What Is SBAR and What Is SBAR Communication?
Industry best practice communication technique for today's Healthcare professional.
The Situation, Background, Assessment and Recommendation (SBAR) technique has become the Joint Commission on Accreditation of Hospitals' stated industry best practice for standardized communication in Healthcare; effortlessly structuring critical information primarily for spoken delivery. Regular use of SBAR is an important part of any organization's Crew Resource Management (CRM) family of skills, which help all levels of caregivers function as effective team members, and is essential to establishing a culture of quality and patient safety and high reliability.
SBAR promotes quality and patient safety, primarily because it helps individuals communicate with each other with a shared set of expectations. Staff and physicians can use SBAR to share patient information in a clear, complete, concise and structured format; improving communication efficiency and accuracy.
Originally developed by the United States Navy as a communication technique that could be used on nuclear submarines, Safer Healthcare helped introduce SBAR into Healthcare in the late 1990's as part of its Crew Resource Management (CRM) training curriculum. Since that time, SBAR has been adopted by hospitals and care facilities around the world as a simple yet effective way to standardize communication between care givers.
Standardize communication among staff and caregivers.
The SBAR technique offers hospitals and care facilities a solution to bridge the gap in communication, including hand-offs, patient transfers, critical conversations and telephone calls. It creates a shared expectation between the sender and receiver of the information being shared.
Here is how SBAR works:
- First, quickly organize the briefing information in your mind or on paper using the four elements (Situation, Background, Assessment and Recommendation) in sequence. Only the most relevant data is included, and everything irrelevant or of secondary importance is excluded.
- Second, present your briefing. Since team members can immediately recognize and understand the familiar, predictable SBAR format, you help them more efficiently and effectively address a situation or solve a problem.
- Third, they may confirm, clarify or enhance what you’ve said, then work with you to take the required action.
SBAR increases overall operational excellence, creates an environment in which a team can work together more effectively and, most important, improves the safety of the patients they serve. One of the ways SBAR does this is by creating a shared mental model that ensures members are on the same page. SBAR also requires you to speak frankly and openly with others, regardless of their position in the organization.
Why is SBAR recommended for nurse calls to physicians?
SBAR promotes better communication in Healthcare. In most cases nurses and physicians communicate in very different ways. Nurses are taught to report in narrative form, providing all details known about the patient. Physicians are taught to communicate using brief “bullet points” that provide only the key information to the listener.
The following is an example of a nurse call to a physician using SBAR:
"Dr. Jones, this is Deb McDonald RN, I am calling from ABC Hospital about your patient Jane Smith."
"Here's the situation: Mrs. Smith is having increasing dyspnea and is complaining of chest pain."
"The supporting background information is that she had a total knee replacement two days ago. About two hours ago she began complaining of chest pain. Her pulse is 120 and her blood pressure is 128 over 54. She is restless and short of breath."
"My assessment of the situation is that she may be having a cardiac event or a pulmonary embolism."
"I recommend that you see her immediately and that we start her on O₂ stat. Do you agree?"
The SBAR communication technique creates the shared mental model that ensures the nurse and physician remain on the same page throughout the conversation.
Why implement SBAR in your Healthcare organization?
The Joint Commission enterprise's (The Joint Commission, Joint Commission Resources, and the Center for Transforming Healthcare) provides an answer in the following excerpt taken from their recent Hot Topics in Healthcare: Transitions of Care paper.
What are transitions of care?
Transitions of care refer to the movement of patients between health care practitioners, settings, and home as their condition and care needs change. For example, a patient might receive care from a primary care physician or specialist in an outpatient setting, then transition to a hospital physician and nursing team during an inpatient admission before moving on to yet another care team at a skilled nursing facility. Finally, the patient might return home, where he or she may receive care from a visiting nurse or support from a family member or friend. The scope of the Joint Commission transitions of care initiative encompasses transitions of patients between health care settings. For example, from a nursing home to a home care agency.
Unfortunately, these transitions do not always go smoothly. Ineffective care transition processes lead to adverse events, and higher hospital readmission rates and costs. One study estimated that 80% of serious medical errors involve miscommunication during the hand-off between medical providers. Problematic transitions occur from and to virtually every type of health care setting, but especially when patients leave the hospital to receive care in another setting or at home, according to experts on this issue. To reduce both readmission rates and adverse events, hospitals must improve the effectiveness of transitions of care in which they play a role. The federal government has taken notice: Hospitals with unacceptably high readmission rates for Medicare and Medicaid patients will soon face financial penalties under the Patient Protection and Affordable Care Act.
Root causes of ineffective transitions of care.
Many factors contribute to ineffective transitions of patient care, and these root causes often differ from one health care organization to another. The root causes most often described in medical literature and by experts include:
Communication breakdowns. Care providers do not effectively or completely communicate important information among themselves, to the patient, or to those taking care of the patient at home in a timely fashion. The communication method - whether verbal, recorded, or written - is ineffective. For example, the Center for Transforming Healthcare’s hand-off communication project found these risk factors among those relating to communication:
- Expectations differ between senders and receivers of patients in transition.
- Culture does not promote successful hand-off (e.g., lack of teamwork and respect.
- Inadequate amount of time provided for successful hand-off.
- Lack of standardized procedures in conducting successful hand-off, ex: use of SBAR (Situation, Background, Assessment and Recommendation) techniques.
The Joint Commission on Accreditation of Hospitals has added standardized communication to the Patient Safety Goals and formally recommends SBAR as the industry best practice.
SBAR badges, checklists and guides to sustain efforts.
Safer Healthcare offers a variety of SBAR products and tools that have been designed to extend and sustain a formalized SBAR effort throughout an organization.
Using SBAR, patient reports are more accurate, efficient, and consistent enterprise-wide. This simple, yet highly effective communication technique can be used when:
- A nurse is calling a physician.
- Nurses are handing off patients to one another.
- Nurses are transferring patients to other facilities or to other levels of care.
SBAR training videos to educate staff and begin the journey.
Safer Healthcare offers SBAR training videos for both Acute and Long Term Care facilities.
SBAR Acute Care: this 15-minute overview and training DVD gives practical illustrations of how to use the SBAR briefing model in critical care situations: such as late-night calls to physicians, emergency departments, OB/perinatal and other high risk areas.
SBAR Long Term Care: this 15-minute overview and training DVD gives practical illustrations of how to use the SBAR briefing model in transfers, handoffs, shift changes, critical calls and other long term care situations.
These educational DVD's are available for only $149 each. Purchase them from our online store today!
Practical and effective SBAR tools and resources for every unique need.
Safer Healthcare's SBAR products are designed to give your staff members the following educational advantage:
- An understanding of the SBAR technique and why it is useful.
- The ability to increase communication productivity.
- Standardization of communication messages.
- Practical tools to begin using SBAR immediately.
- Support materials to sustain program momentum and progress.
Avoid communication breakdowns. Meet Joint Commission goals with standardized transitions of care and hand-off communications. Increase the effectiveness of nurse to physician communication. Equip your team to communicate effectively with practical tools.
Contact Us for More Information About SBAR
Safer Healthcare offers customized SBAR training workshops and customized SBAR resources including checklists, hand-off guides and other educational products. Contact Safer Healthcare's team of experts for more information:
- Phone: 303 298 8083
- Toll-free (US only) 866 398 8083
- E-mail: firstname.lastname@example.org