title: SBAR: a shared mental model for improving communication between clinicians.
abstract: BACKGROUND
  The importance of sharing a common mental model in communication prompted efforts to spread the use of the SBAR (Situation, Background, Assessment, and Recommendation) tool at OSF St. Joseph Medical Center, Bloomington, Illinois.
  
  
  METHODS
  An elderly patient was on warfarin sodium (Coumadin) 2.5 mg daily. The nurse received a call from the lab regarding an elevated international normalized ratio (INR) but did not write down the results (she was providing care to another patient). On the basis of the previous lab cumulative summary, the physician increased the warfarin dose for the patient; a dangerously high INR resulted.
  
  
  CONCLUSIONS
  The medical center initiated a collaborative to implement the use of the SBAR communication tool. Education was incorporated into team resource management training and general orientation. Tools included SBAR pocket cards for clinicians and laminated SBAR "cheat sheets" posted at each phone. SBAR became the communication methodology from leadership to the microsystem in all forms of reporting.
  
  
  CONCLUSIONS
  Staff adapted quickly to the use of SBAR, although hesitancy was noted in providing the "recommendation" to physicians. Medical staff were encouraged to listen for the SBAR components and encourage staff to share their recommendation if not initially provided.
authors.affiliation: OSF St Joseph Medical Center, Bloomington, Illinois, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Haig
authors.forename: Staci
authors.initials: S
authors.lastname: Sutton
authors.forename: John
authors.initials: J
authors.lastname: Whittington
mesh_terms: D006764:Hospitals, Community; D006801:Humans; D007087:Illinois; D033183:Interdisciplinary Communication; D008505:Medical Staff, Hospital; D008508:Medication Errors / Q000517:prevention & control*; D019982:Organizational Case Studies; D009937:Organizational Objectives; D017751:Safety Management / Q000458:organization & administration*