Throughout Lancaster General Health, one similarity that can be found in every department is a huddle board. As teams gather around their respective huddle board, goals are discussed, ideas are shared and concerns are addressed.
Since adopting the Continuous Improvement model in 2015, LG Health benefits from more than 360 huddle boards to provide better patient care and execute system-wide goals.
In the spring, the 6 Lime Intensive Care Unit at LGH and the Labor & Delivery and Couplet Care teams at Women & Babies Hospital piloted a new process to optimize their huddle experience.
“As a unit, our team was huddling three times a day, seven days a week; however we were excited to be asked to expand the huddle concept to address real-time problems that arose,” shared Aimee Anderson, ICU nurse manager.
With the guidance of Performance Improvement coaches, the acute care teams have effectively implemented a real-time problem solving process, which is driving results in their respective units.
Real-time problem solving uses elements of Continuous Improvement to identify the root cause of a problem, while simultaneously responding to it. The new process has three Plan-Do-Check-Act (PDCA) cycles to solve a problem: 1) Address the immediate issue; 2) contain the situation – confirm it can’t happen anywhere else; and 3) investigate to identify and eliminate the root cause
“By evolving the way we huddle, we have made it easier for our team to voice challenges they face during their shift and prevent it from occurring in the future.
Our team adapted this process very quickly, allowing us to develop solutions within our team or with the associated departments,” explained Susan Stahl, ICU assistant nurse manager.
A challenge that the ICU team was able to solve by implementing real-time problem solving included developing a more efficient process for pre-surgery paperwork. These changes ensure that patients’ pre-surgery consent forms are properly completed and scanned into EPIC prior to surgery, resulting in a better work-flow.
The Labor & Delivery and Couplet Care teams have also experienced success in using real-time problem solving. Most recently, they have implemented changes to the newborn glucose monitoring process and newborn ID bracelet templates to improve patient care and safety.
“Our leaders have prioritized learning real-time problem solving, which is key to the success of this initiative,” explained Alyssa Livengood Waite, director nursing, Women & Babies Hospital. “The PI coaches have been instrumental in helping our teams integrate the real-time problem solving into our huddles. Our teams are invested in the process, which is driving long term results for our patients.”
Leaders for both units shared that real-time problem solving success begins with leaders providing the opportunity for staff to share their concerns, but for it to be truly effective, each member of the team must be involved and engaged. They also commended the PI coaches for helping them improve patient safety. The PI team shared that throughout Fiscal Year 2020, the real-time problem solving process will be expanded to additional teams throughout the health system.