title: Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in the Emergency Department.
abstract: OBJECTIVE
  Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework.
  
  
  METHODS
  To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented. Data were gathered from 32 nurses and 2 nurse practitioners using structured observation and pre- and post-implementation surveys. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction.
  
  
  RESULTS
  Eighty-three percent of patient encounters included a joint evaluation. A huddle structured with SBAR was conducted 86% of the time. Registered nurses and nurse practitioners verbalized patients' treatment plans in 89% of cases and 97% of cases, respectively. Improved teamwork, communication, and nursing satisfaction scores were demonstrated among the nurse practitioners and registered nurses.
  
  
  CONCLUSIONS
  This project showed the feasibility of a simple and inexpensive joint nurse practitioner-registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques.
authors.affiliation: Rochester, NY. Electronic address: heather_martin@urmc.rochester.edu.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Martin
authors.affiliation: Rochester, NY.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ciurzynski
mesh_terms: D000328:Adult; D003142:Communication; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D009726:Nurses; D009741:Nursing Staff, Hospital; D010348:Patient Care Team; D061214:Patient Safety; D017410:Practice Guidelines as Topic
keywords: Communication; Emergency department; Huddle; SBAR; Teamwork