With the Super Bowl just a week away, we thought this would be a good time to talk about the benefits of a “huddle.” Football players often huddle up before plays to make sure every team member on the field knows what the plan is. The same “huddle” concept can be extremely effective in the long term care setting with a team of staff. Huddles can help caregiver teams identify residents with one or more challenging behaviors, discuss possible interventions to address the behavior(s), and create a plan together so that interventions can be effective, consistent and more likely to be successful.
If you would like to start a regular “huddle” practice with your team, here are some basic questions to think about. You can always adjust to match your needs:
1. Which team members should be included in the huddle? This can change based on which residents’ behaviors are being discussed.
2. How much time do you and your team want to spend in the huddle? 15 to 20 minutes is a good place to start.
3. How often and where will huddles take place? Each week? Bi-weekly?
4. What time will the huddles take place? Think about the times when your unit tends to be the least busy so team members can give their full attention to the huddle. Try to be consistent with day and time.
5. Who will lead the huddles and set the agenda? Again, this may vary. Notify staff who should attend the huddle during shift report on the day of the huddle. Agenda should be set in advance to specify which resident(s) and which behavior(s) will be addressed.
6. Consider using the DICE approach to address challenging behaviors (Describe, Investigate, Create a plan, Evaluate the plan). See the attached table.
7. Create a file or binder to contain information about the resident (such as resident preferences, social history, past interventions) and huddle notes to refer to later.
8. Provide resources for staff to learn about non-pharm interventions for behaviors that can be discussed during huddles. www.nursinghometoolkit.com is a good place to start.
Try doing a huddle this week with your team and see how it goes. It may take a few tries to find the approach that best works for your team. Stick with it! The benefits of consistent team communication, teamwork to create and execute interventions, and success in managing challenging behaviors will be well worth the effort! Just ask the Kansas City Chiefs and San Francisco 49ers teams who made it to the Super Bowl!