The Healthcare Huddle Upgrade

In most Healthcare settings, daily Huddles are part of the existing routines.  These are short gatherings of key staff to exchange information and determine priorities.   Huddles meetings can take place at the beginning of the day, at shift handoffs and for various other purposes.  There might be a daily “Bed Management Meeting”.  Surgical teams may take a few minutes in a Huddle to go over the pre-op checklist.  Huddle meetings are characterized as involving the working staff in highly focused review and discussions of real time issues.

These are valuable meetings.   Most often they are “pre-emptive fire fighting” – looking just a few hours into the future as a way to prevent problems from affecting care delivery.

But what if they could be more than that?  What if they could be upgraded to become the primary focus for real process improvement?  Indeed, they already have been upgraded at multiple Healthcare Systems yielding dramatic results.  Upgrading your Huddles could generate a significant return on investment in your organization as well.

Stuck in a Lean Six Sigma Parallel Universe

As pressures for higher performance mount in the world of Healthcare, many organizations invest in a Lean Six Sigma implementation.  Typically, some selected staff is trained to the “Green Belt” or “Black Belt” level and a series of Kaizen events and projects ensue.  Alternately, external consultants may be brought in to conduct the improvement activities. Some quite useful tools from the Technical Lean Six Sigma toolbox are used to reduce costs and improve service delivery.

In actual practice, this “Technical Lean Six Sigma” rollout has proven to be  susceptible to the distressing chronic fatigue syndrome known as “Failure to Sustain”.  The improvements fail to permeate the existing culture.  They remain trapped in a kind of parallel universe, isolated from the Huddles and most of the other existing routines among the staff actively doing the work each day.

The LMS Alternative

In Healthcare Systems such as Virginia Mason, Theda-Care and Baylor-Scott-White, among others, those Huddle meetings have become the key focus of a system of process improvement known as the Lean Management System (LMS).  Operating as part of the LMS, the Huddles continue the existing function of pre-empting typical problems.  In addition, new routines are added that engage participants directly into a daily cycle of deeper improvement. Permanent improvement replaces the daily coping with the same broken processes.  Team effort and co-operation replaces individual heroics.  Instead of solving essentially the same problems over and over, the creativity and energy of those skilled Healthcare Professionals is released to take on new problems with an increasing degree of impact.

Completing the System

The upgrade of the Huddles into the Lean Management System is actually the necessary completion of the Adaptive Lean Six Sigma System.  Ultimately all process improvement is people driven and must include the working Staff.  Learning how the LMS functions takes place within the daily routines, both in and out of the Huddle meetings.  Staff members take responsibility for developing local continuous improvements.  The LMS also includes linking each area into the overall flow of the Value Stream or Service Line.  Green Belts and Black Belts now become much more valuable resources, directing Kaizen Events and Projects in ways that are more effective, timely and with improved returns.  “Failure to Sustain” is no longer a problem.

The New Huddle Routines

As the Huddle meetings are integrated into the overall Lean Management System, there are some striking differences in the meeting routine:

• Meetings are 10 to 15 minutes long and scheduled for the same time each day
• The Area Leader or Manager develops a Huddle Board that includes tracking metrics, prioritization of problems, cause-effect analysis and ongoing action items.
• Tracking metrics represent the performance of the Local Staff over the past day or week
• Every Huddle meeting takes place in front of the Huddle board.
• Staff members are invited to surface problems for discussion and prioritization
• Problems within the work area are the responsibility of the Local Staff and are worked on outside of the Huddle meeting
• Problems that go beyond the immediate working area are forwarded to higher level Staff for investigation and action.

The Impact

Most Staff members are already skilled problem solvers.  The problem is they are often stuck solving the same problems over and over again every day.  The upgraded Huddle meeting as part of the overall Lean Management System takes full advantage of this resource to prevent errors, reduce delays and eliminate waste in the processes they use every day.  For more information on how to adapt Huddle upgrades  to  your own situation contact me at AptoLean Adaptive Work Design.

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