At William Osler Health System (Osler), a quality excellence mindset guides the organization, driving it to continuously pursue quality improvements that minimize risk and contribute to positive outcomes. Throughout the COVID-19 pandemic, this mindset never wavered. Instead, a heightened focus on quality, safety, communication and collaboration emboldened its teams to accelerate a number of key strategic initiatives, including the implementation of iHuddle Boards.

“Osler’s iHuddle Boards are the manifestation of a visionary and purposeful approach to quality and patient safety that is used to visually translate our strategic plan so that it is as meaningful to our frontline teams as it is to the Executive and the Board,” said Tiziana Rivera, Vice President, Quality and Chief Nursing Executive, William Osler Health System. “iHuddle Boards enable senior leaders to share strategic, operational, and quality metrics with clinical units in real time so that we’re all working with the same data to support timely decision-making locally and organization-wide.”

Recently recognized as a global leading practice by the Health Standards Organization (HSO) and Accreditation Canada, Osler’s digitally-driven iHuddle Boards are a standardized visual management tool available to clinical teams via accessible 55-inch touchscreen monitors in each emergency department and inpatient and outpatient unit. Unit managers are encouraged to invite patients and families to join unit huddles in front of the iHuddle Boards to discuss patient safety with the team, ask questions and offer solutions.

“This initiative has transformed how our teams manage quality and safety, review unit/program performance, and collaborate on key organizational initiatives,” said Tony Raso, Associate Vice-President, Clinical Practice and Quality, William Osler Health System. “Staff and physicians are quickly able to see and understand what is happening on their unit and across the organization through easy access to real-time data and a process that facilitates input, engagement and feedback.”

Supported by an iHuddle App developed in-house by Osler’s Business Innovation team, each digital board features both standardized and unit-specific performance metrics that align to clinical unit goals and Osler’s four corporate strategic directions, all in an easy-to-read visual format. There are also sections that provide opportunities for staff engagement and recognition, quality improvement, organizational announcements and campaigns relevant to teams at the point of patient care, and staff feedback and improvement ideas. Managers at Osler are also able to customize sections of the board specific to their team’s needs.

“It’s great to be able to access unit-specific metrics and link them to the organization’s broader strategy during team huddles,” said Shailesh Nadkarni, Clinical Services Manager, Mental Health and Addictions, William Osler Health System. “This way, staff are able to see how their daily activities at the point-of-care influence and connect to the strategic directions of the organization.”

Prior to the implementation of the iHuddle Boards, Shailesh had to access multiple screens or databases to deliver relevant information to his team for discussion in team huddles. Now that he and his teams have access to real-time data at their fingertips, they are able to maximize their 15-minute huddles, and include more meaningful discussions.

“The iHuddle Board gives us decision points for improvement, providing immediate line-of-sight as to whether or not the actions we are taking as a team are moving the needle on a performance indicator we are seeking to improve. It’s this type of dialogue that leads to innovation,” said Shailesh.

Earlier this year, Osler’s Quality Team leveraged the digital solution to help prepare clinical teams for Accreditation by conveying learning materials regarding required organizational practices (ROPs) directly on the iHuddle Boards for discussion in team huddles. This included short videos, quizzes and one-page communiques.

“Because the iHuddle Boards standardized our approach to huddles across Osler’s sites, we were able to focus clinical team discussions on the same quality-related topics each week, with managers drilling down the relevance of each ROP to the team’s day-to-day activities on the unit,” noted Tony. “The use of the iHuddle Boards to reinforce the integration of ROPs into practice was among the organizational strengths noted by visiting Accreditation Canada surveyors, who ultimately awarded Osler the Accredited with Exemplary Standing designation, the highest rating granted by the accreditation body.”

At a time when hospitals are facing unprecedented challenges moving patients through the system due to high patient volumes, patient complexity and staffing shortages, the real-time data available on the iHuddle Boards is proving crucial to supporting improved patient flow across Osler sites.

“The metrics for admissions to the emergency department and the inpatient bed census across the organization is live on the board,” said Gresham Kimm, Interim Clinical Services Manager, Stroke Unit, William Osler Health System. “Seeing live data helps our team members better understand why decisions are made that may directly impact the unit, because they can see first-hand where the challenges are.”

Another aspect of the iHuddle Board experience that Gresham likes is the opportunity to devote time to new improvement ideas from the team that are then reflected on the board.

“Typically, we’ll come up with a quality improvement initiative every couple of weeks that we want to work on as a team, based on a challenge we’re experiencing on the unit,” said Gresham. “Whether it’s something that needs to be addressed by myself, the resource nurse or by the team in their day-to-day work, we’re able to post the solution to the iHuddle Board and track its development from idea to ‘in progress’ to implementation. This really promotes problem-solving as a team, while allowing individuals to see the positive impact their ideas can have on the unit and ultimately for the patient.”

Roll-out of Osler’s iHuddle Boards began in late 2020 and was accompanied by robust resources and onboarding including scripts, training and technical videos for directors and managers. Materials were also posted on the hospital’s intranet site where they were accessible to staff and physicians.

For more information on Osler’s iHuddle Boards, visit the HSO Leading Practices Library.