The Situation, Background, Assessment and …

1 International Journal of Caring Sciences September-December 2015 Volume 8 | Issue 3| Page 530. Original Article The situation , background , Assessment and Recommendation (SBAR). Model for Communication between Health Care Professionals: A. Clinical Intervention Pilot Study Lisbeth Blom, MSc, RNs Junior Lecturer, The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden Pia Petersson, PhD, RN, Senior Lecturer, The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden Peter Hagell, PhD, RN. Professor, The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden Albert Westergren, PhD, RN.

2 Professor, The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden Correspondence: Dr Lisbeth Blom, Kristianstad University, SE-291 88 Kristianstad, Sweden E-mail: Abstract background : SBAR has been suggested as a means to avoid unclear communication between health care professionals and in turn enhance patient safety in the healthcare sector. Aim: to evaluate hospital-based health care professionals experiences from using the situation , background , Assessment and Recommendation (SBAR) communication model. Methodology: A quantitative, descriptive, comparative pre- and post-intervention questionnaire-based pilot study before and after the implementation of SBAR at surgical hospitals wards.

3 Open comments to questionnaire items were analyzed qualitatively. Results: The introduction of SBAR increased the experience of having a well-functioning structure for oral communication among health care professionals regarding patients' conditions. Qualitative findings revealed the categories: Use of SBAR as a structure, Reporting time, Patient safety, and Personal aspects. Conclusions: SBAR is perceived as effective to get a structure of the content in patient reports, which may facilitate patient safety. Key Words: SBAR, communication, health care professionals, patient safety. background common understanding (Greenberg et al., 2007). Without a common understanding there is a risk that Unclear and ineffective communication between the basis for healthcare professionals to make correct health care professionals is a common underlying assessments and appropriate decisions is lacking.

4 Cause of patient injuries in healthcare (Gawande, Zinner, Studdert, & Brennan, 2003). Therefore, the The situation , background , Assessment and transfer of information between health care Recommendation (SBAR) model has been suggested professionals is very important. If the information is as a means to facilitate effective communication unclear, there is a risk that it does not create a between health care professionals (Beckett & Kipnis, International Journal of Caring Sciences September-December 2015 Volume 8 | Issue 3| Page 531. 2009). SBAR is a well-tested model (Instititute for Data collection Healthcare Improvement, 2015), which has been The questionnaire was developed specifically for this used for a long time for transmission of important study by two of the authors (LB and AW) based on information in complex work environments, for previous personal and reported experiences (Wallin example in the nuclear industry, aviation and & Thor, 2008).

5 The questions focused on how health NASA's space program (Wallin & Thor, 2008). professionals experienced the current communication SBAR provides a framework for communication structure (Table 1). between members of the health care team about a patient's condition, and has been found to facilitate Intervention both the collection, organization, and exchange of The aim of introducing the SBAR model was to information as well as be an effective strategy to increase focus on patient safety when communicating develop teamwork (Leonard, Graham, & Bonacum, information, while also saving time by enhancing the 2004). structure of the information. Studies show that there are many advantages to using When introducing SBAR, the specific content of the a standardized model such as SBAR when model needs to be adjusted to the relevant context communicating regarding patients (Beckett & Kipnis, (Ko CH, Turner, & Finnigan, 2011).)

6 Therefore, a 2009; Novac & Fairchild, 2012; Whittingham & working group was formed, composed of nurses, a Oldroyd, 2014). It provides an opportunity to physician, and one of the authors. Based on existing maintain focus in the information transfer and to literature the working group presented two pocket- keep the information concise, accurate and easy to sized SBAR-based reference cards, one for understand (Novac & Fairchild, 2012). Patient safety communication when reporting between shifts and will also be facilitated by having a structure for the one for communication in instances of impaired information content when communicating regarding patient status/needs for immediate medical patients (Beckett & Kipnis, 2009; Novac & Fairchild, consultation with a physician (Figure 1).

7 2012), by serving as a reminder as to what should be communicated (Beckett & Kipnis, 2009). Procedures Aim Approvals from the hospital's chief medical officer and head nurses at the included wards were sought The aim was to evaluate hospital-based health care and received before initiating the project. professionals' experiences from using the situation , background , Assessment and Recommendation All staff received oral and written information about (SBAR) communication model. the aim of the project. They were then asked to individually complete the study questionnaire before Methodology the introduction of the SBAR model. When This pilot study had a quantitative, descriptive, implementing the SBAR model all health care comparative pre- and post-intervention design.

8 Data professionals at the included wards received oral and were collected before and after the introduction of written information about how the SBAR model SBAR by a structured questionnaire with the would be used, and the SBAR reference cards were possibility of commenting in free text (Polit & Beck, made available to all staff. All health care 2004). professionals at the included wards were asked to complete the study questionnaire a second time, one Context and participants year after the implementation of the SBAR model. The study was conducted at two surgical and one The questionnaires were coded and no personal orthopedic ward, each with 26 beds, at a hospital in information was collected; reminders were sent to southern Sweden.

9 The sample included all enrolled non-responders after X weeks. nurses, registered nurses and physicians (n=189) who Data analysis were employed at the wards. No specific communication model was used at the included units Since pre-intervention responders could not be linked before this study. to pre-intervention responders, questionnaire data International Journal of Caring Sciences September-December 2015 Volume 8 | Issue 3| Page 532. from the two time points were treated as independent particularly when nurses reported to physicians groups. Thus, quantitative data were analyzed using substituting for patients' regular responsible the Mann-Whitney U-test. P-values of < was physician.

10 It was proposed that patient safety can be considered significant. Written comments were enhanced by supplementing oral communication with analyzed qualitatively according to conventional available written documentation. content analysis (Hsieh & Shannon, 2005). Personal aspects Results Nursing staff felt that the success of the SBAR model The questionnaire was answered by 116 staff to improve communication between staff was members before and 86 after the implementation of dependent on the person communicated. For the SBAR model. A larger proportion of the staff example, the ability of the SBAR model to facilitate reported that they found the structure and content of patient safety was considered related to exactly what oral communication regarding patients efficient after was reported regarding a patient's condition.