Huddles 'help children's hospital care'

Doctors and nurses talking Image copyright SCIENCE PHOTO LIBRARY
Image caption Huddles can help

It's good to talk, we're always told. And now child health expert Dr Peter Lachman says "huddles" - informal meetings of hospital staff - are a simple way of improving children's hospital care.

A lot can be said for good communication - it's a simple art which if done properly can build and maintain strong relationships, improve efficiency and most of all, improve outcomes.

Done badly, it can cause uncertainty and confusion.

In healthcare, good communication is essential if we are to ensure best practice and offer patients, regardless of postcode, access to safe, high quality care at the earliest opportunity.


Currently, coordination of care across the specialties is difficult and this can contribute to extended hospital stays and repeat admissions.

This places increased pressure on the NHS which simply isn't sustainable.

I'm not saying there is uncertainty in the health system, but there is still much more that can be done to improve care.

In paediatrics, there are many professionals working in silos which is preventing nurses, paediatricians and patients and parents themselves, working together effectively.

As a consultant paediatrician, I know the value of working as part of a multi-professional team, drawing on the expertise of a range of colleagues and working in partnership with the child and family members to care for that child.

There must be a shift in attitude - from reaction to anticipation, otherwise we'll never dispel extended hospital stays and repeat admissions.

An intervention called the 'huddle' is one way of shifting this attitude.

It's a model pioneered in Cincinnati Children's Hospital around 12 months ago and one that has been adopted by a number of units in Scotland - to much praise by the Scottish Health Secretary, Alex Neil.

So what actually is it and why isn't it being used elsewhere in the UK?

Sickest children seen sooner

Image copyright Science Photo Library
Image caption Thousands of sick children could be helped by 'simple changes'

The huddle and situation awareness are new concepts in healthcare and although it sounds simple, it's actually complex to execute - it's a change from the way people think and a change in culture.

The huddle is a short exchange of information between all involved in a patient's care.

It's a meeting which can be called by anyone, at any time to enhance 'situation awareness,' by offering a platform to openly discuss patient care with colleagues, determine which patients' need to be prioritised and what the best treatment is for them.

For example, at the start of my shift there might be 12 patients.

The nurse and I call a 'huddle' - three children have just returned to the ward following surgery and another child can actually be discharged.

However two other children need urgent attention. As a result, I see the urgent patients before seeing the other 10 children.

Not only does this mean the sickest children are identified earlier and subsequently get treated quicker, it also means they can get better and can leave hospital much sooner.

It also has huge benefits to the workforce as it allows skills to be enhanced through the sharing of best practice, performance to be sustained and consistent treatment delivered in hospitals regardless of postcode.

Better care hope

The Royal College of Paediatrics and Child Health, on behalf of the Situation Awareness for Everyone (S.A.F.E) partnership, received a cash injection from the Health Foundation of £450,000 to trial a number of quality improving techniques - including the huddle - at 12 hospital sites up and down the country.

Through the development of these techniques and enhanced communication between families, patients and professionals, the project aims to reduce avoidable error and harm of up to 4,000 acutely sick children by 2016 and involve parents and patients more in their care.

We estimate that this programme could reduce deterioration of children in paediatric wards by at least 50% and decrease serious outcomes by at least 10%.

We also believe that there will be a reduction in serious incidents and a culture shift from reactive responses to proactive prevention of harm.

If proven successful, there is scope for this model to be rolled out wider so it not only improves the care of children, but improves the care delivered to adults in the UK and beyond.

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