At Martin's Point Healthcare in Bangor, Maine, huddles started as informal meetings between a single clinician and his clinical support team to improve communication. Ten years later, that simple meeting has evolved into a 10- to 15-minute, high-energy meeting at the beginning of each clinic day—where the entire practice arrives ready to discuss to the day's plan. Paula Eaton, the clinic's administrator, has been a key champion of this evolution. She recalls, “At the first official huddle, even the doctor didn't show up. I had to keep asking, ‘How can we make this useful to the team?'” She cites this question as critically important to developing the level of engagement seen in their daily team huddles. She describes huddles as, “what we are doing today and how that is moving us closer to our goals.” “Every day is an opportunity to make improvements,” she adds.
Martin's Point Healthcare huddles are each morning before the start of the clinic session. The agenda is set using a template that undergoes revision approximately every three months. The minutes for each huddle are recorded electronically and emailed to the team.
Huddles start with an understanding of capacity: how many appointment slots are open, what the staffing levels are, and who is working with whom. This is summarized in the huddle minutes as “today's constraints.” This is followed by a brief summary/recap of patient complaints or concerns from the previous day, such as a patient who was unhappy with a delayed appointment. This allows the team to quickly delegate a team member to address service recovery and maintain patient satisfaction scores. The team then shares “WOWs,” or shout-outs about those who have made a notable contribution to clinic. Ms. Eaton notes that the team highly values WOWs. They make a noticeable impact on teamwork, team appreciation, and team culture. As huddles evolved, the team moved WOWs to the end of the agenda so they would not take time away from the other important items on the huddle checklist.
The huddle model at Martin's Point Healthcare has met challenges over the years. A meeting facilitator role was created to keep huddles on track by tabling and recording issues that required longer discussions for team meetings. Ms. Eaton notes, “Huddles are not really meetings; the team makes the plan, then off we go.” When huddles drag on, the team found that people lost interest and focus. Initially, the huddle leader role rotated amongst team members, but the team has become comfortable with one patient-service representative taking on this role.
Ms. Eaton adds, “Huddles can be as simple or complex as you want them to be. If people find huddles useful, the time will be there. Time is always a constraint; it's how we utilize it that gets people to attend/participate. Making huddles mandatory is beside the point.”
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