Dos and Don’ts of Implementing a Daily Huddle

Posted on 09/09/2019 by CATALYSIS

A daily huddle can go by many names; improvement huddle, performance huddle, just a huddle, whatever you want to call it. No matter the name, there are many reasons to implement a daily huddle; for example, to facilitate continuous daily improvement, engage your team in problem solving, and help your team understand the importance of their work in achieving system objectives. One of the important characteristics about a daily huddle is that it gives an outlet to surface defects in daily flow.

If you are thinking about implementing a daily huddle in your area or unit here are some things you should keep in mind:

Dos

Connect the driver metrics to the work of those on the frontline - The daily huddle is a great place to show front line staff how their work impacts the organization’s True North metrics. This is done by tying the improvement ideas to True North and reviewing area metrics. Encourage staff to consider which area of True North improvement work will impact to help them start to see connections.
Include a process for managing improvement ideas – Hopefully once your team starts huddling daily, they will generate many improvement ideas. It is impossible to work on all of these at once on top of the daily work of taking care of patients. So, you are going to need a process. Set your standards for how many improvements your team can work on at once. It is also helpful to note the owner of each improvement so you will know who to go to for status updates. and to write in dates or use a calendar to note the next follow up, so you are not covering the same information each day. This will also help you stay on time.
Create a process to prioritize work - Once you have determined how many improvements your team can tackle at one time you will need to create a way to prioritize the work. The main elements that should factor into the priority level are impact on True North metrics and difficulty level to implement. Most often teams use some form of a pick chart with categories possible, implement, challenge, and kibosh. The implement and challenge categories are ideas that would have a high impact, while possible and kibosh would have a low impact. Improvements that are easy to do would be in implement or possible, and those that would be more difficult go into challenge or kibosh. Work on the ideas that have the highest impact on the metrics you are measuring in your area.
Allow time for staff to work on improvements – Allowing time for staff to focus on improvements is vital to the success and engagement in the daily huddle. If staff feel overwhelmed and over worked when they get assigned to work an improvement idea, they will probably stop bringing up ideas or defects or owning any improvement work. In addition, if there is no time to do improvement work the impact will be slow which will make it difficult to keep staff engaged in the huddle.
Use huddles as a coaching opportunity – The daily huddle is a great place to coach staff on problem-solving and PDSA thinking. Asking open-ended humble questions can help them refine their thinking and allow them to see the problem through a clearer lens.

Don’ts

Don’t let huddles become punitive – Remember the purpose of the huddle is to engage your team in problem solving and encourage them to surface defects in the work. Making the huddle feel punitive is not going to achieve the desired outcome. Consequently, it is important to celebrate each defect that is brought up. The huddle is not the place to overreact and ask how this could have happened, but rather it is a place to realize that a problem has occurred that needs to be solved. Also, be clear that you want everyone who is available to participate in the huddle but understand that the patient comes first and there may be times staff will need to miss it.
Don’t problem solve in the huddle – All team members are busy doing their daily work. It is important that if you say the daily huddle will last fifteen minutes you stick to it. Some teams even start a timer at the beginning of the huddle to ensure they adhere to the standard time. Often when a huddle lasts longer than the designated time it is because the staff has begun to problem solve in the huddle. While it is fantastic that the team is engaged in solving a problem, taking up too much time is not respectful of others on the team and it could be robbing the opportunity owner of the chance to develop their problem-solving skills.
Don’t take on too many improvements at one time – It may take some experimentation to determine the right amount of improvement opportunities for your team to work at one time. Many factors play into this formula, like problem-solving skill level, engagement in the continuous improvement mindset, and amount of daily work for your team. If you see that progress is slow on the improvement opportunities that the team is working, or that engagement in the huddle is diminishing, this could be a signal that you are working too many improvement ideas at once.
Don’t let the huddle become stagnant – If you notice that engagement is declining it may be because the huddle is becoming stagnate. Maybe the team is not seeing the impact of their work, maybe your staff is overwhelmed with the amount of work coming out of the huddle, or perhaps team members are not feeling challenged by the improvement work they are doing. Decreasing engagement from the team could be a sign that the huddle is getting stagnant. If it is, try to change it up.
Don’t forget to celebrate wins and learning – Remember to celebrate the hard work of the team and the impact that it is making for the patients, staff, and on the True North metrics. Celebrating wins and successes is a great way to keep the team engaged and reinforce that what they are doing has an impact. It is just as important to celebrate failures because each time we fail, we learn, and the learning helps us become better problem solvers.

After you have started regular huddles look for signs that it is working. Some signs are that the team is engaged, the team talks more than the leader, people are willing to own the work, progress is being made, and there is evidence that the scientific method is being used for problem solving. Remember that the success of the daily huddle is dependent on follow-through, the time commitment, removing barriers, and progressing improvement work.

Now go get started! Prepare your visual management, prepare your team, set your business rules, and start to huddle daily.