A new study from the Vanderbilt Health Center for Patient and Professional Advocacy (CPPA) provides health care leaders with an effective framework for addressing concerns that may require an investigation through a standardized huddle process.
The research shows how timely, structured huddles help organizations review and guide next steps after behaviors that may require immediate investigation or intervention. This reduces variability in response and fosters increased communication and trust among key stakeholders, researchers wrote.
“Without a huddle process, siloed information and processes can occur,” said lead author Cynthia Baldwin, MS, RN, CPHRM, senior associate in the Department of Pediatrics and Vanderbilt University School of Nursing and CPPA faculty. “This can lead to differing conclusions, confusion, delays in addressing serious matters, or unfortunately seeing these matters not addressed at all. Having a plan and a process supported by leadership reduces organizational risk on many levels.”
The study, published in BMJ Leader, examined five health care systems that implemented a standardized response process for handling reports of concerning behaviors. During the study period, these organizations conducted 219 huddles, which is less than 1% of all their reports processed by CPPA.
The most common types of reports that prompted huddles:
- reports of violating discrimination policies or laws (30%)
- hostile work environment (29%)
- violent or aggressive behavior (15%)
- potential sexual boundary violations (13%)
The research found that 43% of huddles resulted in referral for formal investigation, while 40% were directed to routine sharing through peer-delivered Patient Advocacy Reporting System (PARS) and Coworker Observation Reporting System (CORS) processes after review by key organizational stakeholders.
“By creating an organized practice of prompt huddles by key stakeholders, using a standardized script to guide timely review, support for individuals involved, and developing trust and dialogue among departments, a huddle process can help create a standardized response to reports of serious behaviors,” said William Cooper, MD, MPH, Cornelius Vanderbilt Professor of Pediatrics and Health Policy at the School of Medicine and President of CPPA. “Health care leaders should recognize the importance of having a prompt response when certain types of behaviors or actions are reported. Consistency ensures that individuals who are reporting behaviors and individuals who may be identified in reports are treated fairly and in a balanced way because huddle participants have the chance to share a range of opinions to guide the huddle group’s ultimate triage decision.”
The huddle approach brings together people from various departments, including physician leadership, nursing leadership, human resources and risk management.
Prior to implementing huddles, many organizations described variability in their approaches to evaluating serious reports, which potentially increased the risk of inconsistent responses or matters falling through the cracks. The study highlights how huddles prevent a single individual from making critical decisions about whether to investigate concerning behaviors, the researchers noted.
The health care organizations in the study reported the huddle process fostered increased communication and trust among stakeholders while ensuring serious reports received appropriate attention and follow-up.
The study outlines a practical framework for addressing unprofessional behaviors in a consistent manner that aligns with organizational values, laws, regulations, and policies.
The research was conducted as part of the CPPA’s national collaborative of more than 200 hospitals that participate in PARS and CORS.
