The Improvement Academy (IA) based at the Bradford Institute of Health Research is celebrating 10 years of its flagship Huddle Up for Safer Healthcare (HUSH) programme: an evidence-based intervention that has consistently demonstrated significant improvement in staff teamworking, improved team communication, job satisfaction and safety culture, and a reduction in patient harm. 

HUSH provides a structured approach for implementing safety huddles in healthcare settings and encourages all team members (clinical and non-clinical) to come together briefly every day with a focus on an area of harm. The shared knowledge at the huddle improves situational awareness and teamwork, thus reducing patient harm as harms are anticipated and prevented and errors are learnt from.

The IA is the implementation arm of ARC Yorkshire and Humber and in the last 10 years the it has been studying and supporting the implementation HUSH safety huddles in a variety of settings and despite challenging times, including a pandemic, teams have achieved amazing results!

Dr Anna Winfield, Geriatrician and Specialist in Elderly Medicine and Quality Improvement (QI) at Leeds Teaching Hospitals NHS Trust and Clinical Leader in QI at the IA, shared,

“Over the last 10 years HUSH huddles have developed from an idea developed and tested by frontline 'guinea pig' healthcare teams in Yorkshire to a validated, evidence-based intervention that has been shown to improve teamwork and culture and reduce patient harm across a wide variety of healthcare settings across the UK. I can’t wait to see how it develops over the next 10 years!"

Some highlights from the IA’s HUSH programme include:

• Supporting 500 teams in 32 organisations across the UK (including: Barnsley Hospitals NHS Foundation Trust, Birmingham Community Healthcare NHS Foundation Trust, Harrogate and District NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Milton Keynes University Hospital NHS Foundation Trust,  Sheffield Health and Social Care NHS Foundation Trust, York and Scarborough Teaching Hospitals NHS Foundation Trust, NHS Humber and North Yorkshire ICB, North Yorkshire County Council, Dove House Hospice in Hull, and Sue Ryder Care.)

• Worked in 9 Healthcare delivery settings including, Mental Health, Community, Primary Care, Care Homes, Prison Health teams, Hospices, and Acute hospital wards.

• Teams have reduced harm in 16 different areas including, falls, pressure ulcers, deterioration, medication errors, restrictive practice, and violence and aggression.

• In the last 10 years, Huddles have helped to prevent over 12,000 falls.

• We have issued over 2000 certificates to teams reaching their harm reduction milestones.

• In 2015 we were awarded a £500,000 grant from the Health Foundation to scale up the intervention.

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Feedback from staff involved in safety huddles has also been very positive:

“I understand if a patient is at risk, more now than ever before because I don’t have to seek out information because any issues are highlighted by the huddle.” Healthcare Assistant

“[Team] members work more co-operatively when caring for patients and are able to help each other more effectively.” Staff Nurse

“Huddles are the best thing we’ve ever done.” Senior Sister, St James’ University Hospitals Trust

“We are so grateful for all the help and support at the IA when we were presented with our great 2nd culture survey results." Manager, Shetland House, Residential and Dementia Care Facility

“We are the first Mental Health service to introduce HUSH Huddles to our practice and can see how effective they have been. The huddles have massively reduced the number of falls and, because they are so effective, we have rolled out to other wards including Care homes.  We would like to say a big thank you to the Improvement Academy for their help and would like to continue using these as they have boosted morale and energy levels.”  Physiotherapist, Sheffield Health & Social Care NHS Foundation Trust

An independent evaluation by the University of Bradford stated that following the implementation of HUSH huddles more than three quarters of frontline team respondents reported improvements in communication (88%), teamwork (79%) and safety culture (75%) on their wards. 83% indicated they would miss the safety huddle if it were stopped tomorrow.

An independent evaluation by the University of York Health Economics Consortium showed an overall return on investment of 107%.

The HUSH programme won the HSJ Value Awards 2018 Patient Safety category for enhancing value through increasing patient safety and reducing litigation. Our initiative to introduce Huddles into all Sue Ryder’s Hospices was shortlisted in 2023 for QI Initiative of the Year at the HSJ Patient Safety Awards and in the same awards’ ceremony was awarded as ‘highly commended’ for the Huddles work in an in-patient mental health setting in Sheffield Health and Social Care NHS Foundation Trust.

If you are interested in implementing safety huddles in your organisation or learning more, visit our website on http://www.improvementacademy.org or email academy@yhia.nhs.uk and one of our team will be in touch.