality of life. We plan to provide targeted education about the FFWP as well as assess other members of the health-care team, in an attempt to increase utilization of the protocol and improve dysphagia management.

Assessing the Sustainability of Initiatives Aimed to Enhance Patient Safety Culture: A > 10-year Experience with Multifaceted Interventions

Culture is a key factor in maintaining high-quality care. We have instituted a series of mutually-reinforcing initiatives aimed to improve operations, and patient and staff safety. We herein review the impact of these initiatives on our Patient Safety Culture over 14 years. We hypothesize that these initiatives can lead to sustained improvements in Culture. In ≈ 2009, our department, with help of dedicated quality improvement coaches from our internal Division of Healthcare Engineering (with knowledge of Lean-Six Sigma and High Reliability methods and tools), instituted (and largely sustained) initiatives aimed to improve our operations, and to improve patient/staff safety; including: (a) daily multidisciplinary team huddles, (b) daily pre-planning/treatment peer review, (c) a robust Incident Learning System, (d) weekly meetings to review reported incidents, (e) monthly department-wide meetings to review the highlights from the weekly incident review meetings, (f) celebration/recognitions for staff participation and (g) leader Gemba walks. Culture was quantitatively assessed via the AHRQ (Agency for Healthcare Research and Quality) Patient Safety Culture Survey (with 51 questions) which was sent to the department every two years (2021 was skipped due to Covid). Changes in the summary survey results over time were assessed using 2-tailed chi-square. Within 2-4 years of starting of our initiatives, there was an increase in the number of survey respondents, and an increase in the % of favorable responses (vs. pre-initiative data from 2009), for most comparisons (see Table with representative data). The % favorable responses plateaued in ≈ 2013-2015, and there was a non-significant decline in % favorable responses in later years (vs. the high scores in 2015). A series of mutually reinforcing initiatives aimed to improve operations, and to improve patient/staff safety, can lead to improvements in Patient Safety Culture; and these improvements can be largely sustained over time. Some of the modest non-significant decline in later years may reflect staff changes, fatigue, increasing practice complexity, financial pressures, and/or Covid-related issues (in the 2022 survey). This speaks to the importance of maintaining quality/safety initiatives through transitions in leadership, staff and external stressors.

Daily huddle best practice: An Evidence-Based guide.

Daily huddles positively influence staff satisfaction and perception; standardization of a daily huddle should be prioritized to benefit from its effects. The aim of this project initiative was to implement an evidence-based, standardized daily huddle on an inpatient medical-surgical oncology unit. A searchable question was developed, and the identified literature was critically appraised and synthesized for evidence-based recommendations. The recommendations for the structure and content of a daily huddle were implemented using a standardized format. Pre-implementation and post-implementation staff perception and satisfaction surveys yielded positive results. Improvements in effective communication and staff satisfaction were identified. An effective daily huddle is essential for communicating pertinent information that can affect workflows and patient safety, as well as promoting teamwork and staff satisfaction.

A Safety Huddle Intervention in In-Patient Surgical Units: A Mixed-Methods Study

Open communication about patient safety concerns is necessary to enable a learning environment where lessons can be learned to improve patient safety, but nurses often hesitate to speak up even in situations where their patients may be at risk. One way to create a safe environment for speaking up is through the use of unit-level daily huddles. This study aimed to assess the effects of a 12-week huddle intervention on nine unit, nurse and patient care outcomes and describe nurses’ experiences with the intervention. We used a single group, pre- and post-test mixed-methods design, with a dominant quantitative thread, and a final sample of 89 staff nurses. The intervention was conducted in four surgical units in a tertiary teaching hospital in Seoul, Korea. The intervention included two educational workshops for huddle leaders, two workshops for staff nurses, and 12-week huddles with coaching visits. We collected quantitative data on nine outcomes using online surveys before and after the intervention and qualitative data on nurse experiences of the intervention after the intervention. Paired t-tests were used for quantitative data analysis, and content analysis was used for qualitative data. We examined four unit-level outcomes (organizational learning, situation monitoring, mutual support, and speaking-up climate), three nurse-level outcomes (promotive and prohibitive voice behaviors and job satisfaction), and two patient care outcomes (patient safety and quality of care). Significant improvements were found in six of the nine outcomes. Findings from the qualitative data confirmed the benefits of the intervention but also identified challenges to huddle participation. Patient safety huddles can contribute to a learning environment by flattening hierarchies and encouraging nurses to speak up regarding safety issues. Leadership is a key in role modelling and creating the foundation for a more collaborative patient safety culture in healthcare organizations, for example, through the use of daily huddles.

