LISBAR
The acronym ISBAR describes a structured approach to clinical handover
which is clear and concise, identifies those involved, specifies timeframes
and assigns/accepts accountability and responsibility. It was originally
'SBAR' in the military nuclear submarine industry, spread to aviation and
finally health care; with an "I" added to remind people to appropriate
identify each other. NETS has added an 'L' to the acronym to stress the
importance of listening (for the 'receiver' of the communication) and the
need for the 'sender' of the information to verify that.
For medical retrieval; there are some special requirements as handover is often done by telephone between people who don't know each other.
L = Listen
Receiver of the communication: Be ready to hear and note what is said. Avoid a noisy environment and other distractions
Sender of the information: Confirm that the receiver is ready to listen and note what is said. Periodically confirm receipt. Use a cordless headset to make the call.
I = Introduction
Identify yourself by first and last name, your role (paediatric registrar, emergency consultant etc) and location (hospital and department)
S = Situation
State the patient's provisional diagnosis, reason for transfer and current status. Provide the name of the consultant-in-charge
B = Background
What is the clinical background or context? Provide the current history, examination findings and relevant pathology and imaging results. State the patient's name, date of birth and body weight. Provide the time of injury or commencement of symptoms and the time of triage. For newborns, provide the time of birth.
A = Assessment
What is your patient's clinical status and support level? What do you think the current problems are which you'd like discussed? Have the patient's current vital signs and support settings (FiO2, ventilatory support, fluids, drugs) available.
R = Recommendations
What is your plan of treatment? What are you asking for from NETS and expert clinicians brought into the NETS' conference call? What is the shared plan of treatment - now and pending a transfer or retrieval?
What do you want from the person you are calling? Be clear about what you are asking and the timeframes. Repeat to confirm what you have heard; including any management plan details.
This tool started life in the nuclear industry as 'SBAR'. Having had the 'I' added in health care, we've added an 'L' to the tool.
L = Listen
Communication is ineffective unless it is accurately and completely heard by the listener. A common problem with handover in the medical retrieval context is while information may be clearly stated, it is sometimes not heard. Active listening is required; without distractions. Ensure that you give the caller your full attention and seek to avoid surrounding noise and activity which might interfer with your ability to listen effectively.
L = Listen
I = Identify
S = Situation
B = Background
A = Assessment
R = Recommendation
For medical retrieval; there are some special requirements as handover is often done by telephone between people who don't know each other.
L = Listen
Receiver of the communication: Be ready to hear and note what is said. Avoid a noisy environment and other distractions
Sender of the information: Confirm that the receiver is ready to listen and note what is said. Periodically confirm receipt. Use a cordless headset to make the call.
I = Introduction
Identify yourself by first and last name, your role (paediatric registrar, emergency consultant etc) and location (hospital and department)
S = Situation
State the patient's provisional diagnosis, reason for transfer and current status. Provide the name of the consultant-in-charge
B = Background
What is the clinical background or context? Provide the current history, examination findings and relevant pathology and imaging results. State the patient's name, date of birth and body weight. Provide the time of injury or commencement of symptoms and the time of triage. For newborns, provide the time of birth.
A = Assessment
What is your patient's clinical status and support level? What do you think the current problems are which you'd like discussed? Have the patient's current vital signs and support settings (FiO2, ventilatory support, fluids, drugs) available.
R = Recommendations
What is your plan of treatment? What are you asking for from NETS and expert clinicians brought into the NETS' conference call? What is the shared plan of treatment - now and pending a transfer or retrieval?
What do you want from the person you are calling? Be clear about what you are asking and the timeframes. Repeat to confirm what you have heard; including any management plan details.
This tool started life in the nuclear industry as 'SBAR'. Having had the 'I' added in health care, we've added an 'L' to the tool.
L = Listen
Communication is ineffective unless it is accurately and completely heard by the listener. A common problem with handover in the medical retrieval context is while information may be clearly stated, it is sometimes not heard. Active listening is required; without distractions. Ensure that you give the caller your full attention and seek to avoid surrounding noise and activity which might interfer with your ability to listen effectively.