Reducing hospital-acquired pressure ulcers through focused clinical daily safety huddles in a stroke unit

Patient safety remains a critical concern in healthcare systems worldwide, particularly in acute settings such as stroke units, where multidisciplinary co-ordination is essential. METHOD: This study explores the implementation and impact of a focused clinical daily safety huddle (FCDSH) as a non-technical intervention aimed at enhancing patient safety, reducing hospital-acquired pressure ulcers (HAPUs), and improving interprofessional collaboration. The project employed Kotter's eight-step change model to guide the implementation process and used Plan-Do-Study-Act (PDSA) cycles for iterative development. Stakeholder engagement, coaching leadership methodology, and a robust data collection process, including run charts, supported the intervention. RESULTS: The results demonstrated a significant increase in the number of days between reported pressure ulcers, with the ward achieving 142 days without an incident post intervention compared with a baseline average of 18.2 days. The findings highlight the effectiveness of FCDSHs in improving communication, fostering teamwork, and reducing preventable patient harm. CONCLUSION: This service evaluation contributes to the growing evidence base for human factors approaches and non-technical skills in clinical practice.