Authors (including presenting author) :
Yeung YW(1), Lee WSB(1), Kwong KYT(1)
Affiliation :
(1) Princess Margaret Hospital
Introduction :
Instead of requesting colleagues to follow detailed work instructions meticulously, it is better to empower them with situational awareness to recognize events around them, to act correctly when things go as planned and react appropriately when they don’t. Safety culture re-engineering via team safety huddles emphasizes team sharing and learning. Frontline colleagues are empowered with situational awareness and decision making to speak up their concerns, errors or near misses, risks and improvement measures quickly to minimize harm to patients. From Dec 2018 till now, a safety culture re-engineering project through daily nursing team safety huddles has been started in all PMH Paediatric wards.
Objectives :
1. To enhance situational awareness and real time communication of daily events among nurses and PCAs.
2. To build a safety culture in all Paediatric wards.
Methodology :
Phase one had adopted a “Pre-test” vs. “Post-test” design to introduce the concept of “Daily Team Safety Huddles” and Situational Awareness (SA) in all PMH Paediatric wards in Dec 2018. A poster with focus on Situational Awareness For Everyone (S.A.F.E) and “See it, Say it, Fix it” was designed to encourage all staff to “Speak up” for safety. A quick reference guide was designed to let staff familiarize with the daily huddles at fixed place and time. Pre- and post-staff surveys were conducted immediate and one year after staff training. Phase two was started since 2019 to consolidate and sustain the cultural change. Strategies included statistics of daily huddles and quarterly sharing of good practices within the department.
Result & Outcome :
Four identical training sessions with total 162 nurses (99%) and 48 PCA (100%) were trained in Dec 2018. Pre and post staff surveys had demonstrated increase understanding of Situational Awareness (p<0.001). Up till now, more than 9,000 episodes of safety huddles were conducted in five Paediatric wards. Average daily huddles attendance per ward is ~ 15 staff (66% nurses, 34% PCA). Good practices were shared to department colleagues quarterly. Safety culture in Paed&AM was consolidated gradually and our team was awarded champion of “PMH Most Reliable Unit” in 2023/24 & 2021/22 and PMH Hand Hygiene Compliance Outstanding Award since 2018. In conclusion, daily team safety huddles are good platform to cultivate safety culture by empowering front-line colleagues with situational awareness to speak up for the safety of patients.
