The Use of SBAR Communication Tool During Warm Hand-Off in Integrated Care

Objective: According to the Joint Commission (2012), about 80% of serious medical errors are related to miscommunication between healthcare providers. The Joint Commission (2012) recommended the utilization of standardized communication tools to reduce the number of medical errors related to the miscommunication. The Situation-Background-Assessment-Recommendation (SBAR) communication tool is a standardized tool that has been used to improve the effectiveness of communication between healthcare providers. The purpose of this project was to evaluate the effectiveness of using SBAR communication tool for warm handoff between primary care providers and behavioral health providers in order to provide a continuous and complete transition of care for patients with psychiatric disorders or psychosocial issues. Method: A mixed method design was implemented in an integrated primary care clinic at two locations in Phoenix, Arizona. A brief presentation about the SBAR tool and copies of the SBAR tool was provided for the clinic staff. Data were gathered from four participants (two nurse practitioners and two behavioral health workers) using structured observation, pre-and post-test surveys, and structured interviews. Length of study was one month. Results: During the data collection, there were 40 observed warm handoffs, 12 unobserved warm handoffs between primary care nurse practitioners and behavioral health workers. Seventy-five percent of the participants felt that the SBAR helped them in organizing their thoughts and providing/obtaining adequate information during warm handoff. They reported satisfaction when using the SBAR tool. There was no statistically significant difference in the scores of collaboration and satisfaction about care decisions between pre and post-SBAR intervention. Conclusion: The SBAR communication tool has the potential to improve communication between primary care providers and behavioral health workers to improve the quality and safety of care for patients with psychosocial concerns. Utilizing SBAR may increase teamwork and ensures adequate hand-off information on the warm handoff. Multiple PDSA cycles should be conducted to refine the change and make it applicable and sustainable in the integrated care setting