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Medical Safety Huddles in Rehabilitation: A Novel Patient Safety Strategy

  • Meiqi Guo
    Correspondence
    Corresponding author Meiqi Guo, MD, FRCPC, 10th Fl, 550 University Ave, Toronto Rehabilitation Institute, Toronto, ON, Canada M5G2A2.
    Affiliations
    Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON; and the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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  • Gaetan Tardif
    Affiliations
    Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON; and the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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  • Mark Bayley
    Affiliations
    Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON; and the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Published:October 10, 2017DOI:https://doi.org/10.1016/j.apmr.2017.09.113

      Highlights

      • Medical safety huddles are a novel strategy to engage rehabilitation physicians.
      • Huddles increase situational awareness of anticipated safety issues.
      • Huddles supplement preexisting patient safety strategies with the medical perspective.

      Abstract

      Objective

      To describe the implementation process, outcomes, and lessons learned in the implementation of medical safety huddles, a novel patient safety monitoring strategy that promotes physician engagement with patient safety.

      Design

      Single-center observational study.

      Setting

      Brain and spinal cord injury rehabilitation program at an urban, academic adult rehabilitation hospital.

      Participants

      Physicians associated with the program (N=18).

      Interventions

      Weekly physicians' safety huddles were implemented to review, anticipate, and address patient safety issues.

      Main Outcome Measures

      Main outcome measures were the number and nature of identified and anticipated patient safety incidents, actions taken, and physician attendance during huddles. The number of adverse events in the program before and after huddle implementation were secondary measures.

      Results

      Over a 7-month period, average physician attendance at medical huddles was 76.0%. There were 1.0±0.8 patient safety incidents and 3.2±2.1 anticipated patient safety issues identified in each weekly huddle. Most patient safety incidents identified were clinical administrative and clinical process related, which differed from information gathered from the organization's preexisting patient safety monitoring strategies. A total of 79 actions, or 3.3±1.8 actions per huddle, were taken in response to improve patient safety for the program. Adverse events decreased from 31.2 (95% confidence interval [CI], 27.0–35.3) to 22.9 per month (95% CI, 19.3–26.5) after implementation.

      Conclusions

      Medical safety huddles are a novel strategy to engage physicians in patient safety and organizational quality improvement. They have the potential to enhance organizational anticipation of safety risks by supplementing existing methods. Other rehabilitation settings may wish to consider implementing and evaluating similar huddles into their existing patient safety and quality improvement frameworks.

      Keywords

      List of abbreviations:

      CI (confidence interval), TRI (Toronto Rehabilitation Institute), UHN (University Health Network)
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