"ABC-SBAR" training improves simulated critical patient hand-off by pediatric interns.
OBJECTIVE
This study was done to assess whether a modified "ABC-SBAR" mnemonic (airway, breathing, circulation followed by situation, background, assessment, and recommendation) improves hand-offs by pediatric interns in a simulated critical patient scenario.


METHODS
Each of 26 interns reviewed a scenario involving a decompensating pediatric patient and gave a simulated hand-off to a responder. They received a didactic session on ABC-SBAR, then performed a second hand-off using another scenario. Two blinded reviewers assessed 52 video-recorded hand-offs for inclusion, order, and elapsed time to essential hand-off information using a scoring tool.


RESULTS
Mean score of hand-offs increased after ABC-SBAR training (preintervention: 3.1/10 vs postintervention: 7.8/10, P < 0.001). In hand-offs after ABC-SBAR training, the reason for the emergency call was more often prioritized before background information (preintervention: 4% vs postintervention: 81%, P < 0.001) and stated earlier (elapsed time preintervention: 19 seconds vs postintervention: 7 seconds, P < 0.001). Hand-offs including an airway or breathing assessment increased after training (preintervention: 35% vs postintervention: 85%, P = 0.001), and this information was also stated earlier (preintervention: 25 seconds vs postintervention: 5 seconds, P < 0.001). Total hand-off duration was increased (preintervention: 29 seconds vs postintervention: 36 seconds, P = 0.004).


CONCLUSIONS
Unstructured hand-off by interns in a simulated patient emergency emphasizes background information, leaving essential information (such as reason for the call and ABCs) delayed or omitted. ABC-SBAR was associated with improved inclusion and timeliness of essential information in simulated critical patient hand-offs by pediatric interns; however, hand-off duration was increased. Further studies are needed to elucidate optimal hand-off in an emergency situation.
Departments of Anesthesiology and Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. mmccrory@wakehealth.edu
Michael Conor
MC
McCrory
Hanan
H
Aboumatar
Jason W
JW
Custer
Chris P
CP
Yang
Elizabeth A
EA
Hunt
D000328:Adult; D015142:Baltimore; D003142:Communication; D003266:Continuity of Patient Care; D004630:Emergencies; D005260:Female; D006333:Heart Failure / Q000628:therapy; D057209:Hospital Rapid Response Team; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D008297:Male; D016544:Patient Simulation; D010372:Pediatrics / Q000193:education*; D017010:Reminder Systems