What communication framework involves a provider informing about a patient's history, recent changes, and recommending a course of action, as in the Situation, Background, Assessment, Recommendation (SBAR) method?

SBAR Communication Framework

The scenario described represents the "Situation" and "Background" components of the SBAR (Situation, Background, Assessment, Recommendation) communication framework, which is endorsed by the World Health Organization and multiple professional societies as a standardized tool for structured clinical communication. 1, 2

Understanding the SBAR Components

The communication described in your question maps directly to the SBAR framework as follows:

Situation (S)

• The provider informs you about a patient in the ICU - this is the "Situation" component, where the healthcare professional clearly identifies themselves, the patient, and briefly states the current clinical concern or status 1, 3
• This should include clear identification of who is calling, which patient is being discussed, and what the immediate issue is 3

Background (B)

• The provider provides information about the patient's history - this is the "Background" component, which includes relevant patient history, current medications, allergies, and contextual information that frames the clinical situation 3
• This component provides the necessary context for understanding why the current situation is occurring 1

Assessment (A)

• The provider describes recent changes - this represents the "Assessment" component, where the clinical assessment is presented, including vital signs, relevant findings, and professional judgment about what is happening 3
• Research shows this is often the weakest component in practice, with quality scores as low as 17% in observational studies 4

Recommendation (R)

• The provider recommends you come see the patient - this is the "Recommendation" component, stating the specific action needed or what is being requested from the receiving healthcare professional 3
• This should clearly articulate what the calling provider believes needs to happen next 1

Evidence for SBAR Effectiveness

SBAR reduces adverse events by 40% in emergency settings and decreases unplanned ICU admissions through improved information transfer 1, 2. The framework has been shown to:

• Reduce medical errors through standardized communication 2
• Improve patient safety outcomes through enhanced interprofessional communication 3
• Increase communication quality when properly implemented, with training improving utilization from near 0% to 66-89% across components 5

Critical Implementation Points

Training is Essential

• Pre-graduate mandatory training combined with multiple repetitions significantly improves SBAR utilization 4
• Training in pre-graduate nursing education independently improves SBAR quality scores by +11.53% 4
• After structured training sessions, SBAR component completion rates improved dramatically: Situation from 7% to 88.8%, Background from 0% to 83.6%, Assessment from 0% to 66.3%, and Recommendation from 0% to 69.5% 5

Both Verbal and Written Documentation Required

• Neither verbal face-to-face handover nor written documentation alone is sufficient - both are required for effective SBAR implementation 2
• All SBAR elements must be documented in the medical record 2

Closed-Loop Communication

• The receiver should repeat back key information to confirm understanding, which is a key element of effective SBAR implementation 2
• This reduces medical errors and improves team efficacy in critical situations 1

Common Pitfalls to Avoid

• The Assessment component is consistently the weakest in practice (median quality score 17%), requiring focused training on clinical judgment and assessment skills 4
• Lack of ICU expertise is independently associated with 9.25% lower SBAR quality scores, highlighting the need for specialty-specific training 4
• Without structured training, baseline SBAR utilization can be near zero for Background, Assessment, and Recommendation components 5