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Mohammad K, Thomas S, Joseph CJ, O'Keef C, Leswick L, Montpetit J, Fiedrich E, Rombough B, Thomas S. Structured Referral Call Handling Process Improves Neonatal Transport Dispatch Times. Am J Perinatol 2024; 41:e2209-e2215. [PMID: 37429321 DOI: 10.1055/s-0043-1771016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
OBJECTIVE In 2019 the Southern Alberta Neonatal Transport Service adopted a transport call handling process change to expedite transport team mobilization. This study compares the impact of this change on neonatal transport decision to dispatch and mobilization times. STUDY DESIGN This retrospective cohort study was conducted using a historical cohort of neonates referred for transportation between January 2017 and December 2021. The "dispatch time" (DT) was the time from the start of consultation to the time a decision to dispatch the transport team was made, whereas "mobilization time" (MT) referred to the time from start of consultation to the time the team departed the home base. In 2019, a DT target of <3 minutes was implemented to meet a target MT of <15 and <30 minutes for emergent and urgent high-risk transport referral calls, respectively. In 2021 use of the "Situation" component of the SBAR (Situation, Background, Assessment, Recommendation) communication tool was introduced with the transport team asking five questions to determine need for mobilization. Data between 2017 and 2018 represented the preintervention period, 2019, the "washout" period for implementation, and 2020 to 2021, the postintervention period. Data were analyzed to determine trends in DT and MT. RESULTS The DT was reduced from a median of 5 to 3 minutes following intervention (p < 0.001). DT target goal of 3 minutes was achieved in 67.08% of calls compared with 26.24% in the preintervention period, (p < 0.001). The team achieved MT target goals in 42.71% of urgent and emergent transfers compared with 18.05% prior to intervention (p < 0.001). CONCLUSION Introduction of a time-sensitive referral call handling process improved dispatch and mobilization time of the neonatal transport team. KEY POINTS · Time-sensitive triaging of neonatal transport referrals improves dispatch and mobilization time.. · A structured referral call handling process improves the efficiency of neonatal transport decision-making.. · Dedicated neonatal transport vehicles are likely to improve neonatal transport mobilization time..
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Affiliation(s)
- Khorshid Mohammad
- Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Soumya Thomas
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Chacko J Joseph
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Chelsea O'Keef
- Division of Neonatology, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Leah Leswick
- Division of Neonatology, Foothills Medical Centre, Calgary, Alberta, Canada
| | - John Montpetit
- Alberta Health Service, Referral, Access, Advice, Placement, Information and Destination (RAAPID), Emergency Medical Services Stonegate Building, Calgary, Alberta, Canada
| | - Elsa Fiedrich
- Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Bryan Rombough
- Alberta Health Service, Southern Alberta Neonatal Transport Service, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Sumesh Thomas
- Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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Toumi D, Dhouib W, Zouari I, Ghadhab I, Gara M, Zoukar O. The SBAR tool for communication and patient safety in gynaecology and obstetrics: a Tunisian pilot study. BMC MEDICAL EDUCATION 2024; 24:239. [PMID: 38443981 PMCID: PMC10916018 DOI: 10.1186/s12909-024-05210-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND In healthcare, inadequate communication among providers and insufficient information transmission represent primary contributors to adverse events, particularly in medical specialties such as obstetrics and gynecology. The implementation of SBAR (Situation-Background-Assessment-Recommendation) has been proposed as a standardized communication tool to enhance patient safety. This study aims to evaluate the knowledge, attitudes, and practices related to SBAR communication through a pilot study conducted in a middle-income country. METHODS This prospective longitudinal study took place in the gynecology-obstetrics department of a Tunisian university hospital from May to June 2019. All medical and paramedical staff underwent comprehensive theoretical and practical training through a 4-hour SBAR simulation. To gauge participants' knowledge, anonymous multiple-choice questionnaires were administered before the training initiation, with a second assessment conducted at the end of the training to measure satisfaction levels. Two months later, the evaluation utilized questionnaires validated by the French National Authority for Health (HAS). RESULTS Among the 62 care staff participants in this study, a majority (89%) demonstrated a low level of knowledge regarding the SBAR tool. The majority (75.8%) expressed enjoyment with the training and indicated their intention to implement changes in their practice by incorporating the SBAR tool in the future (80.7%). Notably, over half of the participants (79%) expressed satisfaction with the training objectives, and 74% reported acquiring new information. Evaluation of the practice revealed positive feedback, particularly in terms of clarity, the relevance of communication, and the time spent on the call. CONCLUSION Our pilot study showed that the majority of professionals on the ward had little knowledge of the SBAR tool, a good attitude and a willingness to put it into practice. It is essential that healthcare managers and professionals from all disciplines work together to ensure that good communication practice is developed and maintained. Organisations, including universities and hospitals, need to invest in the education and training of students and health professionals to ensure good quality standardised communication.
