Case study: Ward safety huddles

Consultant Alison Cracknell is a long-time champion of improvement and when Leeds Teaching Hospitals NHS Trust needed to step up its improvement approach following a CQC inspection, Alison grasped the opportunity to empower and support frontline staff to lead improvements.

She has been involved in a number of improvement projects, most notably the introduction of ward safety huddles. These were tested on 10 wards, and demonstrated reductions in harm and improved safety culture. As a result, the trust looked to see how they could do this at scale across the organisation. The trust was awarded a Health Foundation Improvement grant to see if they could scale up improvement do this on every ward. The huddles support frontline teams to learn how to successfully adapt the principles of the huddle into their clinical context.

The ward team meet for 5 to 10 minutes, to focus around the patient safety concerns of the day such as falls, pressure ulcers and avoidable deterioration. They review data and learning, for example to understand how the last patient fell.

They help teams continually learn and improve. The huddles include regular measurement of progress and celebration of success. Ward staff also report that they foster competition between wards, for example on the number of days they go without a patient falling. Posters are displayed that record days since the last harm event and improvement run charts show progress. Teams get certificates when they achieve milestones.

As of April 2018, 91% wards have embedded safety huddles into routine practice, with 45% of those having seen step reduction in falls. Improvements in ward level safety culture across the organisation have also been demonstrated, alongside a trust-wide step reduction in cardiac arrests.

Senior Sister Sally Rollinson White says the huddles on her ward include physiotherapists, nurses, doctors, non-clinical staff and case support workers, while Senior Sister Kate Varley says they make the ward feel like a safer place to be – her ward clocked up a remarkable 98 days without a fall last year.