Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Improving the quality of handover: implementing SBAR

Zeinab Ruhomauly, Kathryn Betts, Katherine Jayne-Coupe, Luciné Karanfilian, Megan Szekely, Anu Relwani, Joel McCay and Zahra Jaffry
Download PDF
DOI: https://doi.org/10.7861/futurehealth.6-2-s54
Future Healthc J June 2019
Zeinab Ruhomauly
AKing’s College London
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathryn Betts
AKing’s College London
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Katherine Jayne-Coupe
AKing’s College London
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Luciné Karanfilian
AKing’s College London
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Megan Szekely
AKing’s College London
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anu Relwani
BDarent Valley Hospital
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joel McCay
BDarent Valley Hospital
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Zahra Jaffry
BDarent Valley Hospital
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Introduction

Effective communication is essential in the provision of safe patient care. Use of structured communication tools, such as the Situation, Background, Assessment and Recommendation (SBAR) format of handover have been shown to improve patient safety, especially for telephonic handovers.1 SBAR has widely been recommended as a standardised method of handover.2,3 We undertook a quality improvement (QI) project to increase SBAR awareness across two wards in a district general hospital. This study describes the effect of our interventions and the challenges of implementing QI methodology to measuring safe communication and handover.

Materials and methods

A baseline audit was conducted to assess awareness and understanding of SBAR. Additionally, structured interviews were conducted with senior nurses and simulation training officers to understand barriers to SBAR use. One nurse on each ward was appointed as an ‘SBAR champion’. We implemented 10-minute ward-based teaching sessions, which the champions then continued. Posters and telephone cards were implemented to reinforce teaching.

Outcomes measured included:

  • % of nurses reporting exclusively using SBAR as their method of handover

  • % of nurses aware of SBAR

  • perceived effectiveness of giving telephonic handovers (self-reported).

Results and discussion

Implementation of SBAR champions, teaching sessions and visual aids on the wards demonstrated the following results:

  • 54.4% improvement in the proportion of nurses reporting using exclusively SBAR as their method of handover

  • 100% of nursing staff were aware of SBAR (improved from a baseline of 87.5%)

  • 44% average improvement in the self-reported perceived effectiveness of telephone handovers.

Although the results demonstrate a clear improvement in awareness and understanding of SBAR, the use of subjective data presents limitations. Objectively assessing the quality and effectiveness of SBAR handovers requires controlled, simulated environments, which are difficult methods to replicate in real-world settings using QI methodology.4 Despite this, our interventions demonstrate an improvement in SBAR awareness and can easily be replicated across other wards. Additionally, our interventions were well-researched and were developed following the identification of key barriers to SBAR use, from questionnaires and through structured interviews. Engaging senior nursing staff across the trust proved successful in appointing SBAR champions across the wards, ensuring that the teaching intervention remains sustainable.

Conclusion

Ward-based teaching sessions and visual aids may offer effective and scalable methods of increasing awareness and understanding of the SBAR communication tool for handovers. Ultimately, strengthening communication requires engaging senior staff members to promote good handover culture. Our methods demonstrate the difficulties in objectively measuring handover outcomes and adverse patient outcomes. Although good communication represents a crucial component of patient safety and ensuring good quality care, therefore forming an important aspect of QI, lack of objective measures may present difficulties in applying sound QI methodology.

  • © Royal College of Physicians 2019. All rights reserved.

References

  1. ↵
    1. Müller M,
    2. et al
    . Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open 2018;8e022202.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Royal College of Physicians
    . Improving teams in healthcare – Team communication. London: RCP, 2017.
  3. ↵
    1. World Health Organization
    . Communication during patient hand-overs. WHO, 2007.
  4. ↵
    1. Cunningham NJ
    , Weiland TJ, van Dijk J, et al. Telephone referrals by junior doctors: a randomised controlled trial assessing the impact of SBAR in a simulated setting. Postgraduate Medical Journal 2012;88:619–26.
    OpenUrlAbstract/FREE Full Text
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Improving the quality of handover: implementing SBAR
Zeinab Ruhomauly, Kathryn Betts, Katherine Jayne-Coupe, Luciné Karanfilian, Megan Szekely, Anu Relwani, Joel McCay, Zahra Jaffry
Future Healthc J Jun 2019, 6 (Suppl 2) 54; DOI: 10.7861/futurehealth.6-2-s54

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Improving the quality of handover: implementing SBAR
Zeinab Ruhomauly, Kathryn Betts, Katherine Jayne-Coupe, Luciné Karanfilian, Megan Szekely, Anu Relwani, Joel McCay, Zahra Jaffry
Future Healthc J Jun 2019, 6 (Suppl 2) 54; DOI: 10.7861/futurehealth.6-2-s54
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction
    • Materials and methods
    • Results and discussion
    • Conclusion
    • References
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Watchpoint: an NHS-grown electronic communication system shown to improve patient safety
  • A quality improvement project on improving the compliance of ‘oxygen prescription with target saturations’ in a district general hospital
  • Therapies in ACS: the pitfalls of prescribing
Show more Quality Improvement and Patient Safety

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians