Preventing a Fumble on the Handoff- The Power of SBAR
Handoffs are unavoidable for our patients as they transition through our health care system. Medical error is increased with the frequency and the complexity of these transitions. There are effective techniques that can reduce error and enhance communications during handoffs, patient transfers, telephone calls and critical conversations. The SBAR technique provides a framework for communication between members of the health care team about a patient’s condition. SBAR is an easy-to-remember tool used to create mechanisms useful for framing any conversation, especially critical ones, requiring a clinician’s immediate attention and action. It allows for an easy and focused way to set expectations between members of the team for what will be communicated and how. This is essential for information transfer and cohesive teamwork. Not only is there familiarity in how people communicate, but the SBAR structure helps develop desired critical-thinking skills. The person initiating the communication knows that before they pick up the telephone they need to provide an assessment of the problem and what they think an appropriate solution is. Their conclusion may not ultimately be the answer, but there is clearly value in defining the situation.
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 creates an environment in which a team can work together more effectively and 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 following the same Plan of Care. SBAR also requires you to speak frankly and openly with others, regardless of their position in the organization. Prevent the fumble- use SBAR.