Purpose

Unit leaders create situational awareness (cultural/clinical/operational), reinforce behavioral expectations, and create and promote psychological safety through effective unit huddles. Master facilitators use LENS as a window into the culture and operations of the unit and meet with unit leaders to coach and mentor leaders regarding concerns, successes, review unit quality improvement efforts, brainstorm about organizational resources to help solve issues, and overall assist in moving High Reliability Organizations (HRO) and LENS efforts forward.

A well performed huddle or LeaderRound by senior and executive leaders to units accomplishes the following:

Set behavioral expectations
Reinforce organizational goals
Create psychological safety

All leaders, unit leaders, master facilitators, and senior and executive leaders, must remember that LENS gives insight into unit culture and helps shape unit culture. Unit leaders should take advantage of every huddle to create a culture of operational excellence, psychological safety, and continuous learning.

Unit Leader With Staff

Actions

Before the Huddle create a huddle agenda using insights from LENS:

Find a safety story, from staff, to discuss in the huddle
Create introductions for new staff, staff recognitions and rewards
Add new updates
Review older updates
Review Aims and surveys
Review reports data

Tip: Add the above information to new huddle agenda

During the huddle start with the safety story and then discuss findings and updates from above with staff.

Cards - Review new cards in LENS to discuss in Huddle. Select previous issue cards to report out progress in Huddle. Add the above to Huddle Tab (as prompt) on LENS Voice Page.
Aims - Review and select Aims to report out on in Huddle. Add the above to Huddle Tab (as a prompt)
Surveys - Reminder to staff to participate in Surveys. Add the above to Huddle Tab (as prompt) on LENS Voice Page.
Discuss observations regarding unit culture and operations, identify:
- What is working?
- What needs improvement?
- Where help is needed?

After the huddle update LENS. Report back any feedback from master facilitator and champions to staff

Tip: CELEBRATE SUCCESSES!

Unit Staff

Actions

Before the Huddle review information on the Today, Voice, Aims, and Survey pages of LENS. Think about and be prepared to discuss a safety story, when a colleague helped you, patient experience, etc.

During the huddle participate in discussion. Talk about:

What is working?
What needs improvement?
Where help is needed?

Know what improvement activity you are responsible for during the day.

After the huddle:

Add cards to the Voice Page of LENS. Your insight and knowledge is valued and needed. Add cards to the 3 Good Things List, this protects you and your colleagues against burnout and builds joy in work.
Review Aims and be prepared to report out on and discuss your work related to ongoing unit Aims.
Participate in Surveys

Unit Leader With Master Facilitator

Actions

Before the huddle create huddle agenda using insights from LENS

Review Cards:

Identify and be prepared to discuss the cards that have been Flagged for Leadership.
What is working? (i.e. Are team members putting in cards?)
What needs improvement?
Where I/we need help.

Review Aims:

Be prepared to discuss progress on Aims.
What is working?
What needs improvement?
Where I/we need help.

Review Reports:

Be prepared to discuss LENS usage data.
Look for trends in the report and bring them up for discussion.
What is working?
What needs improvement?
Where I/we need help.

During the huddle discuss issues:

Start with cards that are escalated and describe why they are. Identify and discuss the “tone” of the cards submitted by staff (e.g., respectful and professional, focused on work not people, etc.)
Describe the progress on measures, tests, etc. (requires proficiency in tests of change, model for improvement and/or lean).
- Articulate which Aims need additional support and why.
- Identify potential Aims from cards review for future improvement work.
Discuss Reports in LENS:
- Discuss adoption and engagement of staff with LENS using report data.
- What percentage of team members have put in cards?
- Are new cards being put into the board?

After the huddle add updates to huddle agenda with staff and give feedback to staff.

Tip: CELEBRATE SUCCESSES!

For Master Facilitator with Unit Leader

Actions

Before the Huddle:

Review Voice cards in LENS - Review cards that are escalated; start to think of ways to support the unit leader in moving cards forward. Select a few cards to discuss with the unit leader.
Review Aims in LENS - Familiarize yourself with the improvement work on the unit. Identify areas where you may be able to support improvement efforts, especially those Aims that appear to have stalled.
Review Reports in LENS - Become familiar with the unit LENS report, paying special attention to engagement and adoption. Identify areas where you can support unit leadership (i.e., increase in adoption, engagement, and improvement activities as needed)

During the Huddle:

Discuss Voice cards - Start with those that have been escalated then moving to a few of the others. What is working? What is not working?
Discuss Aims - Start with those that you have reviewed. What is working? What is not working? Coach and brainstorm with unit leaders to identify test of change to move aim forward.
Discuss Reports - Use LENS usage and engagement data identify gaps and brainstorm about ways to improve staff usage and engagement with LENS.
Offer assistance to support the unit leader in areas of:
- Adoption
- Engagement
- Improvement work (i.e., aims, measures, strategy, actions, tests. etc.)
- Leadership attention and resources
- Facilitation
- Group dynamics (i.e. cards of professionalism and respect)

After the huddle be prepared to report out to steering committee and potentially senior leadership unit progress based on huddle with unit leaders. Report feedback from steering committee and/or senior leadership back to unit leaders.

Tip: CELEBRATE SUCCESSES!

For Champions with Unit Leader

Actions

Before the Huddle or LeaderRound:

Review LENS Voice cards and take note of emerging themes
- Focus on cards that are escalated in LENS and start to reflect on:
  - Why are they escalated?
  - What is challenging the group that requires senior leadership input? (If no escalated cards, review the themes and discuss the overall engagement of the group - i.e. how many cards are coming in, how are they being categorized etc.)

Review Aims in LENS - What is currently being tested? Are there any new measurements?
- Identify Aims measures where improvement work appears to be stalled.
Review the LENS Usage and Engagement Report and become familiar with the unit LENS report paying special attention to engagement and adoption.
- Identify areas where you can support unit leadership (i.e., increase in adoption, engagement, and improvement activities as needed)

During the Huddle or LeaderRound:

Start with opening comments about shared purpose - creating and maintaining self-reflecting, improvement capable work settings that bring to light and act on clinical, operational and cultural issues and ideas: This requires a willingness to learning and improve, psychological safety, clear behavioral expectations about professionalism and participation in improvement.
Discuss Aims - Ask what is currently being tested? Ask if there any new measures. Are there hurdles or other challenges getting in the way? Ask how unit leadership is prioritizing the activity to make it manageable? Ask if there are individuals in the department or outside of it who are being particularly helpful or problematic that leadership should know about? Ask if the unit is on track to achieve the Aims that have been set? (look to assist, re-calibrate, brainstorm etc.)
Discuss the LENS usage and engagement report - Discuss with the unit leader the participation by unit team member, is it active and/or adequate? Discuss if there are particular groups who are very active or very inactive. Identify individuals that are informal LENS leaders/champions that could be coached and mentored to sustain cultural and improvement (learning) within LENS Discuss any individuals with whom unit leadership needs assistance and how to address problematic behavior.

After the Huddle or LeaderRound, follow-up with unit leader on any items/work that you’ve taken on. Report unit progress to steering committee and report steering committee feedback to unit leaders.

Tip: CELEBRATE SUCCESSES!