Team Huddle: Nurse Role in the Prepared Practice Team

Tuesday, 23 July 2013: 11:25 AM

Kathy L. Goodman, RN
Ambulatory Care Strawberry Health Center, Harris Health System, Pasadena, TX
Jennifer Lahue, MBA, BSN, RN
Ambulatory Care Services, Harris Health System, Houston, TX
Linda Marie Keenan, MPA, BSN, RN-BC, NMCC
Ambulatory Care Services, Harris Health System, Harris Health System, Houston, TX

Learning Objective 1: 1. Explain the creation of the structured Team Huddle Sheet in the ambulatory care setting

Learning Objective 2: 2. Discuss the process of the TEAM Huddle in the ambulatory care setting.


To sustain our continued excellence as a designated medical home level III health center, our team addresses one of the Patient-Centered Medical Home criteria which states, team meetings may include daily TEAM Huddle, a structured communication process to discuss patients coordination of care for planned visits.


Team Huddle starts with nurse completing pre-clinic chart review and documents data on Team Huddle Worksheet.  Nurse clinician reviews the diagnosis,  chief complaints, identifies health maintenance or preventive screenings of the patient. Nurse clinician determines patient’s compliance to care management by trends of No Shows or Cancellations.  Nurse clinician makes a referral for patient to chronic disease nurse, nurse educator, weight management, or case management if barriers to self -care are identified.  Team Huddle worksheet is completed with data collected and referrals from prospective pre -clinic chart review. Nurse collaborates with physicians to coordinate the patient’s care management. Nursing clinician will complete the proper documentation of the outcome of the team huddle in the organization’s medical record.


Team Huddle Worksheet was approved as a corporate document in the organization for other centers and clinics to use as appropriate to sustain our continuous compliance with the Patient-Centered Medical Home criteria Factor 2: The PRACTICE Team. The Center’s patient satisfaction score for the overall nursing care was 89.0%, outperforming the Center’s goal of 78.9% for 3 months reporting period with 93 patients surveyed. Aggregates on nurse friendliness, courtesy and concern of patient care needs were also outperforming the organization’s health center goal.


Efficient focus screening and coordination of care promote professional Team Building and partnership of patient care between physician and nursing staff.  Other center nursing team arranged a site visit and has adopted the best practices to their health center.