Implementation of Unit Based Huddle to Impact Internal Communication at Ward Level

By KWOK Tsz Ling, 31/F


Hong Kong Sanatorium and Hospital (HKSH) is committed to maintaining communication between all departments and staff; the hospital and patients & the public and other organizations. The internal communication modes include different cross-functional committee meetings, intranet, staff corner, retreats and staff newsletters etc. The objectives of internal communication are to collect opinions and concerns of staff members for discussion and to disseminate news and new policy to frontline staff members.

Purpose and Problem Statement

The internal communication challenges in current unit include, there is no formal channel for disseminating ward-based issues to frontline nursing on daily basis despite everyday changing ward situation. Besides, current messages are disseminated to frontline staff members through “Ward Information Book”. However, there is no standard format, no categorization and difficult to retrieve messages through this book. As a result, the information flow to frontline nurse in existing ward is not effective. Nurses’ awareness are limited to named patients through shift handover only, the general ward’s safety and staffing issues etc. may be neglected.

Implementation Plan

Huddles improve communication and patient safety and allowed staff to disseminate knowledge and ideas from the range novice to expert. To improve communication in current unit, a daily communication platform was implemented to reach all frontline staff and serve as a single source for updates and news.  It communicates hospital-wide issues and ward-based issues (Staffing, Safety, Equipment, Supplies, Others) that occurred within the past 24 hours. The messages are disseminated in a more systematic way through newly designed Huddle Binder. Daily unit huddle is led by Nursing Officer or Morning Charge Nurse. During huddle, mutual Interactions and discussions are encouraged.


“Internal Communication Assessment Survey 2019” and “Quiz on recent message update” were used to evaluate the project effectiveness pre- and post- project intervention (n=22). Results show that daily unit huddle improves both staff satisfaction rate and effectiveness of message dissemination. For staff satisfaction, nearly 50% more nursing staff rated the communication receiving from the ward as “Always satisfied”+ “Usually satisfied after huddle. And all nursing staff stated daily huddle improves internal communication. For effectiveness of message dissemination, nursing staff had correct answer from 21% to 77% before and after huddle through the quiz, questions were retrieved from recent meeting minutes from Nursing Task Force Meeting.

Recommendations and Next Steps

Varied schedules of frontline nurses (A,P,N) can lead to challenges for nursing officers when disseminating communication. Therefore, timely dissemination of rapidly changing ward issues, new regulations, policies, and evidence-based practices is crucial in maintaining patient safety.

For sustainability, the project progress will be monitored and evaluated regularly. In addition, all nursing staff will be trained to lead the huddle, instead of only led by nursing officers and charge nurses. The incident rates will also be monitored for long term goal.