Ready for Success: Implementing a Daily Management Tiered Huddle System Using the SQORE Framework

The implementation of Daily Management System (DMS) tiered huddles represents a significant milestone in Memorial Sloan Kettering Cancer Center’s (MSKCC) journey towards becoming a high reliability organization (HRO). The huddles utilized a new effective framework called SQORE, an adaptation of the SQDCM methodology from manufacturing, which emphasizes Safety, Quality, Operations, Resources, & Engagement. DMS huddles incorporated the use of automation to escalate & resolve opportunities across the care continuum in real time. MSKCC has set a foundation for further patient safety, staff engagement, & operational improvements.

Describe & detail the journey of implementing daily management tiered huddles, enhancing organizational accountability, communication, & operational readiness.

Apply the SQORE framework (Safety, Quality, Operations, Resources, Engagement) to assist staff in prioritizing daily operational challenges, while ensuring the organization supports staff in patient safety, care quality, & engagement.

Highlight how automation using tools like Microsoft Teams, Planner, & Power Automate can ensure real time closed-loop communication while also minimizing administrative needs for long-term program sustainment.

Authors

Joseph Aloise is a Lead Process Improvement Engineer for MSKCC's Transformation Management Office (TMO) with a background in both the healthcare and manufacturing industries. Joseph's current role involves development and implementation of new processes and systems to support strategic and operational initiatives across MSKCC. Joseph's previous experience includes a combination of performance improvement, project management, and change management, including but not limited to Lean Daily Management, New Facility Design, Operations and Transition Planning, Equipment and Supply 5S, Clinical Care Pathways, Ideal Discharge & Length-Of-Stay Reduction initiatives, Nursing Operations and Finance, Critical Care & Resuscitation quality improvement, Value Based Management, Readmission Prevention, High Reliability Organizations, & Root Cause Analysis.

Traecy Avanesian Argatin is a master’s student in Industrial and Systems Engineering at Binghamton University – State University of New York and a Graduate Research Associate in the Transformation Management Office (TMO) at Memorial Sloan Kettering Cancer Center. Her work focuses on applying systems engineering and data-driven approaches to improve healthcare operations and resource management. She has worked on projects such as developing performance dashboards, refining institutional policies and best practice guidelines, and supporting large-scale workflow redesign initiatives. Through these projects, she has applied Lean methodologies, process improvement frameworks, and advanced data analytics to support decision-making and organizational efficiency. Traecy's research interests include healthcare analytics, continuous improvement methodologies, and the use of machine learning and predictive modeling to enhance efficiency and outcomes in complex systems.