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Affiliation(s)
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, University of Monastir, Monastir, Tunisia.
| | | | | | - Mouna Gara
- University of Monastir, Monastir, Tunisia
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Yun J, Lee YJ, Kang K, Park J. Effectiveness of SBAR-based simulation programs for nursing students: a systematic review. BMC MEDICAL EDUCATION 2023; 23:507. [PMID: 37452348 PMCID: PMC10347853 DOI: 10.1186/s12909-023-04495-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students. METHODS A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project "Quality Assessment Tool for Quantitative Studies" was used to assess the quality of the included studies. RESULTS Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students' behaviors related to patient safety. CONCLUSIONS This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.
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Affiliation(s)
- Jungmi Yun
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Yun Ji Lee
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Kyoungrim Kang
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jongmin Park
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, 50612, Republic of Korea.
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Good RJ, Boyer DL, Bjorklund AR, Corden MH, Harris MI, Tcharmtchi MH, Kink RJ, Koncicki ML, Molas-Torreblanca K, Miquel-Verges F, Mink RB, Rozenfeld RA, Sasser WC, Saunders S, Silberman AP, Srinivasan S, Tseng AS, Turner DA, Zurca AD, Czaja AS. Development of an Approach to Assessing Pediatric Fellows' Transport Medical Control Skills. Hosp Pediatr 2023:e2022007102. [PMID: 37376965 DOI: 10.1542/hpeds.2022-007102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Pediatric interfacility transport teams facilitate access to subspecialty care, and physicians often guide management remotely as transport medical control (TMC). Pediatric subspecialty fellows frequently perform TMC duties, but tools assessing competency are lacking. Our objective was to develop content validity for the items required to assess pediatric subspecialty fellows' TMC skills. METHODS We conducted a modified Delphi process among transport and fellow education experts in pediatric critical care medicine, pediatric emergency medicine, neonatal-perinatal medicine, and pediatric hospital medicine. The study team generated an initial list of items on the basis of a literature review and personal experience. A modified Delphi panel of transport experts was recruited to participate in 3 rounds of anonymous, online voting on the importance of the items using a 3-point Likert scale (marginal, important, essential). We defined consensus for inclusion as ≥80% agreement that an item was important/essential and consensus for exclusion as ≥80% agreement that an item was marginal. RESULTS The study team of 20 faculty drafted an initial list of items. Ten additional experts in each subspecialty served on the modified Delphi panel. Thirty-six items met the criteria for inclusion, with widespread agreement across subspecialties. Only 1 item, "discussed bed availability," met the criteria for inclusion among some subspecialties but not others. The study team consolidated the final list into 26 items for ease of use. CONCLUSIONS Through a consensus-based process among transport experts, we generated content validity for the items required to assess pediatric subspecialty fellows' TMC skills.
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Affiliation(s)
- Ryan J Good
- Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Donald L Boyer
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ashley R Bjorklund
- Division of Pediatric Critical Care, University of Minnesota, Minneapolis, Minnesota
| | - Mark H Corden
- Division of Hospital Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Matthew I Harris
- Department of Pediatrics, Northwell Hofstra School of Medicine, New Hyde Park, New York
| | - M Hossein Tcharmtchi
- Section of Pediatric Critical Care, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Rudy J Kink
- Le Bonheur Children's Hospital, and University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee
| | - Monica L Koncicki
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Kira Molas-Torreblanca
- Department of Pediatrics, University of California, Irvine, School of Medicine, Children's Hospital of Orange County, Orange, California
| | - Franscesca Miquel-Verges
- Division of Neonatology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Richard B Mink
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Ranna A Rozenfeld
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Hasbro Children's Hospital, Brown University, Providence, Rhode Island
| | - William C Sasser
- Division of Pediatric Critical Care Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Scott Saunders
- School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Anna P Silberman
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sushant Srinivasan
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ashlie S Tseng
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - David A Turner
- Competency-Based Medical Education, American Board of Pediatrics, Chapel Hill, North Carolina
- Division of Pediatric Critical Care, Department of Pediatrics, Duke University Hospital and Health System, Durham, North Carolina; and
| | - Adrian D Zurca
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania
| | - Angela S Czaja
- Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
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Scolari E, Soncini L, Ramelet AS, Schneider AG. Quality of the Situation-Background-Assessment-Recommendation tool during nurse-physician calls in the ICU: An observational study. Nurs Crit Care 2022; 27:796-803. [PMID: 34989068 PMCID: PMC10078777 DOI: 10.1111/nicc.12743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Situation-Background-Assessment-Recommendation (SBAR) is a tool for structuring communication between healthcare professionals. SBAR reduces medical errors, however few studies have evaluated its quality in real practice. AIMS To describe the quality of SBAR utilization by intensive care unit (ICU) nurses during phone conversations with physicians. To assess the influence of nurses' training, professional experience, and call circumstances on this quality. STUDY DESIGN This observational study was conducted in the adult ICU of a university hospital in French speaking Switzerland. All consecutive telephone calls from nurses to physicians during a calendar month, were recorded. Those related to a change in patients' clinical status were selected and analysed. The quality of SBAR utilization was assessed using a pre-defined analysis grid. Scores ranged from 0 (worst quality) to 100% (best quality). Nurses' sociodemographics and training record were collected. Multiple regression was used to assess determinants of SBAR quality including nurses characteristics and level of training. RESULTS We analysed 290 phone calls, made by 99 nurses. The median SBAR quality score was 41% (interquartile range [IQR] 33-48). Quality scores varied across the four items of SBAR: Situation 88% (81-94), Background 17% (6-27), Assessment 17% (0-33), and Recommendation 33% (17-40). Factors independently associated with higher SBAR quality were age (-0.66%, p = .002, 95% CI [-1.07; -0.25]), primary language other than French (-8.40%, p = .017, 95% CI [-15.29; -1.51]), lack of ICU expertise (-9.25%, p = .013, 95% CI [-16.5;1-1.99]), and SBAR training in pre-graduate nursing education (+11.53%, p = .028, 95% CI [1.27; 22.79]). CONCLUSIONS The quality of SBAR utilization remains low in ICU clinical practice. Pre- and post-graduate training seem to improve its quality. RELEVANCE TO CLINICAL PRACTICE Pre-graduate mandatory training associated with multiple repetitions could improve nurses' SBAR utilization. Training using the SBAR tool should be combined with the development of nursing skills in assessment and clinical judgment.
