Could you imagine a football team that didn’t huddle before a big play or a basketball team taking to the floor during a championship game without huddling with their coach and teammates? No way! So why do we as providers and care teams take to the clinic floor without even a quick review or check in with each other?
The best way to take control of each clinic session is to begin each one with a quick, focused, strategic huddle. I know, I can hear you saying, “I don’t even have time to grab a quick cup of coffee before I get started with my busy day!” But remember, if we want great results, we’re going to need tight teamwork and some “perfect planning” to get them. Keep in mind, “if you fail to plan, then you plan to fail.”
A huddle is not complicated or time consuming. A good huddle can be done in as little as 15 minutes. It does require everyone to show up on time, which means, if your first appointment is at 8:30 am everyone on the patient care team must show up at 8:15 am to begin the huddle. Most teams build their huddle time into their work schedules.
Let’s look at what is needed for a successful huddle:
- All team members present (typical teams include the provider, MA, nurse, front office member, and a flow coordinator)
- Everyone is on time!
- A place for the team to meet with room for charts (if you are still using paper charts) or with a couple of computers available (for electronic medical records) for the team to use.
- Intense and purposeful focus. No interruptions! Do not be distracted by phone calls, emails, or other staff.
- Proximity! A team shouldn’t spread out in a room sitting in chairs to huddle. Imagine how sports teams huddle. They get up close, heads together, and speak to each other with focus and energy. Try to mimic this kind of huddle.
Once these elements are in place, the huddle begins.
Here is how a typical huddle discussion might go:
Provider: “Our first patient is Joe S. He is coming in for a diabetic follow up. According to his labs, Joe is having a hard time controlling his blood sugars and his weight.”
MA: “Should I ask the dietician to talk to him while he’s here so they can set up a counseling session?”
Provider: “That’s a good plan. Let’s see if she’s available right after this huddle, maybe she can come in to the room right after I finish with the visit. Let’s also see if we can get a glucometer for him because it looks like he told me last time that his other one broke.”
Nurse: “I’ll get one from the supply closet and show him how to check his blood sugars regularly.”
Flow Coordinator: “I see that you have Alicia M. scheduled right after Joe. She’s Spanish speaking only. She seems to always take a lot of time. Let’s have Leti (the Spanish speaking MA) take her back and see if we can figure out what her biggest concerns are today. If I see that you start running behind with her, are there any patients you’d like me to route to your nurse or another provider?”
Provider: “Yes, Mike H. is just coming in for a follow up on his blood pressure. We started him on some new medication and I see that his labs look good so route him to the nurse and she can check his blood pressure. If everything looks good, ask him to come back in 3 months. Looks like he’s also due for a tetanus shot, can we get that to him today if he wants? Also, he probably needs that pamphlet on aging care and colonoscopies. He’s turning fifty next year and I’ll want to get him checked…let’s mention that to him to get him thinking about it.”
Nurse: “I also see that the patient coming in at 9:30 is coming in for a well woman exam. Why don’t I get all of her vitals and history and by the time you’re finished with Alice, your 9:30 patient will be ready for you.”
MA: “When I called that patient last might to remind her of her well woman exam, she told me she was having burning when she urinated.
Provider: (to nurse) “Can you then go ahead and get a urine on her when she arrives so I can have the result before I go in to see her?”
Nurse: “Sure. She seems to get those infections a lot. I think I’ll get her some educational material as well.”
As you can see, these discussions are not a boring recitation of the contents of a patient’s chart, but rather a strategic planning session. In this example, you will notice that everyone contributes to the discussion of the patient and offers ways to utilize resources available in the clinic to meet the patient’s needs. The team also anticipates potential problems that might come up during the clinic session and strategizes how to handle them. It is so much calmer planning for these bumps before they happen rather than dealing with them in the midst of seeing patients, isn’t it?
One last thing about the huddle… it also serves as an opportunity to do a quick check-in with each team member. How is everyone feeling today? Is anyone leaving early? Is anyone out today? How can we support each other through the session, etc… Don’t underestimate the importance of this brief check-in. A high performing team makes it a point to know the status of each team member because they know that everyone is critical to the success of the team. If one person is going to be out or is feeling under the weather that day, the huddle is the team’s chance to problem-solve and decide how best to allocate their resources.
So is the Patient Care Team Huddle for you? Give it a try! Don’t get us wrong, it will take discipline and a consistent effort because others on your team may not be on board right away to the idea. The best way to get buy-in is to show everyone the benefits of the huddle. Those benefits include improved efficiency, superior performance, increased communication, and a well-oiled team that is ready to take charge of the day. If these sound good to you, then what are you waiting for? Let’s get ready to huddle!