Skip to main content

Why Nursing Should Be More Like Football

 |  By Alexandra Wilson Pecci  
   February 19, 2013

When I hear the word "huddle," I think of sports, of a bunch of guys in helmets, crowding around a leader, strategizing as a team before they execute a play.

They prepare together before getting into position, and once the ball is in play, every player is ready for action, ready to work as a unit to accomplish a single objective. How would that on-field action look without the preceding huddle?

Like chaos.

It's reasonable to think about nursing as a team sport, too, which is why I'm intrigued by the idea of "safety huddles" performed at the beginning of each shift by the award-winning nursing team at the Robert Wood Johnson University Hospital in New Brunswick, NJ.

Like the huddles that football teams perform before running a play, safety huddles allow the nurses at RJUH to strategize as a team before executing patient care.

Doing so has paid off, according to data from the ANA's National Database of Nursing Quality Indicators (NDNQI), a database of nursing performance measures.

The huddles help the nursing team identify risks and implement prevention strategies, such as bed alarms and risk mitigation during hourly nursing rounds. As a result, the hospital has reduced its patient falls rate by more than 50% for a unit with adults with cardiac-related diseases combined with other conditions.

Robert Wood Johnson University Hospital is among six winners of the NDNQI Award for Outstanding Nursing Quality. The honorees were identified by researchers from among more than 1,900 hospitals (representing about one-third of U.S. hospitals) that report results to NDNQI and measure their performance against other NDNQI hospitals.

And the hospital's nursing team wasn't the only NDNQI Award for Outstanding Nursing Quality winner that used teamwork to improve outcomes.

For example, the nursing staff at Rose Medical Center in Denver, CO, improved team-based oral care standards and implemented a series of interventions proven to reduce infection rates.

Using this team-based strategy, the hospital was able to significantly reduced ventilator-associated pneumonia, the leading cause of death resulting from hospital-acquired infections, from 17 cases in 2008-09 to just one case in 2011-12.



Nursing teamwork has been shown to be a powerful force in factors from patient safety to staff satisfaction to staffing.

For example, a 2010 study called "Nursing staff teamwork and job satisfaction" in the Journal of Nursing Management found that within nursing teams on acute care patient units, a higher level of teamwork and perceptions of adequate staffing leads to greater job satisfaction.

Nurses' job satisfaction with their current position, as well as their satisfaction with their occupation in general were both higher when nurses rated their teamwork higher. The authors concluded that "efforts to improve teamwork and ensure adequate staffing in acute care settings would have a major impact on staff satisfaction."

Another 2010 study, "The impact of teamwork on missed nursing care," published in Nursing Outlook, concluded that "when teamwork was stronger, less missed nursing care was reported." The authors pointed to a need to invest in ways to improve teamwork.

Robert Wood Johnson University Hospital has won the NDNQI Award for Outstanding Nursing Quality for two years running, so their teamwork efforts are clearly paying off. Sports teams for which teamwork is paramount have similar winning records.

Remember what happens when athletes don't play as a team? They lose the game. For nurses, the stakes are even higher.

Alexandra Wilson Pecci is an editor for HealthLeaders.

Tagged Under:


Get the latest on healthcare leadership in your inbox.