SBAR: four boxes, in order, in under a minute

Situation, what is happening now; Background, what brought the patient here; Assessment, what you observed, with the figures; Recommendation, what you are asking for.

Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.

What it is for

You have four minutes of a prescriber's attention at the end of a shift, and a report that wanders loses the one thing you called about. Four boxes in the same order every time means the person on the other end knows what is coming next and can act on it.

How to think about it

Write the four letters down the side of a scrap of paper before you dial and fill each with a line or two. Situation is who and what, right now. Background is short. Assessment is the observations and the figures, with units. Recommendation is the ask, said as a request, with a time on it.

Worked example

S: the nurse on the surgical ward; this patient's blood pressure has fallen over the last two sets

Who you are, who it is about, what is happening.

B: admitted three days ago after surgery, on intravenous fluids

The short version of how the patient got here.

A: blood pressure 88/54 mmHg, pulse 112 beats/min, awake, urine output 15 mL in two hours

What you measured, with units and times.

R: I am asking you to come and review the patient now

The ask, said plainly, with a time attached.

Your turn

Write the name of the box that holds what you are asking for.

S, B, A, then

The trap

Leaving out the Recommendation because it feels like telling a prescriber what to do. Without an ask, the call is information and nothing changes; asking for a review at a stated time is the whole point of making it.

Practise SBAR handoff on HoneA question on it now, a coding challenge where there is one, and it is remembered for review. Free, no email needed.