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Evaluation of a problem-specific SBAR tool to improve after-hours nurse-physician phone communication: a randomized trial.
Jt Comm J Qual Patient Saf. 2013 Nov; 39(11):495-501.JC

Abstract

BACKGROUND

After-hours telephone communications are common in patient management. Patterns of communication of key information during after-hours phone calls were evaluated, and the utility of problem-specific Situation, Background, Assessment, Recommendation (SBAR) forms in improving this communication was assessed.

METHODS

In a randomized trial using a simulated on-call setting, 20 nurses called physicians regarding six cases adapted from inpatient records and based on the six most common reasons for after-hours nurse-physician communication. Three of the cases were handled without the SBAR forms (control cases), and three cases were handled with the forms (SBAR cases). Two cue types of communication were evaluated: situation cues, which conveyed the patient's situation (for example, a patient is confused), and background cues, which conveyed problem-specific data indicated on the SBAR forms (for example, the patient has a low sodium level).

RESULTS

Ninety-two phone calls were analyzed (43 SBAR/49 controls). Most of the nurses reported the situation cues (SBAR 88%, control 84%, p = .60) but not the background cues. There was a trend toward fewer background cues communicated in the SBAR cases (14% versus 31%, p = .08). In 14% of the cases, on average, nurses omitted information or reported wrong information regarding the background cue. Physicians asked questions that resulted in the communication of the cues in a minority of the cases when the background cues were not originally provided by the nurses (SBAR 6%, control 16%, p = .39).

CONCLUSIONS

In after-hours phone communication between physicians and nurses, significant information was often not communicated and physicians did not elicit the necessary information. Simply providing an SBAR-based form did not ensure complete communication of key information.

Authors+Show Affiliations

School of Biomedical Informatics, University of Texas Health Science Center at Houston, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24294677

Citation

Joffe, Erel, et al. "Evaluation of a Problem-specific SBAR Tool to Improve After-hours Nurse-physician Phone Communication: a Randomized Trial." Joint Commission Journal On Quality and Patient Safety, vol. 39, no. 11, 2013, pp. 495-501.
Joffe E, Turley JP, Hwang KO, et al. Evaluation of a problem-specific SBAR tool to improve after-hours nurse-physician phone communication: a randomized trial. Jt Comm J Qual Patient Saf. 2013;39(11):495-501.
Joffe, E., Turley, J. P., Hwang, K. O., Johnson, T. R., Johnson, C. W., & Bernstam, E. V. (2013). Evaluation of a problem-specific SBAR tool to improve after-hours nurse-physician phone communication: a randomized trial. Joint Commission Journal On Quality and Patient Safety, 39(11), 495-501.
Joffe E, et al. Evaluation of a Problem-specific SBAR Tool to Improve After-hours Nurse-physician Phone Communication: a Randomized Trial. Jt Comm J Qual Patient Saf. 2013;39(11):495-501. PubMed PMID: 24294677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of a problem-specific SBAR tool to improve after-hours nurse-physician phone communication: a randomized trial. AU - Joffe,Erel, AU - Turley,James P, AU - Hwang,Kevin O, AU - Johnson,Todd R, AU - Johnson,Craig W, AU - Bernstam,Elmer V, PY - 2013/12/4/entrez PY - 2013/12/4/pubmed PY - 2014/1/5/medline SP - 495 EP - 501 JF - Joint Commission journal on quality and patient safety JO - Jt Comm J Qual Patient Saf VL - 39 IS - 11 N2 - BACKGROUND: After-hours telephone communications are common in patient management. Patterns of communication of key information during after-hours phone calls were evaluated, and the utility of problem-specific Situation, Background, Assessment, Recommendation (SBAR) forms in improving this communication was assessed. METHODS: In a randomized trial using a simulated on-call setting, 20 nurses called physicians regarding six cases adapted from inpatient records and based on the six most common reasons for after-hours nurse-physician communication. Three of the cases were handled without the SBAR forms (control cases), and three cases were handled with the forms (SBAR cases). Two cue types of communication were evaluated: situation cues, which conveyed the patient's situation (for example, a patient is confused), and background cues, which conveyed problem-specific data indicated on the SBAR forms (for example, the patient has a low sodium level). RESULTS: Ninety-two phone calls were analyzed (43 SBAR/49 controls). Most of the nurses reported the situation cues (SBAR 88%, control 84%, p = .60) but not the background cues. There was a trend toward fewer background cues communicated in the SBAR cases (14% versus 31%, p = .08). In 14% of the cases, on average, nurses omitted information or reported wrong information regarding the background cue. Physicians asked questions that resulted in the communication of the cues in a minority of the cases when the background cues were not originally provided by the nurses (SBAR 6%, control 16%, p = .39). CONCLUSIONS: In after-hours phone communication between physicians and nurses, significant information was often not communicated and physicians did not elicit the necessary information. Simply providing an SBAR-based form did not ensure complete communication of key information. SN - 1553-7250 UR - https://www.unboundmedicine.com/medline/citation/24294677/Evaluation_of_a_problem_specific_SBAR_tool_to_improve_after_hours_nurse_physician_phone_communication:_a_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-7250(13)39065-5 DB - PRIME DP - Unbound Medicine ER -