(78) Creating and Sustaining a Night Shift End-of-Life (EOL) Safety Huddle to Improve Communication and Collaboration Among Disciplines

Title: The Night-Shift EOL Safety Huddle proved to be a valuable practice, significantly improving team communication, awareness, and overall care efficiency

Abstract : Basis of Inquiry
Inpatient standardized huddles have been shown to increase the timeliness of communication, the quality of teamwork, and the understanding of contingency planning. Our unit experienced an extremely high frequency of expected inpatient deaths over a short amount of time. A night shift communication and collaboration tool was needed.

Purpose/Objectives
The purpose of creating the Night Shift EOL Safety Huddle was to increase communication, awareness, and collaboration among interprofessional team members caring for active end-of-life oncology patients through the use of a streamlined checklist and nighttime Zoom huddle.

Methods
A QI intervention guided by the Plan, Do, Study, Act (PDSA) framework was performed on one 30-bed inpatient oncology unit for eight weeks. Two PDSA cycles were performed. A four-question EOL Safety Huddle Checklist was developed by nursing leadership with input from team members. This checklist identified pertinent interdisciplinary members for the shift, patient/family goals of care, critical symptom management contingencies, and whether pharmacy or consulting teams required awareness.

Findings or Outcomes:
Qualitative and quantitative data were collected from nurses, physicians, and nurse practitioners 8 weeks and 6 months post-pilot to gauge their response to the intervention. At both time points, over 90% of respondents identified the huddle as being useful and believed it should continue. Top staff-reported changes since the huddle initiated include: Clearer symptom escalation management plans (n=25; 92.6%); clear identification of critical event contingencies (n=22, 81.5%); more transparent and open communication among team members (n=21, 77.8%); and Increased awareness of first call among teams (n=21, 77.8%).

This Safety Huddle proved to be a valuable practice and has been sustained for over one year. The intervention's feasibility, coupled with positive feedback and observed benefits, underscores its value in providing high-quality EOL care in the inpatient setting.