Table 1

Example huddle participants and problem discussion at each tier

Tier	Example participants	Example discussion of a problem at each tier: patient fall
1	Bedside care team and their manager within an inpatient unit	Detailed discussion of every patient fall since yesterday’s huddle. Determine adherence to standard processes (fall assessment and precautions) and identify root cause. Plan actions (countermeasures) to address root cause.
2	Team of managers and their director	Discuss total patient falls on each unit, root causes identified and countermeasures underway. Check quality of fall investigations, planned countermeasures and follow-up. Provide coaching and assistance to managers as needed.
3	Team of directors and senior leader (ie, chief nursing officer, chief operating officer)	Summary of patient falls in all inpatient units, including key learnings and recurrent patterns. Checks quality of fall investigations, planned countermeasures and follow-up. Provide coaching and assistance to directors as needed.
4	Senior leaders (chief nursing officer, chief operating officer and hospital president) at one hospital location	Summary of falls at this location, including key learnings, recurrent patterns and information to share with other hospital locations. Provide coaching and assistance to senior leaders as needed.
5	All hospital leaders and system physician and nursing executives	Summary of falls at all locations, including indicators of stability in our processes over time and across locations. Provide coaching and assistance to hospital leaders as needed.
6	System clinical leaders, CEO and other members of the executive team	Summary of falls across the enterprise, including key learnings, trends and opportunities. Provide unique resources where needed to address causes of patient falls (eg, additional safety measures at door and parking lots).

CEO, chief executive officer.