Daily Huddle: Navigating the Complexities of a Women’s Health Clinic

Health care is a complex field with extremely high stakes for patients. This review examines the benefits of implementation of the daily huddle in a women’s health clinic. Huddles can increase patient safety in multiple ways such as improving communication, preventing errors and adverse events, and improving situational awareness of the care team. In our program, huddles were an effective tool on a daily basis and were especially crucial in system implementation and during the coronavirus disease 2019 pandemic. This review also examines factors that can negatively influence huddles and suggestions to improve implementation.

Improving Reporting Culture Through Daily Safety Huddles.

A major obstacle to safer care is lack of error reporting, preventing the opportunity to learn from those events. On an acute care unit in a children's hospital in southeastern United States, error reporting and Survey for Patient Safety Culture (SOPS 1.0) scores fell short of agency benchmarks. The purpose of this quality improvement project was to implement a Safety Huddle Intervention to improve error reporting and SOPS 1.0 scores related to reporting. Marshall Ganz's Change through Public Narrative Framework guided creation of the project's intervention: A story of self, a story of us, a story of now. A scripted Safety Huddle was conducted on the project unit daily for 6 weeks, and nurses on the project unit and a comparison unit completed the SOPS 1.0 before and after the intervention. Monthly error reporting was tracked on those same units. Error reporting by nurses significantly increased during and after the intervention on the project unit ( P = .012) but not on the comparison unit. SOPS 1.0 items purported to measure reporting culture showed no significant differences after the intervention or between project and comparison units. Only 1 composite score increased after the intervention: communication openness improved on the project unit but not on the comparison unit. Using a Safety Huddle Intervention to promote conversation about error events has potential to increase reporting of errors and foster a sense of communication openness. Both achievements have the capacity to improve patient safety.

Perceived Impact of Affect Labeling and Social Sharing in Healthcare: Insights from a Pilot Study and Opportunities for Future Investigation

Perceived Impact of Affect Labeling and Social Sharing in Healthcare: Insights from a Pilot Study and Opportunities for Future Investigation

Inpatient Neurology Huddle Quality Improvement Project (P3-7.006)

<h3>Objective:</h3> To implement a standardized huddle checklist that includes the important patient related issues that need to be addressed daily during inpatient neurology huddle and to assess the level of satisfaction of neurology health care providers about daily huddle flow both before and after implementing the checklist. <h3>Background:</h3> Inpatient interdisciplinary medical team members’ daily huddle is a meeting at which key issues related to patient care and management are discussed among medical team members. Clear communication is important for good patient outcome as well as health care providers satisfaction. Daily huddle improves patient care, safety, and outcomes by facilitating direct communication among all key members involved in patient care. <h3>Design/Methods:</h3> Using Survey monkey, a pre-implementation data was collected to assess the level of satisfaction of the healthcare providers with huddle flow and patient safety. Post-implementation data collected after 9 months of standard checklist implementation. Descriptive analysis was performed for survey results. <h3>Results:</h3> 33 health care providers participated in the pre-implementation survey: 10 (30.3%) nurses, 20 (60.6%) physicians, 2 (6.06 %) case managers, 1 (3.03%) social worker. 32 health care providers participated in the post-implementation survey: 11 (34.38%) nurses, 17 (53.13%) physicians, 2 (6.25%) case managers, 2 (6.25%) social workers. Prior to checklist implementation, 13 (39.39%) of the participants were satisfied with overall huddle flow. After checklist implementation 25 (78.13%) were satisfied with overall huddle flow. Regarding overall patient’s safety as a result of daily huddle, 14 (42.4%) of the participants were satisfied, 5 (15.15%) were dissatisfied and 14 (42.4%) were neither satisfied nor dissatisfied prior to checklist implementation. After checklist implementation, 24 (75 %) were satisfied, 2 (6.25%) were dissatisfied and 6 (18.75%) were neither satisfied nor dissatisfied with the overall patient’s safety because of daily huddle. <h3>Conclusions:</h3> Our data suggest that standardized huddle checklist improves provider’s satisfaction with huddle workflow and patient safety. <b>Disclosure:</b> Dr. Matloub has nothing to disclose. Dr. Carter has nothing to disclose. Dr. Wang has nothing to disclose.

