Tool: SBAR

SBAR, which stands for Situation, Background, Assessment, and Recommendation (or Request), is a structured communication framework that can help teams share information about the condition of a patient or team member or about another issue your team needs to address.

In phrasing a conversation with another team member, consider the following:

SBAR is one of the most widely used TeamSTEPPS tools for many reasons:

• Structured communication tools such as SBAR can enhance communication between members of the healthcare team.
• SBAR provides a vehicle for individuals to speak up and express concern in a concise manner.
• SBAR is useful for framing any conversation, especially critical ones requiring a team's immediate attention and action, such as when a patient's condition is rapidly deteriorating. It may also be useful with providers who are not part of the core team, such as remote consultants or mental health providers.

Using SBAR effectively requires careful attention to each step:

• Situation states what is currently happening with the patient. It usually begins with the identity of the person communicating the SBAR, patient identifiers such as age and gender, and a brief statement of the current problem or situation.
• Background covers clinical background such as patient history related to the current situation, signs and symptoms of the presenting complaint, and any test results, such as lab or imaging reports.
• Assessment reports what the person communicating the SBAR thinks the problem is. It states what the nurse or other provider has assessed based on the background information, patient history, and observations. Assessment asks what else it can be, provides sense making, considers sources of other information to provide clarity, and relates actions to consequences. Assessment can also include objective data such as vital signs.
• Repeat-Back Recommendations and Requests states an initial recommendation, what is needed and when, and repeats back the stated response from the other provider or patient to ensure accuracy.

Additional notes on using SBAR include:

• Do not forget to introduce yourself—you should not assume that everyone knows who you are.
• SBAR is adaptable. Think of it as a menu: the parts you choose to use and the order in which they are used depend on your team's unique needs. Determine which parts of SBAR are relevant to your team's needs and use those when communicating critical information among your team members.
• SBAR can be modified for use by the patient or family caregivers to communicate with the care team. For example, your facility could provide patients with a summary of SBAR to enable them to share information about their own situation, background, assessment, and recommendations or to ask the care team about their care.
• Consider saying the actual words to keep yourself on track: "The situation is..., The background is..., My assessment is…, I recommend..."

The table shows other practical examples of SBAR.

To expand your understanding of and ability to use SBAR, choose from the options below:

• Reflect on a patient story involving the use of SBAR:
  After watching the video, consider:
  • Why is SBAR particularly helpful in situations where rapid and accurate decisions are essential?
  • How do trust and positive working relationships between team members affect the use of SBAR?
• Reflect on a video scenario involving the transfer of information using SBAR.
  After watching the video, consider:
  • How did the SBAR technique improve communication between the nurse and physician?
    • The nurse identified herself and the reason she was calling.
    • The physician was quickly made aware of Mrs. Everett's deteriorating situation.
    • The nurse provided the background of the deep vein thrombosis (DVT) diagnosis and all current labs.
    • The recent assessment of the patient has led the nurse to call the physician with her concerns.
    • The recommendation was initiated by the nurse for additional labs, and a plan was discussed for future care.
  • How would SBAR help you in similar encounters within your healthcare context?
• Reflect on your own experience with SBAR.
  • Have you used SBAR in your institution? If so, how was it used? What was the result of its use?
  • What were the challenges to implementing SBAR and how were these challenges overcome?