Hospital at Night

A hospital at Night huddle should take 15 minutes once a night at 1am and is held in the Emergency Department.

The huddle is led by the ICU Registrar. All junior medical staff rostered on overnight are expected to attend to rapidly exchange information, identify deteriorating patients and discuss predicted hospital activity over the rest of the night.
The huddle is also be attended by the After Hours Manager.

The purpose of a huddle
Hospital huddles are becoming increasingly popular as the evidence shows that huddles improve staff engagement and flow activity. Huddles are meant to be proactive to prevent patient safety issues and staff concerns and to bring the team together.

A huddle is not a handover!
By the end of the huddle each junior doctor will

• Have a clear idea of what they have to achieve for the rest of the shift
• Have a better understanding of how other clinical areas are operating
• Increase learning through shared memory and collaboration

The huddle rules

1. Everyone must attend on time every night
2. Everyone must be able to present issues from their clinical area concisely to the rest of the team
3. The ICU Registrar will lead the discussion and assign actions if necessary to responsible staff and make it clear how they should feed back
4. The ICU Registrar will ask 4 questions of each team member.
   1. How busy are you? i.e., number of admissions to do
   2. Do you have any patients of concern? e.g., clinical review patients or MET calls
   3. Do you need help?
   4. Are you able to offer help?

The key is to make it quick!!!