Design of a Nursing Home Infection Control Peer Coaching Program.

To pilot test and refine an infection control peer coaching program, Infection Control Amplification in Nursing Centers (ICAN), in partnership with providers. Intervention design and pilot test. Infection preventionists (IPs) from 7 Connecticut nursing homes (NHs). We codesigned and pilot tested the ICAN program with NH IPs. The initial program involved designating peer coaches to provide real-time feedback on infection control practices to coworkers and targeting coaches' observations using data from both observations shared by coaches in daily huddles and weekly audit data about hand hygiene, masking, and transmission-based precautions. IPs tested the initial program while providing feedback to the research team during weekly calls. We used information from the calls, participant surveys, and the pilot process to update the program. Despite IPs reporting that the initial program was highly aligned with facility priorities and needs, their weekly call attendance dropped as they dealt with short staffing and COVID-19-related outbreaks and none implemented all of the program's components as intended. Most IPs described making changes to increase feasibility and reduce burden on staff amid short staffing and other ongoing issues exacerbated by the SARS-CoV-2 pandemic. We used information from the IPs and the pilot to update the program, including shifting from having IPs lead implementation solo to using a team-based approach. The updated program retains peer coaches and audit data, while broadening the mode of feedback from huddles only to communication using one-on-one meetings or emails, huddles, or other strategies. It also provides NH staff with flexibility to tailor implementation of each to their needs and constraints. Working with staff, we developed an infection control peer coaching program that may be of use to NH leaders seeking strategies to strengthen infection control practices. Future work should involve implementing and evaluating the updated program.

Quality Improvement Report: Improving Pre- and Postprocedure Care Area Workflows at a Busy Urban Academic Hospital Using Lean Management Principles

Radiology procedure workflow is a summation of individual workflows for scheduling, precertification, preprocedure clinic visits, and day of procedure, representing a complex total process with many opportunities for inefficiencies and waste. At the authors' institution, a lack of standard work and communication gaps in a pre- and postprocedure care area (PPCA) workflow were identified as factors in bottlenecks, waits and delays, and staff and patient frustrations. Using "lean" process improvement tools, these workflows were targeted in a rapid improvement event (RIE). A cross-functional team was formed to work on the PPCA workflow RIE. Using lean management principles, process gaps were identified and changes were instituted to improve patient and information flow. Three projects were implemented over a course of 4 months. These included a 5S, a lean methodology of workplace organization to optimize supply cabinets; standardization of nursing preprocedure documentation and process; and standard work confirmation in daily management system huddles. At baseline, 45% of patients were prepared within 60 minutes of their arrival in the PPCA. After the RIE and instituting the changes from the RIE, 80% of patients were prepared within 60 minutes of their arrival in the PPCA. Implementing lean management strategies, such as daily management systems and huddles, and establishing standard work confirmation help to eliminate waste and create systems and teams that sustain and improve complex workflows. © RSNA, 2022.