An exploration of the use of safety huddles in ICUs across the United Kingdom – A cross-sectional national e-survey

BACKGROUND: Safety huddles aim to reduce adverse events by fostering communication and teamwork, enabling early risk identification and mitigation. Despite their potential, evidence of effectiveness in ICUs is limited, with concerns about variability in models, focus, and delivery. RESEARCH AIM: To explore how safety huddles are utilised in adult ICUs across the United Kingdom. METHODS: An exploratory, cross-sectional electronic survey was conducted with Nurse Unit Managers or delegated nurses in charge from United Kingdom (UK) ICUs in December 2024- May 2025. The 41-item anonymous survey, informed by the Systems Engineering Initiative for Patient Safety (SEIPS) 2 model, gathered data on huddle characteristics, perceived effectiveness, and improvement areas. Analysis included descriptive statistics, Hierarchical Task Analysis, and framework analysis of qualitative responses. RESULTS: Seventy-four responses were analysed; 71 reported using safety huddles. Registered nurses attended safety huddles most consistently (n = 63, 89%), with less frequent attendance from medical staff (n = 8, 32%) and allied health professionals (n = 5, 15%). Timing, frequency, and structure varied widely, and most huddles did not adopt an evidence based or structured framework. Task analysis revealed complex, layered subtasks including the discussion of safety determinants, and the evaluation, escalation, dissemination and documentation of the safety huddle. Influencing factors included staffing, skill mix, workload, and organisational culture. Reported benefits included improved teamwork, communication, and staff support. Drawbacks include time burden, perceived irrelevance, care interruptions, and lack of psychological safety. CONCLUSIONS: Safety huddles in UK ICUs vary widely and face systemic challenges. Current practice lacks an evidence-based framework, robust risk escalation, and mechanisms for shared learning. IMPLICATIONS FOR CLINICAL PRACTICE: Findings highlight characteristics and influencing factors to inform development of an evidence-based framework and a standardised, systems-based safety huddle model, balancing consistency, local flexibility, and person-centred principles.