Class 5 - Communication Tools Flashcards
What do the letters in SBAR mean?
S = situation: describe the situation
Ex: “I am calling about Mr. Jones who has a
fever of 101.5.”
B = background: explain the background
(doctor does not have pt chart in front of
him)
Ex: She is a 24-year-old G2P2 who delivered by
C-section for fetal distress yesterday at
2300.”
A = assessment: provide an assessment to the
physician (vital signs, lab work)
Ex: “Her other vital signs are normal. Her wound
is clean, lochia normal, lung sounds normal.
Patient has no complaints.”
R = recommendation: explain what you need
and be clear and specific
Ex: Would you like me to get a urinalysis, blood
cultures and/or CXR?
What is an SBAR used for?
It is a communication tool. Taken from the military to provide precise, clear and effective communication.
Why do we need to use the SBAR?
Helps to focus communication to improve the effectiveness of information transfer.
Very important for urgent or high acuity situations where clear and effective communication is critical to patient outcomes.
What factors can affect error and human performance
Limited memory capacity
Impact of stress
Fatigue
Multi-tasking limits
What are some hierarchical power blocks to communication?
Power structures may stop team members from sharing observations
Individuals may discredit their own observations and suggestions
Some perspectives and communication styles are privileged
What are some cultural influences on communication?
Relationship to authority
What does it mean to question?
Am I being polite?
What are 2 gender influences on communication?
Accommodation vs. Assertion
Multi-tasking abilities
What are some clinical tools or concepts to responding to human factors?
Appropriate assertion:
-individuals speak up, and state their information with appropriate persistence until there is a clear resolution.
Critical language: C - I’m Concerned U - I’m Uncomfortable S - This is unsafe “We have a serious problem, stop and listen to me!
Situational awareness: Maintain the big picture – quality of care – safety Think ahead and plan Tune into red flags
Create a learning environment: After an event, program or day, ask: What did the team do well? What were the challenges? What will the team do differently next time
Common debriefing model
– SBAR
Why is it so difficult to be assertive?
Power differences
Lack of common mental model
Don’t want to look stupid
Not sure that you’re right
What are some “red flags” in terms of communication?
Ambiguity Poor communication Trying something new under pressure Verbal violence Doesn’t feel right Boredom Task saturation Being rushed Deviating from established norms
When should you use an SBAR?
In time sensitive or critical situations
When making treatment decisions and everyone needs to be tuned into the plan
During phone calls to MDs and other team members
During hand-offs and transitions in care
When dealing with system and organizational problems
When you need clarity
