SBAR DSA

Question 1

What is the importance of handoffs in malpractice?

Answer 1

communication failures were responsible, at least in part, for 30% of all malpractice claims in US hospitals

(resulted in 1744 deaths and 1.7 billion in malpractice over 5 yrs)

Question 2

What was the Robust Process Improvement?

Answer 2

project that found that receivers thought that 37% of handoffs were bad

senders only thought 21% of handoffs were bad

Question 3

What did the Bartlett Regional Hospital in Juneau, Alaska do?

Answer 3

reduced its ineffective hand-offs by 58% by using the Center for Transforming Healthcare’s Targeted Solutions Tool (TST)

Question 4

What does I-PASS stand for?

Answer 4

Illness severity

Pt summary

Action list

Situation awareness and contigency plans

Synthesis by receiver

Question 5

In what form did the Joint Comission suggest handoffs to be?

Answer 5

both verbally and in written form

not just in EMR - talk to receiver in either face-to-face, phone, or video chat

Question 6

How should vital signs and lab tests be presented during a hand-off?

Answer 6

they must be dated

Question 7

Where should hand-offs occur?

Answer 7

between senders and receivers in locations free from interruptions

include multidisciplinary team members and family as appropriate

Question 8

How should hospitals encourage transitioning to better hand-off practices?

Answer 8

standardize training

use acronyms, do pt simulations, etc

Question 9

How should EHR be used in the handoff process?

Answer 9

EHR should be used to enhance hand-offs and allow for ongoing communication feedback loops

online pt portals should be encouraged

Question 10

What does ISBAR stand for?

Answer 10

Identification

Situation

Background

Assessment

Recommendation

Question 11

What does PSYCH stand for and when is it used?

Answer 11

Pt information/background

Situation leading to hospital visit

Your assessment

Clinical info

Hindrance to discharge

Question 12

What is the last pneumonic used in emergency situations that I will not go through bc it is long af?

Answer 12

I PUT PATIENTS FIRST

(if you want a definition go to the SBAR DSA)

Question 13

What was the leading root cause of sentinel events reported to the Joint Commission in the USA btw 1995 and 2006?

Answer 13

breakdown in communication

Question 14

What, in general, does hand-over communication entail?

Answer 14

passing pt-specific info from one caregiver to another or one team to another

also transfer of info from one type of health-care org to another or from health-care org to pt’s home

Question 15

What is the best way to improve hand-overs?

Answer 15

redesign the system of care delivery so there is less room for human error

educate physicians

Question 16

What are 2 other techniques besides SBAR that are helping to improve sendoff communication?

Answer 16

read-back techniques (receiver reads back info to sender)

collaborative (multidisciplinary) rounds

Question 17

How is health literacy been defined?

Answer 17

the capacity of individuals to obtain, process and undertand the basic health info and services needed to make appropriate health decisions

Question 18

What is teach-back?

Answer 18

a technique used by caregivers to ensure pts understand info

pt describes what he or she has just heard to assess their comprehension

Question 19

What percentage of serious medical error is estimated to be due to miscommunication during handoff?

Answer 19

80%

Question 20

What should be included in the background portion of SBAR?

Answer 20

pertinent positives and negatives only

Question 21

What is one suggested way to reduce interruptions during handoffs?

Answer 21

hold an object when you are speaking and then you’re the only one allowed to speak