However, the actual effect of SBAR on patient outcome is unclear. 41–44 Furthermore, less time was needed for the patient hand-off in several studies. 34–40 Especially in patient hand-off, the quality of the communication and the completeness of transferred information was increased after the implementation of SBAR. Positive resonances of employees after the introduction of SBAR were reported 24–28 with improvements of the communication perception and interdisciplinary teamwork 29–33 as well as the quality of the communication. 9Ī number of studies have investigated ‘soft’ outcomes such as employee satisfaction 21 22 and interdisciplinary communication 19 23 in relation to SBAR. The tool is available for download from the website of the Institute for Healthcare Improvement. The immediate need is explained clearly and specifically, including what is necessary to address the problem What is the next step in the management of the patient?Īn informed suggestion for the continued care of the patient has to be made by the speaker. ‘I don’t hear any breath sounds in his right chest. This section can include a provisional diagnosis or clinical impression Then specific information on vital signs, recent laboratories and other quantitative or qualitative data related to the patient’s current state are provided. ‘He’s a 54 year old man with chronic lung disease who has been sliding downhill, and now he’s acutely worse’ The patient’s chart is reviewed and questions the other care provider may have are anticipated The speaker then provides the background, such as the patient’s diagnosis or reason for admission, medical status and relevant history. What is the background or context on this patient? ‘Dr Preston, I’m calling about Mr Lakewood, who’s having trouble breathing’ What is going on with the patient? What is the situation you are calling/communicate about?įirst, the speaker presents the situation, by identifying himself, stating the patient’s name and briefly describing the problem 19 The SBAR tool is regarded as a communication technique that increases patient safety and is current ‘best practice’ to deliver information in critical situations. 18 Besides, it reduces inhibitions especially in hierarchical context by encouraging the sender to provide a personal assessment and suggestion of the situation (‘Recommendation’). 16 Furthermore, it enables a preparation before the communication process, 16 17 and because sender and receiver share the same mental model, understanding and awareness are expected to be higher. 12–15 By virtue of a clear structure, SBAR calls for the provision of all relevant information, organised in a logical fashion. 9–11 The SBAR (situation, background, assessment, recommendation) instrument (see table 1) and its derivatives ISBAR, SBAR-R, ISBARR and ISOBAR fulfil this need and are widely used in different healthcare facilities as a communication and hand-off tool both intraprofessionally and interprofessionaly. 8 To overcome these barriers, communication strategies are desirable, which take little time and effort to complete, deliver comprehensive information efficiently, encourage interprofessional collaboration and limit the probability of error. 7 The components and processes of communications are complex and prone to misunderstanding. Such settings include the perioperative period, 5 the intensive care unit (ICU) 6 and the emergency department. 4 Poor communication is found in many different healthcare settings and is especially prominent in patient hand-offs and settings where fast and effective management is indispensable. The Joint Commission reported that poor communication is a contributing factor in more than 60% of all hospital adverse events they reviewed. Following the definition of Brennan et al, 3 adverse events are injuries that are caused by medical conduct resulting in prolonged hospitalisation and/or disability at the time of discharge. 2 To illustrate the impact of patient safety on healthcare quality, the incidence of adverse events is commonly cited. Patient safety is crucial for the delivery of effective, high-quality healthcare 1 and is defined by the World Alliance for Patient Safety of WHO as ‘the reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum’.
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