Job Satisfaction:
Monash et al’s randomised controlled trial measured attending and
trainees job satisfaction as a secondary outcome.35This was carried out using an electronic survey adapted from previously
published work,42 however this is not a standardised,
validated survey. The efficiency of the new style of rounds
incorporating a huddle was assessed against normal rounding practices
and it found that trainees found the rounding less efficient (60.5 v
72.3, intervention v control; p=0.008). Trainees reported that it
increased workload for the rest of the day and gave them less autonomy.
The opposite was reported for attending physicians. Jain et alreported that the ‘day’s flow’ improved dramatically after huddle
implementation in a surgical environment (median rating increased from 5
to 9, with 10 being the best).34 The average number of
unexpected delays also decreased post-implementation (15 v 4). This was
a much smaller study however, with only three surgeons surveyed.
Dingley et al analysed 495 discrete communication events pre and
post-huddle implementation.32 Trained data collectors
were used to record communication processes within the health system by
using a standard form and asking nurses their perception of
communication events. Comparison of pre- and post-intervention positive
resolution of communication/issue (nursing staff’s perception of
resolution of the patient’s issue following an interaction/communication
with medical staff) and satisfaction scores revealed a significant
increase in positive resolution scores (p =0.04), and a difference
in satisfaction scores approaching significance (p =0.08) in the
Medical Intensive Care Unit and nonsignificant increases in resolution
and satisfaction scores (p =0.13, p =0.53, respectively) in
the Acute Care Unit. Positive responses to both the resolution and
satisfaction questions in the post-intervention period increased.
Turnover intention has been shown to be a reliable indicator of job
satisfaction.15,16 Hastings et al examined
intent to leave within the next twelve months. This was conducted using
staff interviews (n=15) and staff surveys (n=25) and showed those that
implemented team huddles were significantly less likely to plan to leave
after implementation than they were before the new model was introduced
(20% at final evaluation vs. 48% at baseline).33This included nursing staff, allied health professionals, managers, and
physicians. Of note, there were multiple changes to the organisation
including comfort rounds, bedside shift reports, patient whiteboards,
rapid rounds, and team huddles.
Newman et al similarly found improved job satisfaction across all
provider groups (cardiologist, resident, nursing
staff).36 Job satisfaction was measured using an
electronic survey that was piloted to twelve senior staff members to
establish validity. Pre-post intervention surveys asking if staff had a
positive overall experience working in the unit resulted in (20 v 25
residents agree/strongly agree (n=26 pre) (n=25 post); p=0.001), (8 v 16
cardiologists agree/strongly agree (n=14 pre) (n=17 post); p=0.005), (3
v 13 nursing staff agree/strongly agree (n=14 pre) (n=15 post); p
< 0.001).
The job satisfaction ratings post-huddle implementation were also higher
in Rodriguez et al’s study. They measured differences in
‘huddlers’ and ‘non-huddlers’ by using a survey that included the
experiences of teamwork and practice climate.1 Those
who implemented daily huddles in their practice were found to have
higher satisfaction with their teams (83.1% v 51.7% satisfied; p
<0.001), higher psychological safety (61.7% v 46.0%; p
<0.001), and better experiences of practice communication
(60.9% v 48.1%; p <0.01). However, 42% (n=174) of those
surveyed indicated they found huddles ‘not very helpful’ when asked.
Psychological safety in the workplace has been strongly linked to
improved job satisfaction in the literature.46
As previously mentioned communication between team members has been
shown to be a specific intervention that improves interdisciplinary
teamwork21 O’Malley et al similarly reported
that huddles played a role in improved communication among healthcare
professionals and that this improved communication resulted in higher
job satisfaction.37 23 out 27 practices mentioned that
huddles were ‘key to maintaining structured communication within
teams’ . Participants who adopted new forms of delegations such as
huddles reported improved provider satisfaction and productivity.
However, it was also found that not all teams found the huddle was
required to improve work engagement, teamwork, or job satisfaction.
Rodriguez et al reported that some teams that did not choose to
partake in daily huddles “have positive experiences of teamwork and
indicated daily huddling was not necessary once team norms were firmly
established and roles and responsibilities were very
clear”.1 It is noted however that a greater
proportion of non-huddlers interviewed described “challenging
interpersonal dynamics among team members”.