August 15, 2013

Daily briefing keeps Children’s Hospital operating smoothly

Every day at precisely 1:35 p.m., the conference room in Suite 2410 at the Monroe Carell Jr. Children’s Hospital at Vanderbilt becomes the central hub of activity.

The Daily Safety Operations Brief at the Monroe Carell Jr. Children’s Hospital at Vanderbilt brings together representatives from all areas to discuss hospital operations. (photo by Anne Rayner)

Every day at precisely 1:35 p.m., the conference room in Suite 2410 at the Monroe Carell Jr. Children’s Hospital at Vanderbilt becomes the central hub of activity.

It is the site of the Daily Safety Operations Brief, commonly called the DOB or safety huddle, and representatives from all areas meet there every day without fail, even on weekends and holidays, to discuss hospital operations.

“The representatives are expected to already have rounded in their areas and know the issues that need to be discussed.

“The mindset is to reflect on the previous 24 hours and anticipate the next 24,” said Jenny Slayton, MSN, R.N., administrative director of Performance Management and Improvement.

Led by the administrator on call, the meeting includes perioperative services, neonatal and pediatric transport, emergency department, newborn nursery and neonatal intensive care unit, acute care, ambulatory care, pharmacy, radiology, environmental services, infection control, supply, respiratory therapy, the police department, administrative coordinators and a Chief of Staff designee.

Participants either gather in the conference room or call in remotely. The meeting is always kept under 15 minutes and averages about 10 minutes.

Each area gives a report, usually addressing staffing levels, bed occupancy, safety issues and other concerns. Maybe a floor needs more stretchers, there has been an accidental needle stick or a critical piece of equipment is out of service.

“The people in the room are the ones who can make things happen. If there is an issue, someone immediately volunteers to follow up, and then there is accountability the next day that they have acted,” Slayton said. “The biggest benefit is the face-to-face conversation with near immediate mitigation.”

The idea for the meeting came from participation in a national collaboration called the Ohio Children’s Hospital’s Solution for Patient Safety.

“The last thing anybody wants is another meeting, but they charged us to get this going and we saw the benefits right away,” Slayton said.

“Once there was an extended case planned in the OR, scheduled for, I think, 27 hours. This was discussed at the meeting and there was an immediate look of panic on pharmacy’s face. They knew nothing about it. So they were able to immediately get the medical record and contact the physician and plan for the medications that might be needed. In the end, the surgery went much faster than planned.”

Kathy Moss, MSN, MBA, R.N., director of Nursing and Clinical Support Services, who has led the operations brief as an administrator on call, admitted she was initially worried about adding a daily meeting to her calendar.

“But we saw the impact right away,” she said. “It’s a central place to gather, and it has expedited follow-up because everyone knows they will be reporting out on the progress tomorrow. When issues come up, there is good follow-through. Someone commits to taking it on and seeing it through, which has helped with the quick resolution.”