SBAR (Situation, Background, Assessment, Recommendation)
SBAR (Situation, Background, Assessment, Recommendation) is a verbal or written communication tool that helps provide essential, concise information, usually during crucial situations. In some cases, SBAR can even replace an executive summary in a formal report because it provides focused and concise information.
SBAR was introduced by the United States military in the 1940s and later targeted specifically for nuclear submarines where concise and relevant information was essential for safety. Since then, the SBAR communication tool has been used in a variety of industries, and its ability to improve safety is well documented.
SBAR can be written or provided verbally, but the purpose is to provide essential, concise information, usually during crucial situations.
In this initial section, the exact circumstances of the situation get explained. Non-essential information is excluded. The focus should be on the seriousness of the situation.
The background section presents essential information related to the situation. This information should pertain only to the current situation.
The assessment is a precise statement based on the situation and background information. The assessment must be made by a qualified staff person.
The qualified staff person makes a recommendation for resolving the issue based on the situation, background, and assessment.
Because of its simplicity and usefulness in crucial situations, SBAR has many implementations in healthcare. It can be used between professional staff such as nurses and physicians, and it also has value for hand-offs by nurses between change of shifts or patient transfers. Below is a basic example of how SBAR communication can be used in a healthcare setting, but SBAR can be used as a leadership communication tool in any industry.
Situation: The patient has been hospitalized with an upper respiratory infection. Respiration are labored and have increased to 28 breaths per minute within the past 30 minutes. Usual interventions are ineffective.
Background: The patient is a 72-year-old female with a history of congestive heart failure and chronic obstructive pulmonary disease. Her husband has requested to be notified if the patient's condition changes.
Note: The patient's past illnesses are highly relevant to the current situation, but the patient's home address is not.
Assessment: Patient's breathing has deteriorated in the last 30 minutes. Usual interventions (i.e., inhaler, oxygen, breathing treatments) have been ineffective and are not relieving symptoms.
Note: The assessment must be made by a qualified staff person, such as a registered nurse, but it is not a diagnosis unless it is made by a provider such as a medical doctor or physician assistant.
Recommendation: Consider intubation immediately. Call physician STAT or initiate Rapid Response Team.
Table 1 below is an example of an SBAR communication to hospital leadership written by a primary care physician.
Table 1: SBAR Communication for Community Services
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