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Implementing Huddles Improves Care Coordination in an Academic Health Center
Carolyn S Townsend1, Mary McNulty, Adria Grillo-Peck
1Carolyn S. Townsend, DNP, RN, CPHQ, LSSBB, has more than 20 years of experience in quality improvement, specializing in improving patient flow and reducing readmissions. She is currently Assistant Professor of Nursing at Indiana University Kokomo School of Nursing, as well as clinical educator and case manager at Indiana University Health. Mary McNulty, MSN, RN, has practiced case management in a variety of settings for 20 years with a continually expanding focus on patient-centered care and developing the roles of the patient and family in plans of care. She is currently the Director of Integrated Care Management at IU Health Methodist and University hospitals. Adria Grillo-Peck, MS, RN, CMC, CNS, serves as Vice President of Integrated Care Management for Indiana University Health. She is responsible for the strategic vision of this division through planning, directing, and coordinating initiatives around access, throughput, quality and patient safety, customer service, physician integration, financial stewardship, and consistency of practice. Ms. Grillo-Peck has several years of case management experience with expertise in length of stay management and readmission avoidance strategies.
Purpose Of The Study:
To determine whether routinely scheduled, organized interdisciplinary huddles result in decreased length of stay and readmissions.
Primary Practice Setting:
The study was conducted in an academic health center (AHC) that also fills a community hospital need for a diverse inner-city population. Results are applicable in other care settings.
Methodology And Sample:
Daily interdisciplinary huddles were piloted on 5 medical/surgical units. The 2015 readmission and length of stay data were compared with the 2013 baseline.
Results:
There was a mean readmission reduction of 0.56%. A paired t test comparing the 2013 and 2015 readmission rates of the 5 units was significant (p < .05). There was a 0.42-day increase in the mean LOS between the 2013 baseline and the 2015 follow-up. A paired t test comparing 2013 and 2015 readmission rates of the 5 units was not significant at the .05 level.
Implications For Case Management Practice:
Daily interdisciplinary sessions can result in reduced readmissions. Long-lasting positive outcomes related to enhanced communication are possible. Requirements for success include consistency in the standard huddle content reviewed. Data should be followed closely throughout an extended period of time to identify trends and support sustainment. Creative means to obtain input from services that cover multiple units and not be able to attend huddles may be necessary. Staff turnover will impact success. Variation in physician engagement can be addressed by frequent communication on the "why" behind the significance of the huddles, as well as sharing of change data highlighting success stories.
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