Module 2: Communicating Change in a Resident's Condition

Appendix. Example of the SBAR and CUS Tools

A. A good tool for shift-to-shift handoffs and for situations that require immediate attention and action: SBAR


  • Situation (identify yourself, the resident, and the problem).
  • Background (history, vitals, results, etc).
  • Assessment (findings, severity, life-threatening?).
  • Recommendation (what is next?, needs, timeframe).
    • Review the chart.
    • Complete the SBAR.
    • Speak clearly.
    • Document SBAR in the progress notes.


B. Getting your supervisor's attention when you really need it: CUS

CUS Tool

  • I am Concerned about my resident's condition.
  • I am Uncomfortable with my resident's condition.
  • I believe the Safety of the resident is at risk.

Example: "I'm concerned that Ms. C is not her usual self. I'm uncomfortable that she is behaving so oddly. I believe she is not safe; she may have something serious going on that we are missing."

Page last reviewed October 2014
Internet Citation: Appendix. Example of the SBAR and CUS Tools. October 2014. Agency for Healthcare Research and Quality, Rockville, MD.