Introduction of a night shift huddle on labour ward to improve communication, safety and team-working

Abstract

Introduction: Night shifts in obstetric theatres carry inherent risk through working in an unscheduled, rapidly evolving and often time critical environment out-of-hours. Human factors are the most common cause of adverse obstetric events. Therefore initiatives to mitigate miscommunication and encourage team-working can promote safety and good quality care.1 Handovers do not routinely include all staff working at night meaning key information may be shared informally or late. We introduced a multidisciplinary night shift huddle with the aim of improving communication, teamwork and safety in obstetric theatres. Method(s): Ethics approval was not required as no patient data was collected. Peer review involved senior anaesthetists, obstetricians and midwives. A brief structured huddle was introduced for a two-week trial period. Awareness was promoted via posters, safety briefings, emails and direct engagement. Content covered introductions, staffing concerns, escalation pathways, labour ward and theatre status, high-risk patients, recovery capacity, equipment or facilities issues, and contingency planning. Feedback was collected via an anonymous post-implementation survey using Likert-scale questions and free-text comments. Result(s): Pre-implementation, 68% of anaesthetists felt a huddle was warranted. Twenty staff responded to the post-implementation survey. Ninety percent strongly agreed or agreed that the huddle improved communication at night. Similarly, 90% and 85% agreed or strongly agreed that the huddle promoted good team working and safety respectively. Qualitative feedback highlighted improved situational awareness, clearer role allocation, and greater confidence in raising concerns. The huddle enabled early identification of system issues including faulty bleeps/phones and unavailable thromboelastometry equipment, allowing contingency plans to be made before emergencies occurred. Discussion(s): Initial concerns were that the huddle may be burdensome at a busy time of night however, staff feedback showed enthusiasm and was positive. Challenges included project visibility and timing conflicts with midwife allocation; these were addressed during the trial by adjusting start time and content order. The huddle fostered a shared mental model, mitigated human factor risks, and supported a culture of safety without delaying care. In conclusion, huddles represent a simple, low-cost intervention with potential to improve safety and staff experience in obstetric theatres. [Formula presented] Copyright © 2026