Editor's note: This popular story from the Daily Briefing's archives was republished on Jan. 10, 2020.
Midland Memorial Hospital's daily leadership huddles in the hospital's lobby have helped drastically increase patient satisfaction, a hospital executive tells Hospitals & Health Networks.
The Texas-based hospital's shift in culture began when it realized that spending millions on new infrastructure wasn't enough to improve the patient experience, says Bob Dent, CNO, COO, and a SVP at Midland.
Dent thought that building a new $165 million patient tower in 2012 would boost patient satisfaction scores, he tells the American Organization of Nurse Executives' Terese Hudson Thrall. But eight months after the tower was complete, "patient satisfaction scores were still going down," Dent says. "We knew we had to take action."
The hospital went "through a transformation to a culture of ownership, including a new mission, vision, and core values," Dent says.
The 'Pickle Challenge'
In 2014, Midland kicked off the "Pickle Challenge" to eliminate workplace toxicity—including by collecting nearly $2,000 in quarters after fining staff members for language violations. (The money was donated to Midland's staff catastrophic assistance fund.) And last year, the 464-bed hospital began holding leadership huddles every day, starting at 8:16 a.m., that last a maximum of 14 minutes.
Any of the hospital's employees can attend the huddles, but it's essentially mandatory for all leaders, including managers, directors, and VPs who are not involved in the provision of care. Physicians and frontline staff can also join if they are on a break.
About 30 to 40 leaders attend a typical huddle, which takes place in the main lobby to "sen[d] a message of inclusivity and transparency," Dent says. The attendees:
- Recite a pledge to "turn every complaint into either a blessing or constructive suggestion" and not waste time on "blaming, complaining, and gossiping," as well as a self-empowerment message that changes daily;
- Discuss throughput issues for the day; and
- Talk about patient-safety-related events and assign a huddle member to address the issue and report back the next day on what action has been taken.
A summary of the huddle is then sent to 186 leaders by 9:30 a.m. Each hospital department or unit is expected to have its own huddle, including reciting the pledge and self-empowerment message, reviewing takeaways from the leadership huddle, and discussing patient safety events.
Huddle gets results
Huddles have helped to "anchor" the hospital's new "culture of ownership" and improve patient safety, Dent says. For instance, a physical therapist's concerns about "several near misses ... between patients and staff who were pushing carts, beds, or wheelchairs" led the hospital to install bubble mirrors on all floors that were having the issue, Dent says.
And overall, the hospital's patient satisfaction scores have gone "from all-time lows to all-time highs," include from below the 10th percentile to above the 90th percentile in the hospital's ED, Dent says.
The huddles are a crucial tool to "develop relationships" and "realize we are all on the same team and working toward the same goal"—but they also need to be coupled with a broader push to encourage hospital staff to speak up, Dent says.
That's why Dent hosts weekly breakfasts with directors and managers and prioritizes senior leaders taking action on "everything that is brought up" in the huddle.
"If nothing is done, leaders won’t feel their contributions are valued and the huddle loses integrity," Dent says. "It's part of my job to creative a positive workplace environment, where issues can be communicated and the messenger won’t fear facing some kind of punishment" (Hudson Thrall, Hospitals & Health Networks, 3/14).
The science—and strategy—behind having a 'great meeting'
There are about 11 million formal meetings in the United States every day—and more than half of them may be unproductive. Why? Because many meetings are inefficiently run. They don't set or achieve clear goals. And we hold them out of habit.
Drawing on best practices—as well as lessons from across our own organization—we've created this useful infographic to guide if you really need a meeting (and if so, how to maximize everyone's time).