In an interview with Becker's Hospital Review, Intermountain Healthcare CEO Marc Harrison shared how the health system implemented an innovative meeting system of tiered escalation huddles—and the dramatic effect the process had on patient safety, access, and employee satisfaction.
Harrison, who previously implemented the new meeting process when he was CEO of Cleveland Clinic Abu Dhabi, said he was first inspired by its success in the nuclear power industry.
The daily tiered escalation huddle process
At Intermountain, the process begins with the front line staff, who huddle for up to 15 minutes at 7 a.m. each day to talk about concerns or issues that they're facing. Those concerns and issues are then escalated through management throughout the morning, so that by 10 a.m., five huddles have already happened—from the front line staff, to local managers, to regional managers, and all the way through the health system's executive team.
At that point, Harrison said, the executive team—including Harrison himself—commences its own meeting, called the "tier six huddle." By the time the huddle ends, Harrison said he is aware of all "serious safety events, hospital acquired infections, downtime on major equipment of IT systems, caregiver injuries, power outages, capacity constraints, and pharmacy shortages" occurring in the system.
According to Harrison, the meeting structure provides him and his executive team with a "snapshot of the entire system," which enables leadership to strategize on which issues need to be addressed and how to solve them.
Very positive results
Intermountain has been using tiered escalation huddles since April, Harrison said, and the results have been striking. According to Harrison, as a result of the huddle process, Intermountain has issued 13 system-wide safety alerts, increased patient access at Intermountain's clinics from 53 percent to 86 percent, and improved the continuity of care by quickly escalating concerns about patient diversion at any given facility and ensuring patients get "to the proper facilities in a timely manner."
Moreover, Harrison said the process has improved employee satisfaction because it gives every employee a voice and has fostered a team atmosphere. He said that because of the process, the health system has implemented more than 1,000 ideas that were proposed during the front line huddles, from environmental science workers, finance representatives, physicians, and nurses, among others. "Since implementing these huddles, we think less about hospitals and regions and instead as an enterprise and team," Harrison said.
Harrison added that while he encountered some challenges implementing the process early on, when some staff was participating inconsistently, it quickly was met with approval. "I had to make it very clear that this was a standard we would abide by," he said. "We would all play by the same metrics and initiatives. It was a bit challenging for some folks, but once they realized the huddles were not to be used punitively—but rather only in a positive way—people got on board really quickly" (Paavola, Becker's Hospital Review, 9/6).
The science—and strategy—behind having a 'great meeting'
There are about 11 million formal meetings in the United States every day—and more than half of them may be unproductive. Why? Because many meetings are inefficiently run. They don't set or achieve clear goals. And we hold them out of habit.
Drawing on best practices—as well as lessons from across our own organization—we've created this useful infographic to guide if you really need a meeting (and if so, how to maximize everyone's time).