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Why Nursing Should Be More Like Football

Alexandra Wilson Pecci, for HealthLeaders Media, 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.

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3 comments on "Why Nursing Should Be More Like Football"


Mary K. Freel (3/15/2013 at 10:00 AM)
When I was in the workforce this was called "Report". Instead of each nurse reporting off to her counterpart EVERYONE listened to report and discussed each patient. When primary care came in report got fragmented to one on one or one team from nights reporting to one team on days. Good to see that the old ways are sometimes the best.

Ruth Hansten RN PhD FACHE (2/20/2013 at 12:27 PM)
As Kalisch and Lee's (et al.) research indicates and my research and field work recommends, another key ingredient in teamwork goes beyond safety huddling at the beginning of the shift but also includes assistive personnel (techs, CNAs) into a patient/family goals-oriented shift report at the bedside, during which the RNs offer initial direction to CNAs. Fundamental to successful teamwork is planning time to set up checkpoints, timelines, parameters for reporting, and time to debrief their teamwork and share feedback. Expert teamwork includes the "post-game" discussion or debrief if the team is to improve. All of these teamwork skills are essential to patient safety and to positive clinical outcomes. Safe delegation and assignment prevents care omissions and improves patient and staff satisfaction. Huddles are only the beginning.

Peter McMenamin, PhD (2/19/2013 at 3:35 PM)
Alexandra: I'm with you as long as "football" uses the global definition rather than the American one. The problem with the American reference is that it brings us back to "quarterback," a subject likely to take us off on another tangent. For nurses, the easy mnemonic goes from Title VIII (nursing education) to Title 9 (and American success[INVALID]if not dominance[INVALID]of women's soccer). Soccer and lacrosse are the better sports metaphors for patient-centered, team-based care. [See my note at http://www.ananursespace.org/ananursespace/blogsmain/blogviewer?BlogKey=6aadd9d1-1d5f-486c-ae09-b309ecc89c4c.] Peter McMenamin, PhD Senior Policy Fellow American Nurses Association