NUR 431 Module 7 Project Two Leadership Action Plan Example

Project Two: Five Minutes at 7:30, a Leadership Action Plan for a Nightly Cross-Department Safety Huddle

[Student Name]

Southern New Hampshire University

NUR 431: Leadership Practices for the Professional Nurse

Project Two

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Project Two: Five Minutes at 7:30, a Leadership Action Plan for a Nightly Cross-Department Safety Huddle

The Project One team analysis found that Ridgeline's night team is capable but rarely shares a common picture of the night: its members work in different places, some of them miles from the hospital, and the weakest teamwork mechanisms are shared understanding and closed-loop communication. This leadership action plan addresses that gap with one change, a five-minute cross-department safety huddle at the start of every night shift. The plan argues that the huddle's success depends less on its format than on how it is introduced, so it uses a change model to build urgency and support before the first huddle and defines measures that will show whether the team's shared understanding actually improves. The hospital, staff and data are composites.

The Change

At 7:30 p.m., the night supervisor leads a five-minute huddle at the nurses' station, with on-call staff and the tele-hospitalist joining by conference line or video. The script covers four items: patients at risk tonight and why; staffing gaps and who covers what; equipment or supply problems; and anything a team member is worried about. Each on-call member states their response time for the night. Any concern raised is assigned an owner before the huddle ends. The huddle does not replace bedside report or the tele-hospitalist's own handoff; it adds the cross-department picture neither of those provides.

Why Huddles

Provost et al. (2015) studied huddles in three health care settings through observation, interviews and literature review, and proposed that huddles create time and space for conversation, strengthen relationships and reinforce a culture of safety, which they linked to the goals of high-reliability organizations. Their work describes mechanisms rather than measured outcomes, so it supports the huddle's design more than it predicts its effect. Evidence from structured teamwork interventions sets realistic expectations: in a study of structured interdisciplinary rounds on five medical units, O'Leary et al. (2015) found that teamwork scores improved, especially among nurses, but that adverse event rates did not change. For Ridgeline, the huddle should be judged first by whether the team shares a clearer picture of the night, not by an immediate fall in adverse events.

Leading the Change With Kotter's Steps

Kotter (1996) proposed eight steps for leading organizational change. The plan uses them in compressed form, matched to a small hospital. To create urgency, the supervisor will share three recent composite nights on which a delay occurred because someone did not know who was covering what, including a lab draw that waited forty minutes. To build a guiding coalition, the supervisor will recruit a respected night nurse, the lead respiratory therapist and the tele-hospitalist group's medical director. The vision is a single sentence: everyone on nights knows the plan by 7:35. The vision will be communicated at staff meetings, in a short email and by the coalition members to their own departments. Obstacles will be removed by testing the phone bridge and keeping the huddle to five minutes. Short-term wins, such as the first night a huddle concern prevented a delay, will be shared. The change will be consolidated by building the huddle into the night supervisor's checklist and anchored by adding it to orientation for travelers and new staff.

Stakeholders and Resistance

The likely resistance comes from three places. On-call staff may resent joining a call from home when they are not being paid for that time; the plan asks the laboratory and respiratory managers to count the two minutes as paid on-call time and makes joining optional for x-ray, whose calls are rare. Bedside nurses may see the huddle as one more task at the busiest time of the evening; the five-minute limit and a fixed script address that concern, and the coalition nurse will ask for feedback after two weeks. The tele-hospitalist group may be reluctant to add another call; its medical director's membership in the coalition is intended to secure support. Resistance will be treated as information about the design, not as opposition to be overcome.

Measures

The three-month trial will track four measures. The process measure is the share of nights with a huddle completed by 7:40 p.m., with a target of 90%. A shared-understanding measure asks each nurse at the end of the shift a single question, whether they knew who to call for each service that night, rated yes or no, with a target rise from a baseline of about half to 90%. An outcome measure tracks delays attributed to not knowing who was covering, counted from the supervisor's log. A balancing measure asks whether the huddle delayed the start of medication passes, checked by comparing first medication administration times before and after. Results will be reviewed monthly with the coalition.

Timeline

Weeks one and two cover coalition building, baseline measurement and testing the phone and video bridge. Weeks three and four introduce the huddle on three nights a week. From week five, the huddle runs every night. At week eight, the coalition reviews measures and staff feedback and adjusts the script. At week twelve, the supervisor reports results to the director of nursing and recommends whether to make the huddle permanent.

Communication Plan

Each group will hear about the huddle from someone it trusts. Night nurses will hear about it at their staff meeting from the coalition nurse, who will describe the forty-minute lab delay and ask for help designing the script. On-call staff will hear from their own managers, with the paid-time arrangement confirmed in writing. The tele-hospitalist group will hear from its medical director. A one-page summary will be posted at the nurses' station and emailed to all night staff, and the huddle script will be laminated and kept at the phone. After the first month, a short update on what the huddles caught will go to everyone, so staff can see that their five minutes are producing something.

Conclusion

A five-minute huddle is a small change aimed at a real gap: a dispersed night team without a shared picture of the night. Introduced through a guiding coalition, with objections anticipated and measures set in advance, it has a reasonable chance of improving how the team coordinates, and the evidence suggests it should be judged first by that coordination rather than by an immediate drop in adverse events.

References

Kotter, J. P. (1996). Leading change. Harvard Business School Press.

O'Leary, K. J., Creden, A. J., Slade, M. E., Landler, M. P., Kulkarni, N., Lee, J., Vozenilek, J. A., Pfeifer, P., Eller, S., Wayne, D. B., & Williams, M. V. (2015). Implementation of unit-based interventions to improve teamwork and patient safety on a medical service. American Journal of Medical Quality, 30(5), 409-416. https://doi.org/10.1177/1062860614538093

Provost, S. M., Lanham, H. J., Leykum, L. K., McDaniel, R. R., Jr., & Pugh, J. (2015). Health care huddles: Managing complexity to achieve high reliability. Health Care Management Review, 40(1), 2-12. https://doi.org/10.1097/HMR.0000000000000009