SBAR: A small but mighty tool for communicating clearly
We are bombarded with information, inputs and distractions coming at us from all directions, all day long, whether we are busy caring for patients or hard at work ensuring the daily operations of our work areas are running smoothly.
The SBAR tool can be used effectively in clinical and non-clinical settings as it is a great way to structure your thoughts for clarity and understanding.
When time is of the essence
You manage to catch your department leader for five minutes in between meetings and want to make your case for an unplanned budget variance. Or your attending has a few minutes between surgeries and one of the earlier patients is experiencing a problem.
How will you hold their attention AND get your point across in five minutes or less? Put it in an SBAR! An SBAR is a way to get your point across without a lot of background noise.
- Situation: Tell me what the problem is you are trying to solve or what it is that you are asking for.
- Background: What do I need to know in order to make a decision?
- Assessment: What root cause(s) have you identified? What is the worst-case scenario/outcome of your problem if nothing changes?
- Recommendation: What is your proposed countermeasure or action? (Tip: Be sure it directly addresses the root cause(s) you identified!)
A versatile tool
SBARs can be short, sweet and to the point, while others are used to convey larger, more complex problems.
When rapid, clinical decision making is necessary, use an SBAR:
House officer to attending:
Situation: Our patient, Ms. XX, is in the PACU complaining of nausea.
Background: She had a complicated eye surgery earlier today that took a little longer than expected.
Assessment: I suspect her intraocular pressure is high.
Recommendation: I will check her eye pressure and administer IOP lowering drops, if appropriate.
When the issue is complex, such as assessing the risk of external corrugated cardboard shipping boxes being found throughout the organization (a real example from U-M Health!), a longer SBAR may be warranted.
When working with their teams, leaders can use SBARS to role model how the tool can help everyone communicate more clearly and make decisions more effectively together.
Connection to quality improvement
Our colleagues in Quality have been educating many of our teammates around using A3 Problem Solving, a systematic and collaborative approach to problem solving. While they are distinct tools, putting things in an SBAR and A3 problem solving are BOTH ways to tell a story, concisely, clearly and effectively.
One nursing team uses a template to prepare SBARs so they can insert relevant information at a moment’s notice when needed. Here is an example.
So go ahead and try it out! The first couple times using an SBAR may feel a little awkward, but you will come to see it as one of your most valuable tools in providing clear, concise communication in support of high reliability.