The Improvement Academy has successfully adapted the “Huddle Up for Safer Healthcare” (HUSH) into the veterinary world. Our unique approach to safety huddles provides teams with a platform to collaborate and address identified harms in healthcare, enhancing communication within teams of colleagues at all levels and creating a culture where all voices are heard, ultimately leading to improved patient safety. The daily team huddle introduced at Paragon Veterinary Referrals Unit focuses on enhancing patient care and medication safety, promoting psychological safety, and boosting team wellbeing.
Background
In March 2024, the Improvement Academy was contacted by Paragon Veterinary Referrals, a small animal referral hospital based in Wakefield with approximately 150 staff members. Whilst researching the use of safety huddles for optimising quality and safety, they came across the HUSH initiative used within the NHS and had already started huddling on a small scale in their dispensary. An initial visit and meeting with the staff at the animal hospital identified medication errors as an area of harm, which safety huddles might help them reduce.
“HUSH” Safety huddles with staff involved in caring for inpatients started July 2024. The staff explored how medication errors occur and how future medication errors can be prevented. This quickly spread to all units within the hospital, and safety huddles became embedded into their daily routine in September 2024. The huddle takes a proactive approach to preventing errors with involvement and suggestions from those working closest with the patients, rather than a top-down approach.
The huddle is based on embedding key principles including:
- Being held daily and lasting 5-10 minutes only.
- Led by the most suitable person for the team with all team members invited (including non-clinical).
- Being focused: in this case on preventing medication administration and dispensing errors.
- Agreed actions are followed up and learning shared amongst the team.
- Harms data is visualised on a “days between board” updated daily. Achieved milestones are celebrated with certificates.
A teamwork and safety climate survey was conducted to assess the baseline level of culture, communication, and patient safety amongst staff. The results were analysed, and feedback discussions took place with the staff to discover what was working well and where some improvements might be possible. This feedback, along with staff inclusion in discussions and observations, helped boost staff enthusiasm for attending and engaging with safety huddles.
Impacts
Since the introduction of HUSH safety huddles in July 2024, Paragon Veterinary Referrals has seen a notable reduction in medication errors. Within the first five months of testing safety huddles, ten error-free weeks were achieved compared to ten error-free weeks in an entire year previously. The average days between incidents has also improved from an average of 2.6 days before the introduction of safety huddles to 5.7 days after safety huddles were embedded. Furthermore, previously unnoticed medication errors have been identified and successfully mitigated through enhanced communication and improvements in teamwork.
To date, there has been an overall reduction of 25% in all medication errors.
Recognition and award
In July 2025, Paragon Veterinary Referrals was awarded first place in the Royal College of Veterinary Surgeons Knowledge award for Quality Improvement in Practice, acknowledging their success in reducing medication errors and improving patient care through the HUSH safety huddles programme. The hospital is now expanding their safety huddles to address other areas of concern, such as reducing skin incidents related to incontinence and faecal matter in their patients.
