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The SBAR (Situation-Background-Assessment-Recommendation) tool was introduced to health care in 2002 to guide communication of patient care information. Evidence of an integrated literature review indicates SBAR is an effective intervention for patient safety through improved communication.
In the landmark Institute of Medicine report To Err is Human, editors Kohn, Corrigan, and Donaldson (2000) brought attention to the epidemic of medical errors occurring in the U.S. healthcare system. They concluded the root cause of these errors often could be traced to faulty systemic processes. Errors in communication have been a major source of miscalculation and misdirection in health care. According to The Joint Commission (2015), communication errors have been among the top three leading root causes of reported sentinel events every year since 2004. Times of patient handoff may contribute to informational gaps due to the frequency with which these reports occur and the highstakes nature of the information being exchanged (Staggers & Blaz, 2013).
Objective
The objective of this systematic review is to analyze literature addressing use of the SituationBackground-Assessment-Recommendation (SBAR) framework to determine its effectiveness during patient handoff communication between healthcare providers. The review approach allowed inclusion of multiple variables and diverse methodologies, making it the most suitable method available for analyzing the literature pertaining to SBAR's impact on communication and patient safety (Torraco, 2016).
Background
The Joint Commission (2008) initially defined handoff as "the realtime process of passing patient-specific information from one caregiver to another, or from one team of caregivers to another for the purpose of ensuring the continuity and safety of a patient's care" (p. 65). Despite their purpose of providing necessary information for delivery of safe patient care, patient handoffs appear to be prone to errors related to frequent communication barriers (Mardis et al., 2016). Common barriers to effective handoff communication include the hierarchical nature of health care, organizational culture, differences in the practiced communication style of healthcare professions, lack of a standardized process, and an increasingly complex care environment (Daniel & Wilfong, 2014; The Joint Commission, 2005, 2012). In addition, the varying parties and the large amount of complex information included in handoff reports frequently contribute to informational gaps and omissions in the handoff report that can lead to sentinel events and patient harm (Staggers & Blaz, 2013).