Reference Study Design Setting Study Sample Size Methods of Evaluation Intervention
Dingley et al, 2008 Uncontrolled pre-post study University-based hospital (USA) 2 hospital units (495 communication events) Analysis of 495 communication events Structured communication tool including huddle during each shift
Goldenhar et al, 2013 Qualitative study using semi-structured interviews and focus groups University-based hospital (USA) 10 key informants, 21 focus group participants Analysis of interview and focus group data 3-level huddle system operating at different levels of the staff structure. Group training to implement huddling
Hastings et al, 2016 Mixed methods using interviews and uncontrolled pre-post surveys of staff and patients, plus administrative records University-based hospital (USA) 15 interviews with staff post, 25 staff surveys pre- and post-, 26 patient surveys pre-, 37 patient surveys post-intervention Qualitative analysis of interview data, qualitative analysis of staff and patient surveys, quantitative analysis of key indicators from administrative data. New model on delivering care including regular huddles during the day
Jain et al, 2015 Pilot study University-based hospital (USA) 3 surgeons, plus surgical teams (totalling 65 operations) Baseline and timepoint measurement of surgical outcomes, interruptions, and questions from a worksheet completed by surgeons for each day’s cases. Daily pre-operative huddle using template with entire surgical team
Monash et al, 2017
Cluster RCT
University-based hospital (USA)
Intervention arm: 19 attendings + 60 trainees; 595 patients. Control arm: 17 attendings + 61 trainees; 605 patients.
Audit of adherence to practice recommendations; patient satisfaction questionnaires using Likert-type scales; staff questionnaires based on previously-published work
Workshop to train teams on daily pre-round huddle as part of a package of 5 Attending Round practices
Newman et al, 2016 Retrospective cohort study University-based hospital (USA) Resident (n= 26 Pre and 25 Post), Cardiologist (n= 14 pre and 17 post) and Nursing (n= 14 pre and 15 post) Retrospective chart review + retrospective pre-post survey on satisfaction with the intervention and impact of the intervention on team-based communication Intervention arm teams were trained in 5 Attending Round practices: 1) pre-rounds huddle; 2) bedside rounds; 3) nurse integration; 4) real-time order entry; 5) whiteboard updates. The control arm continued normal practices..
O’Malley et al, 2015 Qualitative study using in-depth interviews Community-based facilities (USA) 63 respondents ranging from physicians to front-desk staff. In-depth interviews using standardised protocol followed by qualitative analysis. Team huddles to support communications (exact type not specified as this paper accessed a large number of organisations/teams)
Pannick et al, 2017 Prospective stepped-wedge non-randomised cluster controlled trial University-based hospital (UK) 85 staff members from 7 interdisciplinary medical ward teams Anonymised patient and ward level outcomes extracted from routinely collected data sets. Anonymous staff surveys were administered at baseline and 6 month timepoint. Prospective Clinical Team Surveillance (PCTS) - Intervention program comprised structured team briefing, facilitation, and feedback
Rodriguez et al, 2015 Mixed methods study using interviews and surveys of staff Community-based facilities (USA) 79 teamlet member interviews + 418 clinician and staff PCMH survey responses (total number of individuals unclear) Analysis of interview and survey data followed by qualitative and quantitative analysis. Patient Aligned Care Teams (PACT) initiative including structural reorganisation of teams
Scotten et al, 2015 Uncontrolled pre-post study University-based hospital (USA) 65 faculties –number of participants unclear Analysis of questionnaire data completed at baseline and timepoints, with providers using T-TAQ, T-TPQ, ITPS§, AITCS, and patients using EHCPS# TeamSTEPPS introduced with in situ simulations and development of an interprofessional transitional care model intervention which included telehealth approaches for patient / provider communication
Stapley et al, 2018 Qualitative study using semi-structured interviews University-based hospital (UK) 76 staff Qualitative analysis of interview data. ‘SAFE’ (Situation Awareness for Everyone) programme which incorporates huddling
Thomas et al, 2013 Quality improvement report Community-based facilities (USA) Whole system (1300 staff) Adoption of TeamSTEPPS competencies was assessed using direct observation and anecdotes. Effects of the training was evaluated, using Hospital Survey on Patient Safety Culture and targeted variables. TeamSTEPPS training was implemented across the system after piloting.