Center for Healthcare Organization and Implementation Research and the New England Geriatric Research, Education and Clinical Center, VA Bedford Healthcare System, Bedford, MA, USA.
Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
J Gen Intern Med. 2021 Sep;36(9):2772-2783. doi: 10.1007/s11606-021-06632-9. Epub 2021 Feb 8.
Brief, stand-up meetings known as huddles may improve clinical care, but knowledge about huddle implementation and effectiveness at the frontlines is fragmented and setting specific. This work provides a comprehensive overview of huddles used in diverse health care settings, examines the empirical support for huddle effectiveness, and identifies knowledge gaps and opportunities for future research.
A scoping review was completed by searching the databases PubMed, EBSCOhost, ProQuest, and OvidSP for studies published in English from inception to May 31, 2019. Eligible studies described huddles that (1) took place in a clinical or medical setting providing health care patient services, (2) included frontline staff members, (3) were used to improve care quality, and (4) were studied empirically. Two reviewers independently screened abstracts and full texts; seven reviewers independently abstracted data from full texts.
Of 2,185 identified studies, 158 met inclusion criteria. The majority (67.7%) of studies described huddles used to improve team communication, collaboration, and/or coordination. Huddles positively impacted team process outcomes in 67.7% of studies, including improvements in efficiency, process-based functioning, and communication across clinical roles (64.4%); situational awareness and staff perceptions of safety and safety climate (44.6%); and staff satisfaction and engagement (29.7%). Almost half of studies (44.3%) reported huddles positively impacting clinical care outcomes such as patients receiving timely and/or evidence-based assessments and care (31.4%); decreased medical errors and adverse drug events (24.3%); and decreased rates of other negative outcomes (20.0%).
Huddles involving frontline staff are an increasingly prevalent practice across diverse health care settings. Huddles are generally interdisciplinary and aimed at improving team communication, collaboration, and/or coordination. Data from the scoping review point to the effectiveness of huddles at improving work and team process outcomes and indicate the positive impact of huddles can extend beyond processes to include improvements in clinical outcomes.
This scoping review was registered with the Open Science Framework on 18 January 2019 ( https://osf.io/bdj2x/ ).
简短的站立会议，即碰头会，可能会改善临床护理，但有关碰头会实施情况和在一线的有效性的知识是零散的，且因环境而异。这项工作全面概述了在不同医疗保健环境中使用的碰头会，检查了碰头会有效性的实证支持，并确定了知识空白和未来研究的机会。
通过在 PubMed、EBSCOhost、ProQuest 和 OvidSP 数据库中搜索从创建到 2019 年 5 月 31 日发表的英文研究，完成了范围综述。合格的研究描述了在提供医疗保健患者服务的临床或医疗环境中进行的碰头会，(1)包括一线工作人员，(2)用于提高护理质量，(3)进行了实证研究。两名审查员独立筛选摘要和全文；七名审查员独立从全文中提取数据。
在 2185 项确定的研究中，有 158 项符合纳入标准。大多数(67.7%)的研究描述了用于改善团队沟通、协作和/或协调的碰头会。碰头会对团队流程结果产生积极影响的研究占 67.7%，包括提高效率、基于流程的功能以及跨临床角色的沟通(64.4%)；态势感知以及员工对安全和安全氛围的看法(44.6%)；以及员工满意度和参与度(29.7%)。近一半的研究(44.3%)报告碰头会对临床护理结果产生积极影响，例如患者及时接受基于证据的评估和护理(31.4%)；减少医疗差错和药物不良事件(24.3%)；以及其他负面结果的发生率降低(20.0%)。
涉及一线工作人员的碰头会是在不同医疗保健环境中越来越普遍的实践。碰头会通常是跨学科的，旨在改善团队沟通、协作和/或协调。来自范围综述的数据表明，碰头会在改善工作和团队流程结果方面是有效的，并指出碰头会的积极影响不仅可以扩展到流程，还可以包括临床结果的改善。
本范围综述于 2019 年 1 月 18 日在开放科学框架上注册(https://osf.io/bdj2x/)。
