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Quality Improvement Promising Practices from the Field

An RWJF Collection

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TCAB Spread

Unit Highlight - 4 Main / Shadyside

Intervention Title:
Increasing Vitality of Front-Line Nurses Through Team Huddles – University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pa.

Decrease staff isolation and build a support system for nurses on a unit floor.

Staff implemented a new, regular meeting of unit nurses.

The primary result was an invigorated staff functioning as a team.

University of Pittsburgh Medical Center
200 Lothrop St.
Pittsburgh, PA 15213-2582
P: (412) 647-8762

From the experts:
“Finding a new way to build camaraderie among our nursing staff has been critical to invigorating staff and establishing a new sense of teamwork. While team huddles are brief, their effects are lasting and have helped our nurses reconnect and function as a team.”

Mary Beth Thomas, R.N.
Staff Nurse 4 Main
UPMC Shadyside

University of Pittsburgh Medical Center is composed of 19 hospitals and a network of other care sites across western Pennsylvania and throughout the world.

Clinical areas affected:

  • Medical/surgical units

Staff involved:

  • Nurses

The program began in August 2006 and is ongoing.

Judy Shovel, B.S.N., Improvement Specialist
Center for Quality Improvement and Innovation
P: (412) 802-8072

Innovation implementation:
With the conversion to the electronic health record (e-record) at UPMC, nurses began using computers on wheels (COW). As a result, nurses no longer need to go to the central nurses' station to use a computer, review a chart or sign off on doctor's orders. They tend to stay with their COW in locations closest to their assigned patients' rooms.

Staff complained about feeling isolated and experiencing a loss of collegiality because they no longer cross paths with their coworkers. It also has negatively affected the ability of seasoned nurses to mentor new staff.

To respond to the isolation, nurses are now called to a “Vitality Huddle” between 9:30 and 10:00 a.m. via the unit's call system. The nurses gather in the workroom near the nurses' station for 10-15 minutes to interact and focus on relationship building. Nothing clinical is discussed. Sometimes there is a theme, such as “Tell us about your best friend” or “What is your favorite movie?” and sometimes it's just to get a snack and have a few minutes to be social.

Advice and lessons learned:

  1. Make the time positive. Make sure any activity or theme is focused on a positive subject.
  2. Keep it light. Meetings are intended to be fun and build a sense of camaraderie, so it's important to keep the topics light.

Cost/benefit estimate:
Five to eight nurses attend each time and huddles occur three to five times per week. Staff members greatly enjoy the huddles, and the evening shift has started them as well.