Changing the Culture for SBAR Communications

By Leigh Ann Myers  /  24 Jun 2014

A few weeks ago we hosted a webinar with Doug Bonacum, a leader in SBAR (Situation, Background, Assessment, Recommendation) communications. The technique is all about streamlining and standardizing clinician communications so that important information is conveyed clearly to improve patient care. Doug’s presentation was inspiring and really made me think about how critical it is for hospitals and other healthcare delivery systems to transform to a SBAR communications model. Far too often, a failure of communication means a delay or error in delivering care to a patient who needed it critically.

As an industry, how can we begin to more broadly adopt SBAR communication in care delivery? And, perhaps more importantly, how can we change the culture to support this type of communication environment?

I know the answer is not a simple one. The healthcare industry as a whole is slow to change, and our culture is deeply ingrained. What I do know, is that all healthcare professionals can take steps to transform our culture and move towards SBAR:

  1. Acknowledge failures: In our industry, it can be hard to say, “That went wrong” or “We could have done that better.” Instead, clinicians should acknowledge failures in communication and keep track of the times when they could have communicated differently to prevent miscommunication. By acknowledging that we’re not all perfect communicators, we’ll be more open addressing our communication challenges.
  2. Flatten the hierarchy: We’re an industry with necessary and distinct roles that reflect our training and expertise. But as Doug talked about in his webinar, in order for SBAR to work, nurses have to feel empowered to give a clear assessment (not diagnosis) of a patient’s condition and a recommendation on the next steps. For this to work, physicians in the hospital must be supportive and encourage this from the nursing team.
  3. Drive from within: In my work with hospitals and health systems, I’ve learned that in order for new initiatives to take hold, they must have wide support from all levels of the organization. Adopting SBAR hospital-wide can’t be a directive from the top—and in fact, may work better if clinicians come together to show their leadership team why SBAR is needed and how it will improve patient care.
  4. Prepare for bumps: Even once an organization adopts SBAR, it can’t just plow forward assuming everything will work out. One of the things Doug spoke about during his webinar was a need to help clinicians adapt to the new communications standard. Changes like this don’t come easily. During the implementation phase, hospitals should be prepared for some imperfect deployment of SBAR communications as clinicians get used to the format and shift in communications.
  5. Keep the patient in mind: Sometimes in the rush to implement improved tools and procedures, people can forget why they are making improvements in the first place. As organizations begin to implement SBAR, they should remember that the goal of adopting the SBAR communication model is to improve patient care and safety, and should keep the patient at top-of-mind as they make these clinical communication changes.

I don’t have all of the answers, but I do know that we can learn from the hospitals and health systems who have adopted SBAR. I’d like to hear from you: What can we as an industry do to change our culture, and begin adopting SBAR more widely?

Posted By Leigh Ann Myers

One thought on “Changing the Culture for SBAR Communications

  1. Michael smith

    While employed as a Director of IT at a west coast health system my team embraced SBAR with great results. IT soon was embraced by the entire IT department. Great tool.


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