Handover and note-keeping: the SBAR approach

Patient handover – the poor relation of medical training?

“…Studies show that structuring the handover process improves its quality and consistency and has a positive impact on communication, teamwork and patient safety [7], [8], [9]. 24% of nurses and 39% of physicians rate handoversas inefficient and not well structured.…”

Standardizing Handoff Communication

“…Comparison of Description of Information Labeled as "Background" in 6 Mnemonics Mnemonic Detailed Description of "B" Representing "Background" Element for the Mnemonic I PASS the BATON [5][6][7][8] Comorbidities, previous episodes, current medications, family history SBAR 7,9,10 Explain circumstances leading to the situation, put situation into context, history, laboratory findings, test results SBAR +2 (ISBARQ) 8 Vitals, code status, list of medication, laboratory results SBARR 11,12 Context, history, relevant condition SBAR-T 11,13 Chief complaints, treatments, pending tests and treatments, special needs I-SBAR 5 Vitals, other pertinent issues, care provided so far, patient's response to care 240 JOURNAL OF NURSING CARE QUALITY/JULY-SEPTEMBER 2016 handoff, hand-off, handover, and hand-over. A mnemonic was included if it explicitly specified information that should be transferred between health care practitioners during a handoff.…”

“…First, descriptions of the methods used to develop these mnemonics and why information was selected are vague. [5][6][7][8][9][10] Second, different mnemonics may use the same word, but the word may have a different meaning from one mnemonic to another. Table 1 compares how the word background is used by 6 different mnemonics, 5 of which stem from the commonly used SBAR (Situation, Background, Assessment, Recommendations).…”

A vision for safer care?

“…The use of structured checklists is just one example we have featured in Clinical Risk. 3 The five-year forward view also rightly identifies technology as critical to the successful transformation of service delivery in the future:…”