The PACT Project: improving communication at handover

Clark, Eileen; Squire, Sally; Heyme, Anne; Mickle, Mary-Ellen; Petrie, Eileen

doi:10.5694/j.1326-5377.2009.tb02618.x

Cited by 43 publications

(51 citation statements)

References 3 publications

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“…The mechanisms of improving referral effectiveness in this situation are likely to be a combination of all three. Other studies have suggested that use of an SBAR minimum information tool helps staff ‘know what they should say’ when making referrals 15. Although we expected to show improvement in knowledge (presence of expected critical data to be transferred during referral), this was not the case.…”

Section: Discussioncontrasting

confidence: 58%

Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting

Cunningham

Weiland

Dijk

et al. 2012

Postgraduate Medical Journal

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Objective To determine whether exposing junior doctors to Situation, Background, Assessment, Recommendation (SBAR) improves their telephone referrals. SBAR is a standardised minimum information communication tool. Methods A randomised controlled trial with participants and rating clinicians both blinded to group allocation. Hospital interns from a 2-year period (2006e2007) participated in two simulated clinical scenarios which required them to make telephone referrals. The intervention group was educated in SBAR between scenarios. Pre and post intervention telephone referrals were recorded, scored and compared. Six-month followup and year group comparisons were also made. An objective rating score measured the presence of specific 'critical data' communication elements on a scale of 1e12. Qualitative measures of global rating scores and participant self-rated scoring of performance were recorded. Time to 'first pitch' (the intern's initial speech) was also recorded. Results Data were available for 66 interns out of 91 eligible. SBAR exposure did not increase the number of communication elements presented; objective rating scores were 8.5 (IQ 7.0e9.0) for SBAR and 8.0 (IQ 6.5e8.0) for the control group (p¼0.051). Median global rating scores, designed to measure 'call impact', were higher following SBAR exposure (SBAR: 3.0 (IQR 2.0e4.0); control: 2.0 (IQ 1.0e3.0); p¼0.003)). Global rating scores improved as time to 'first pitch' duration decreased (p¼0.001). SBAR exposure did not improve time to 'first pitch' duration. Conclusion In this simulated setting exposure to SBAR did not improve telephone referral performance by increasing the amount of critical information presented, despite the fact that it is a minimum data element tool. SBAR did improve the 'call impact' of the telephone referral as measured by qualitative global rating scores.

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Section: Discussioncontrasting

confidence: 58%

Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting

Cunningham

Weiland

Dijk

et al. 2012

Postgraduate Medical Journal

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“…Importance and relevance of capturing information related allergies, comorbidities, assessment of pain, neurological monitoring, and aspects to be documented under the plan of care need to be incorporated as a regular part of continuing education program. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes[3] and thus, provide safe and quality care to patients.…”

Section: Resultsmentioning

confidence: 99%

“…[2] Studies indicate that use of structured handoffs will improve the quality of patient handover. [345] Hands off is the transfer of responsibility and accountability of a patient, from one nurse to another[6] either during shift handover or transfers of the patient from one department to the other.…”

Section: Introductionmentioning

confidence: 99%

Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study

Achrekar

Murthy

Kanan

et al. 2016

Asia-Pacific Journal of Oncology Nursing

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Objective:The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR) form.Methods:Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM). Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR) form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1st week (A1) and 16th week (A2), post introduction of SIM. Nurse's opinion about the SBAR form was also captured.Results:Majority of nurses were females (65%) in the age group 21-30 years (80%). There was a significant association (P = 0.019) between overall audit scores and graduate nurses. Significant improvement (P = 0.043) seen in overall scores between A1 (mean: 23.20) and A2 (mean: 24.26) and also in “Situation” domain (P = 0.045) as compared to other domains. There was only a marginal improvement in documentation related to patient's allergies and relevant past history (7%) while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76%) of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53%) to document while recommendation was the difficult (53%) part.Conclusions:SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.

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“…Based on literature review in chart note writing and EHR documentation functionalities, five categories were created: EHR-writing competence (21), EHR-reading competence (19, 21), and EHR-writing preference in terms of input format (typing vs. check boxes) (16, 26), EHR-reading preference in terms of output format (narrative vs. bullet points) (27), and EHR-reading preference (succinct vs. lengthy) (28). EHR-writing competence includes an ability to create thorough and complete notes, using an appropriate form in a timely manner.…”

Section: Methodsmentioning

confidence: 99%

Writing and reading in the electronic health record: an entirely new world

Han

Lopp

2013

Medical Education Online

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BackgroundElectronic health records (EHRs) are structured, distributed documentation systems that differ from paper charts. These systems require skills not traditionally used to navigate a paper chart and to produce a written clinic note. Despite these differences, little attention has been given to physicians’ electronic health record (EHR)-writing and -reading competence.PurposesThis study aims to investigate physicians’ self-assessed competence to document and to read EHR notes; writing and reading preferences in an EHR; and demographic characteristics associated with their perceived EHR ability and preference.MethodsFourteen 5-point Likert scale items, based on EHR system characteristics and a literature review, were developed to measure EHR-writing and -reading competence and preference. Physicians in the midwest region of the United States were invited via e-mail to complete the survey online from February to April 2011. Factor analysis and reliability testing were conducted to provide validity and reliability of the instrument. Correlation and regression analysis were conducted to pursue answers to the research questions.ResultsNinety-one physicians (12.5%), from general and specialty fields, working in inpatient and outpatient settings, participated in the survey. Despite over 3 years of EHR experience, respondents perceived themselves to be incompetent in EHR writing and reading (Mean = 2.74, SD = 0.76). They preferred to read succinct, narrative notes in EHR systems. However, physicians with higher perceived EHR-writing and -reading competence had less preference toward reading succinct (r= − 0.33, p<0.001) and narrative (r= − 0.36, p<0.001) EHR notes than physicians with lower perceived EHR competence. Physicians’ perceived EHR-writing and - reading competence was strongly related to their EHR navigation skills (r=0.55, p<0.0001).ConclusionsWriting and reading EHR documentation is different for physicians. Maximizing navigation skills can optimize non-linear EHR writing and reading. Pedagogical questions remain related to how physicians and medical students are able to retrieve correct information effectively and to understand thought patterns in collectively lengthier and sometimes fragmented EHR chart notes.

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The PACT Project: improving communication at handover

Cited by 43 publications

References 3 publications

Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting

Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting

Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study

Writing and reading in the electronic health record: an entirely new world

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