In healthcare, there is room for improvement in the communication between care teams. Communications gaps are thought to account for a significant portion of adverse events, particularly during handoffs (such as from the inpatient to ambulatory setting). The Joint Commission has estimated that handoff miscommunication is responsible for 80 percent of serious medical errors, raising the need for tools and practices that support improved communication.
A communications framework that outlines essential elements can help clinicians convey important information and is a key component of a care management plan. One such tool, SBAR (Situation, Background, Assessment, Recommendation), establishes common expectations about the information clinicians share and how they structure the communication. SBAR’s standardized communications approach also helps nurses and physicians build trust around sharing information, and creates open and structured communication between members of the care team.
This article explains how an integrated, effective communication methodology, such as SBAR, can help health systems avoid medical errors and improve outcomes and the patient experience.
Doug Bonacum, the vice president of safety management for Kaiser-Permanente in Denver, developed SBAR in an effort to bridge the communication gap between nurses and physicians. Bonacum based the guidelines for consistent and concise handoffs on his experience on a Navy submarine, where crew members often needed to communicate strategy in less than 60 seconds.
Similar to a submarine, healthcare information handoffs tend to involve complex messages; the accurate and timely delivery of these messages can be a life or death matter. As clinicians see more patients in shorter time frames, quality care increasingly relies on an effective communication and handoff methodology. By using a concise format, such as SBAR, clinicians share only the relevant information they need to make an efficient, informed care decision.
A communication tool is most effective when organizations standardize it as a regular part of workflows and make it part of the culture. For example, one health system saw improved SBAR compliance when they gave clinicians SBAR reminder pocket cards and posted summaries of the methodology at each telephone. The entire organization soon adopted SBAR guidelines in all communication.
Organizationwide adoption of a communication methodology is critical in today’s interdisciplinary, patient-centered care. Today’s healthcare setting requires a collaborative team approach that includes physicians, nurses, nurse care managers, social workers, community health workers, and patients at the front of the team.
The SBAR communication model, a leading healthcare methodology, has four parts that streamline healthcare communications:
Under part one: situation, a clinician gives a concise statement about the patient’s current situation; for example:
Under part two: background, clinicians provide brief and pertinent information related to the current situation; for example:
Under part three: assessment, the clinician analyzes the situation and background, and considers intervention options; for example:
Under part four: recommendation, the clinician requests or recommends an action to address the situation; for example:
A consistent strategy for effective healthcare communication improves efficiency and provides a best practice method that optimizes the sharing of patient information. Health systems can reduce their risk of medical error by integrating a communication framework into their care management that, such as SBAR, defines the concise, vital, and relevant information for successful care team handoffs.
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