Have You Updated Your SBAR Methodology?

March 5th, 2025

Background

A nursing team at Methodist Hospital in San Antonio, Texas, revised the Situation, Background, Assessment, and Recommendation (SBAR) handoff process between the emergency department (ED) and telemetry unit. The goals were to improve patient care, reduce rapid response calls, and enhance communication between departments.

Key issues before the change included:

• Overloaded SBAR reports with excessive details that nurses did not have time to read.
• Frequent follow-up calls from telemetry nurses requesting information already in the SBAR.
• Poor communication between ED and telemetry staff, leading to missed critical information and strained relationships.

The Revised SBAR Approach

The nursing team conducted observations and meetings with telemetry nurses to refine the SBAR format, ensuring it only included essential patient information.

Key Changes

• Reduced SBAR content to only include:
  • Diagnosis
  • Medical history
  • Allergies
  • Other immediate care needs
• Eliminated unnecessary details (e.g., patient demographics, next of kin, and historical records not relevant to immediate care).
• Implemented a new transfer communication process:
  • ED charge nurse texts the unit charge nurse before patient transfer.
  • Charge nurses exchange contact information of transferring and receiving nurses.

Results

• Fewer rapid response calls for transferred patients.
• Significant reduction in follow-up calls from the telemetry unit to the ED.
• Improved teamwork and relationships between ED and telemetry staff.
• Increased efficiency and reduced workload for both units.

Implementation and Challenges

The project took a year to fully implement, with some IT-related delays in revising the SBAR system. Initial resistance came from:

• Nurses reluctant to share direct contact numbers.
• Charge nurses uncertain about patient assignments at the time of transfer.

Over time, staff recognized the benefits, and the changes were successfully adopted across other hospital units.

Creative Approach: "Let’s Taco Bout SBAR"

To engage staff, the project was branded as “Let’s Taco Bout SBAR,” incorporating taco-themed meetings (a nod to San Antonio’s culture). This approach boosted participation and enthusiasm for process improvements.

Conclusion

The new SBAR process at Methodist Hospital streamlined handoffs between the ED and telemetry unit, leading to:

• Faster, clearer communication
• Improved patient safety
• Better teamwork and reduced frustration
• Wider hospital adoption of the improved SBAR model

By focusing on essential information and efficient communication, the hospital significantly enhanced continuity of care and patient outcomes.

For a fuller look at the updated SBAR methodology and its benefits, click here.