Enhancing Clinical Handover with ISBAR Tool for Patient Safety

ISBAR ISBAR A patient safety tool for clinical handover of the A patient safety tool for clinical handover of the critically ill child critically ill child Anna Toti

Communication relating to patient care Communication relating to patient care Requires concise transfer of patient clinical information Occurs between health care professionals with different specialties, levels of experience and communication styles A standardised tool needed for communication of all the important aspects of patient information and needs

ISBAR ISBAR Started off as SBAR used by US military then in aviation industry Communication tool introduced into health care c.2002 Now widely recommended in health care communication Provides a structured way to handover a patient Each step calls for action Reduces communication errors that lead to negative patient outcomes

Specify: I Yourself, your role and location to: The colleague/team you are handing over to Patient s parent or guardian IDENTIFY Patient name, age, gender and ward or department

State: S The current clinical situation Changes in patient s condition Scores or measurements taken Vital signs or NEWS GCS SITUATION Relevant bedside or lab test results Risks or concerns you may have

Briefly outline: B Admission details Presenting complaint Relevant clinical history and diagnosis BACKGROUND Allergies and previous illness of significance Interventions to date

State clearly: A Your clinical opinion of patient s current status ABCDEFGHI assessment ASSESSMENT Ongoing concerns Patient instability what has been or needs to be done to stabilise

Briefly: R Recommend management plan with rationale Request specific advice, interventions RECOMMENDATION Clarify expectations Close the loop of communication

Clinical context Clinical context Morning meeting team hand over On call hand over ICU/PICU/HDU/PCC unit ward rounds CED to main wards Post anaesthesia/Paediatric surgical procedure Inter ward transfers Referral to hospital