ISBAR for clear communication A standardised structured communication tool to improve patient safety

1. ISBAR for clear communication A standardised structured communication tool to improve patient safety

2. ISBAR - a structured communication tool Identify: Name, position & location. Ask to speak to the correct person. Patient details: unique ID number, ward & bed Situation: Why you are calling? What is currently happening? If URGENT, say so! Background: Tell the story eg: admission diagnosis and date Brief relevant medical history and treatment summary Assessment: Vital signs, your clinical impressions and what you think is going on Request:State what you want from them - come and review the patient? Management advice?

3. ISBAR - background Healthcare: increasingly complex, fast paced, multiple interactions Communication failure is a major factor in 60-70% adverse events (JCAHO, 2004) Southern Health complaints and adverse events: 35 % are related to communication WHO has made clinical communications one of its ‘High 5’ priorities to improve patient safety Australia has taken a leading role in this initiative

4. ISBAR – background Southern Health Simulation Centre adapted SBAR from US Navy. ‘I’ was added for identification of self , location, receiver and patient Structured method of communication in High Reliability Industries (HRI): Air traffic control, nuclear power generation & military Currently HRI error rating 1:10,000 Healthcare Globally error rating 1:10 to 1:15

5. ISBAR - the evidence Simulation Centre : Medical students taught ISBAR ISBAR trainees out performed non trainees each time 88% of Junior Staff using ISBAR tool six months later Marshall et all Qual Saf Health care 2009,18(2):137-40 There is leading evidence that ISBAR promotes improved patient safety and outcomes

6. ISBAR - Southern Health project Rolled out as a QUALITY Improvement project 7001 Medical Nursing & Allied Health staff trained in ISBAR technique 4760 attended face to face sessions2813 evaluation forms were completed Staff feedback94.08% worthwhile, 91.66% relevant to them 93.85% relevant to colleagues 6 6

7. ISBAR in practice Diagnostic Imaging: reduction in errors (Interim results - Southern Health 2009 ) Reduced inpatient misidentification: 9% to 2 % Reduced incorrect procedure verification: 30% to 4% Reduced incorrect side and site verification: 55% to 5% Referrer Audit: improved compliance. Clinical details provided 100% of time Contact details: non conformance reduced: 15% to 2%

8. ISBAR forms • Emergency Dept to ward transfer form • Emergency surgery booking form • Medical Referral Form • Pain Consultancy Request Form New ISBAR forms discovered during evaluation • Birth Suite record of telephone contact • Wound Assessment Request

9. Receiving a referral How you can help – If you want good communication, please ask for it! Are we using the ISBAR format? Can you give this to me in ISBAR format please? Can you please identify ….? the patient’s name, location What is the Situation? What is the Background? What is your Assessment? What do you think needs to happen?

10. How can senior staff help? Provide leadership by modelling behaviour - Please use ISBAR! Check your staff have attended training - ask them at ‘rounds’ Make it an expectation that the tool is used when communicating about your patients

11. Questions? Further training can be organised as required (insert your contact details) Thank you for supporting the use of ISBAR in our organisation ISBAR tools (2010) – developed by Southern Health in partnership with the VMIA