SBAR

Another lesson in variation...

"SBAR" is a hand-off tool that Muppet Corporate is suggesting that nursing units use when handing off their patients. It stands for Situation, Background, Assessment, and Recommendation and it's a proven methodology for consistent and safer communication. When I was asked to lead the SBAR implementation project at St. Fozzie's, I figured, how hard can this be? Just get everyone to use the same methodologies for hand-off's? No problem!

We had our first brainstorm the other day. We filled up 6 sheets of newsprint. My hand cramped from scribbling everyone's thoughts and words. This is what I learned from that first brainstorm:

1. There are actually TEN different kinds of hand-off's. Everything counts from ER to Unit, Unit to Unit, Shift to Shift, Unit to OR, etc. Caregiver-to-caregiver.

2. There is a whole separate form (and hand-off process) for charge nurse hand-off's. Charge nurse-to-charge nurse.

3. And physician communication, when nurses must call the physicians.

So yes, the project suddenly morphed into a brainstorm from hell. Actually, what I experienced was a migraine of a brainstorm!

It was good, though, because we talked through the process. As it turns out, each unit uses its own SBAR form. None of them actually follow the SBAR format, but they have pieces of it. So I formed one task force to develop the caregiver-to-caregiver SBAR tool that will be used on all units. This task force will seek the input of front-line staff; projects like this are far more successful if you obtain their buy-in. It will work, because we'll give them the "S," "B," and "R" and let them modify the "A" to fit their individual units' needs. It'll be standardization that fits all units. Hurray!

Then we agreed to tackle the physician hand-off tool. Luckily, we can borrow a template from a neighboring hospital and adopt it to St. Fozzie's. I can make these changes and will be rolling this out to the appropriate committees next week.

The charge nurse-to-charge nurse piece was not touched. That's for next week.

Okay. Now. When is that Overachievers' Anonymous meeting?! We can do Mensa puzzles next!