March 2007
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New patient safety effort
SBAR is an acronym you'll be hearing a lot in the next few months. It stands for situation, background, assessment and recommendation, and is one component of a new communications approach being rolled out to clinicians across the institution by the Program for Patient Safety and Quality.
Communications issues are at the heart of nearly 40 percent of medical errors, according to studies by the Risk Management Foundation, the hospital's medical insurer. To streamline communications as health care delivery becomes ever more complex, hospitals are borrowing techniques and protocols from other high-risk industries, such as aviation and nuclear power, that have been shown to reduce errors. SBAR, along with "appropriate assertion" and "closed loop communication," are structured communication techniques designed to enable and empower members of clinical teams to convey important information concisely yet thoroughly in situations where immediate attention and response are needed.
SBAR provides a framework for a clinical team member to easily and quickly tell a story from the headline describing the situation to the bottom line recommendation. It's a tool now being implemented in health care for use when a patient is transferred from one clinician or service to another. Receiving clinicians will be prepared to accept, integrate and react to the new information.
Appropriate assertion is a communication tool that lets clinicians gain a colleague's attention to quickly resolve a clinical problem. Once all clinicians are tuned into the assertion terms, team members will recognize the cues when a colleague expresses a "concern," that becomes a "challenge," then escalates to the need for immediate "collaboration" on the problem.
Closed loop communication, the third component of the new approach, will be familiar to all clinicians since it is fundamental to the Read Back/Feed Back National Patient Safety Goal. Just as it sounds, closed loop communication describes the practice of repeating back information when one member the team member makes a request of another.
As of March 1, 165 clinical leaders have been trained as super trainers in these three techniques. The goal is to have 3,000 clinicians using structured communications by September.
