Being prepared for a busy clinic session is an essential part of any high-performing practice, particularly one that sees patients with complex health care needs. Implementing daily team huddles is an effective strategy to prepare physicians and practice staff for the day and maximize the quality and quantity of time that can be spent with patients.
In an episode of the “AMA Moving Medicine” podcast, AMA Chief Experience Officer Todd Unger is joined by Marie T. Brown, MD, a geriatric and internal medicine specialist at Rush University Medical Center, in Chicago, to discuss how to boost practice productivity and team morale by implementing a daily team huddle.
Unger: Thank you so much for joining us today.
Dr. Brown: Great to be here.
Unger: Today we're going to talk about implementing daily team huddles. Let’s start with the basics. What are they and why are they important?
Dr. Brown: A daily team huddle is a time for the whole team to come together, even briefly, at the beginning of the day or the beginning of the clinic session. It may be once a day, it may be twice a day, and it can be as brief or as long as the team feels is necessary. It's a time to check in, both personally and to prepare for the important work we do, taking care of patients.
For our team huddle, which we do in the outpatient setting, we'll check in and just see how everybody's doing amongst the team. How are the kids? Anybody have a big test that day? Is school let out early? How's mom? How's everybody? How's everybody's personal life? The physicians might have a phone call that they have to be away from, or they might have to step out of the office, or somebody might have something that they're worried about that day and they might be a little distracted. So, it's important for the team to develop trust amongst themselves and to make sure that everybody knows what's going on in each of their personal lives.
So, in addition to making sure that the team members understand what's going on in each other's lives, it is a time to look at the patients that we're going to see that day and recognize whether a patient may need additional service or the team needs to understand something about that patient that isn't readily apparent on the schedule.
For instance, in my office somebody might say, "We need to make sure the interpreter's service is available for this patient," or, "Let's make sure we have the large room, because that person has a wheelchair and they're bringing two of their family members." That makes the whole day, and efficiency of the day, much better, so that we can all see patients on time and finish on time and get home to our own families for the second job of the day, for most of our team members.
Unger: What are the most important steps for effective huddles?
Dr. Brown: Well, the most important step to develop an effective huddle is to get the buy in. With anything, you have to answer for each member, "What's in it for me?" Some people abbreviate that WIIFM, I have discovered. Unless you can answer that for every single person, the receptionist, the medical assistant, the IT person, if they're there that day, the social worker, the mental health worker, it's not going to be very effective.
They're going to feel that there's nothing in it for them, this is just one more thing they have to do that day, so discussing the value of the team huddle and helping them discover what is in it for them is critical. What's in it for them is probably that they'll be better prepared to see the patients, the flow of the day will go more easily, patients will be more satisfied, patients won't be angry because everybody's running behind and they'll probably be able to get out on time feeling that they did a good job that day.
Most of the team has places to go after they leave work, often to pick up a child from daycare, or to take care of a parent, or to get dinner on the table, so it's sometimes forgotten that there's aspects of the team huddle that allow us all to have a more joyful day and to be more joyful and happy when we actually see our patients, because the work we do is so important.
Unger: How do you go about establishing a routine for the huddle?
Dr. Brown: So, establishing a routine is paramount. If everyone knows that at five [minutes] to 8 we gather around at the center of the clinic and just do a quick check in, then everybody's going to be there on time. The important thing is that everybody is there on time. If the physician comes late, then they've wasted the time of the rest of the team. So if everybody values the huddle, they'll start on time and they'll finish on time.
Unger: How do you make time for a new process?
Dr. Brown: Making time for any new process is a challenge, and you just give it a try and say, "Let's do this for a week, and then let's meet up again next week and decide whether it was helpful or not." Chances are, when you meet up the following week, everyone will have something positive to say. It may be, "Wow, it would have taken us half an hour to get the interpreter, and because we knew that person was coming, we were ready," or, "I didn't know that a team member was struggling with their child being sick at home, and I understood when she was short that day or had to get on the phone to talk to the school."
It's iterative. Try it, see what works, see what doesn't, meet up again and be open. The important thing for the leader is to listen, to make sure that everybody weighs in on what the experience was, so that it can get better and everyone can say exactly what's in it for them. But the bottom goal is that we're all prepared to take the best care of our patients that day.
Unger: Speaking of a leader, how do you designate roles within the huddle?
Dr. Brown: Well, some teams designate the leader as the physician. Some people will rotate. Often it is the receptionist who has their finger on the pulse of everything that's going on amongst all the team members. They know when lunch is, they know who's leaving early, they may know the flow of the patients, they may see the need for a larger room, for a wheelchair, that sort of thing.
So, it really is the best person, sometimes rotating it. You might not know who the best person is until you rotate it, so rotate the leadership. Initially, you might decide that you're going to rotate the leadership. Some members may be uncomfortable with that, but more often than not, you'd be surprised at who is a very good leader, and then that person may take that role on for the rest of the year or the month. But you never know until you try.
Unger: You mentioned that this is an iterative process. How do you ensure huddles evolve and improve over time?
Dr. Brown: Ensuring that huddles evolve and improve over time is critical. The leader should ask the team members how huddles can be more useful for them and their patients. You might get somebody from another clinic who has found that it's useful, and that other person from another clinic might share their experience and how it helped them. They might bring ideas that your team hadn't thought about, and you can use that person as a coach.
You could use tactics to encourage huddles—like competitions, incentives and positive reinforcement—and then show the results of the huddles. Are patients being seen more efficiently? Is the team better prepared to care for more-complex patients? And of course, doing pre-visit planning and making sure that we're ready for the patients the next day is another wonderful way to improve the efficiency and the care we provide patients.
Unger: Great. Do you have any final thoughts on daily team huddles?
Dr. Brown: Team huddles are very important to bring more joy to the practice. It may be the only time that day that the team knows what's going on with each other, and we have to take care of each other first, before we take care effectively for our patients.
It's an important time to share good news as well—somebody's birthday coming up, or a milestone, or an award or something very positive that someone's experiencing—because there just isn't time to share the good news, as well as some challenges. So, team huddles have improved the joy in our practice and been able to allow us to provide much more effective care in a timely fashion for our patients and we always finish the day on time.
Unger: That’s wonderful to hear, and thank you so much for joining us today.