Improving time to diagnosis and discharge in clinical decision units: the impact of progression of care huddles

Purpose This study evaluates the impact of implementing progression-of-care huddles on diagnosis and discharge times. It contributes to understanding how adaptive coordination among healthcare professionals enhances decision-making and streamlines care transitions. Design/methodology/approach Guided by coordination theory, this study tests hypotheses using negative binomial regression models applied to 6,794 patient episodes from two observation wards in a U.S. hospital over 14 months. The analysis compares pre- and post-huddle periods, controlling for patient and operational factors, with outcomes including time to diagnosis and discharge. Findings Huddles reduced diagnostic decision time by 14%. The impact on post-diagnosis discharge time was only significant for patients discharged to a facility, resulting in a 39% reduction. Effectiveness was contingent on organizational structure: the impact was reduced within focused units. In contrast, huddling remained equally effective in the presence of clinical protocols. Huddles did not compromise care quality, as 30-day readmission rates remained unchanged. Research limitations/implications The findings show that communication structures can partly substitute for specialization. Protocols and huddling operate as complementary systems to jointly manage uncertainty and complexity. Practical implications Huddles are particularly effective when intricate workflow interdependencies constrain the speed of decision-making. Healthcare organizations can benefit from huddles even when clinical protocols are implemented. Originality/value The study advances research on care huddles by demonstrating that high-frequency huddles enhance decision-making in dynamic healthcare environments. It offers insights into how huddles can complement or substitute other organizational mechanisms and demonstrates their capacity to provide adaptive coordination even without dedicated teams.