Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review

Shahid, Shaneela; Thomas, Sumesh

doi:10.1186/s40886-018-0073-1

Cited by 119 publications

(103 citation statements)

References 49 publications

(49 reference statements)

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“…Adoption of clinical protocols, additional recruitment and training of nurses, and replacement of junior obstetricians by those with more experience reduced anxiety around management of labour. Use of structured communication by junior obstetricians promoted greater participation in clinical decision-making [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

Reducing caesarean section rate in an urban hospital serving women attending privately in India – a quality improvement initiative

Bhartia

Dhar

Bhartia

2020

BMC Pregnancy Childbirth

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Background In line with global trends, India has witnessed a sharp rise in caesarean section (CS) deliveries, especially in the private sector. Despite the urgent need for change, there are few published examples of private hospitals that have successfully lowered their CS rates. Our hospital, serving private patients too, had a CS rate of 79% in 2001. Care was provided by fee-for-service visiting consultant obstetricians without uniform clinical protocols and little clinical governance. Consultants attributed high CS rate to case-mix and maternal demand and showed little inclination for change. We attempted to reduce this rate with the objective of improving the quality of our care and demonstrating that CS could be safely lowered in the private urban Indian healthcare setting. Methods We hired full-time salaried consultants and began regular audit of CS cases. When this proved inadequate, we joined an improvement collaborative in 2011 and dedicated resources for quality improvement. We adopted practice guidelines, monitored outcomes by consultant, improved labour ward support, strengthened antenatal preparation, and moved to group practice among consultants. Results Guidelines ensured admissions in active labour and reduced CS (2011 to 2016) for foetal heart rate abnormalities (23 to 5%; p < 0.001) and delayed progress (19 to 6%; p < 0.001) in low-risk first-birth women. Antenatal preparation increased trial of labour, even among women with prior CS (28 to 79%; p < 0.001). Group practice reduced time pressure and stress, with a decline in CS (52 to 18%; p < 0.001) and low-risk first-birth CS (48 to 12%; p < 0.001). Similar CS rates were maintained in 2017 and 2018. Measures of perinatal harm including post-partum haemorrhage, 3rd-4th degree tears, shoulder dystocia, and Apgar < 7 at 5 min were within acceptable ranges (13, 3, 2% and 3 per thousand respectively in 2016–18,). Conclusions It is feasible to substantially reduce CS rate in private healthcare setting of a middle-income country like India. Ideas such as moving to full-time attachment of consultants, joining a collaborative, improving labour ward support, providing resources for data collection, and perseverance could be adopted by other hospitals in their own journey of moving towards a medically justifiable CS rate.

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Section: Resultsmentioning

confidence: 99%

Reducing caesarean section rate in an urban hospital serving women attending privately in India – a quality improvement initiative

Bhartia

Dhar

Bhartia

2020

BMC Pregnancy Childbirth

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“…This qualitative analysis provides insights on what factors should be addressed to implement the use SBAR by healthcare professionals within the interprofessional context of a pediatric non-acute care ward. 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 (Shahid & Thomas, 2018). However, the process of interprofessional communication is complex and prone to misunderstanding.…”

Section: Discussionmentioning

confidence: 99%

The use of SBAR as a structured communication tool in the pediatric non-acute care setting: bridge or barrier for interprofessional collaboration?

Coolen¹,

Engbers

Draaisma³

et al. 2020

Journal of Interprofessional Care

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“…12 A simulation introduced the SBAR (Situation, Background, Assessment, Recommendation) mnemonic as a framework for overnight calls. 13,14 The joint training sessions were designed to address elements of the hidden curriculum and increase the receptiveness of faculty to resident calls. A printable version of the expectations for calls was incorporated in the shared sign-out document as a point-of-care reminder.…”

Section: Perspectives Viewpointsmentioning

confidence: 99%

Reactive, Holistic, Proactive: Practical Applications of the AAIM Learning and Working Environment Conceptual Model

Jaffe

Bergin

Loo

et al. 2019

The American Journal of Medicine

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AAIM is the largest academically focused specialty organization representing departments of internal medicine at medical schools and teaching hospitals in the United States and Canada. As a consortium of five organizations, AAIM represents department chairs and chiefs; clerkship, residency, and fellowship program directors; division chiefs; and academic and business administrators as well as other faculty and staff in departments of internal medicine and their divisions.

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Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review

Cited by 119 publications

References 49 publications

Reducing caesarean section rate in an urban hospital serving women attending privately in India – a quality improvement initiative

Reducing caesarean section rate in an urban hospital serving women attending privately in India – a quality improvement initiative

The use of SBAR as a structured communication tool in the pediatric non-acute care setting: bridge or barrier for interprofessional collaboration?

Reactive, Holistic, Proactive: Practical Applications of the AAIM Learning and Working Environment Conceptual Model

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