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Affiliation(s)
- Emil Scolari
- Adult intensive care Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.,School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Délemont, Switzerland.,Haute Ecole de Santé Vaud (HESAV), Lausanne, Switzerland
| | - Leda Soncini
- Adult intensive care Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Antoine Guillaume Schneider
- Adult intensive care Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Shahid S, Thabane L, Marrin M, Schattauer K, Silenzi L, Borhan S, Singh B, Thomas C, Thomas S. Evaluation of a Modified SBAR Report to Physician Tool to Standardize Communication on Neonatal Transport. Am J Perinatol 2022; 39:216-224. [PMID: 32819017 DOI: 10.1055/s-0040-1715524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE SBAR (situation, background, assessment and recommendation) is a structured format for the effective communication of critically relevant information. This tool was developed as a generic template to provide structure to the communication of clinical information between health care providers. Neonatal transport often presents clinically stressful circumstances where concise and accurate information is required to be shared clearly between multidisciplinary health care providers. A modified SBAR communication tool was designed to facilitate structured communication between nonphysician bedside care providers operating from remote sites and physicians providing decision-making support at receiving care facilities. Prospective interventional study was designed to evaluate the reliability of a "SBAR report to physician tool" in sharing clinically relevant information between multidisciplinary care providers on neonatal transport. STUDY DESIGN The study was conducted between 2011 and 2014 by a dedicated neonatal transport service based at McMaster Children's Hospital which provides care for approximately 500 infants in Southern Ontario annually. In the preintervention phase, 50 calls were randomly selected for the evaluation and 115 consecutively recorded transport calls following adoption of the reporting tool. The quality of calls prior to and after the intervention was assessed by reviewers independently. Inter-rater agreement was also assessed for both periods. RESULTS Inter-rater agreement between raters was moderate to perfect in most components of the SBAR "report to the physician tool" except for the assessment component, which showed fair agreement during both preintervention and postintervention periods. There was an improvement in global score (primary outcome) with a mean difference of 0.95 (95% confidence interval [CI]: 0.77-1.14; p < 0.001) and in cumulative score with a mean difference of 8.55 (95% CI: 7.26-9.84; p < 0.001) in postintervention period. CONCLUSION The use of the SBAR report to physician tool improved the quality of clinical information shared between nonphysician members of the neonatal transport team and neonatal transport physicians. KEY POINTS · Long-Accurate and concise information sharing is crucial for decision-making in neonatal transport.. · Information sharing between multidisciplinary teams can be enhanced by using a commonly understood information sharing template.. · The SBAR report to physician tool improves the quality of information shared between multidisciplinary team members in neonatal transport..
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Affiliation(s)
- Shaneela Shahid
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Department of Pediatrics, McMaster University, Hamilton, Canada.,Department of Anesthesia, McMaster University; Biostatistics Unit, St Joseph's Healthcare, Hamilton, Canada
| | - Michael Marrin
- Department of Pediatrics, Division of Neonatology, McMaster University, Hamilton, Canada
| | - Karen Schattauer
- Department of Pediatrics, Division of Neonatology, McMaster University, Hamilton, Canada
| | - Laurel Silenzi
- Department of Pediatrics, Division of Neonatology, McMaster University, Hamilton, Canada
| | - Sayem Borhan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Department of Family Medicine, McMaster University, Canada
| | - Balpreet Singh
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Cherian Thomas
- Department of Pediatrics, Division of Neonatology, McMaster University, Hamilton, Ontario, Canada
| | - Sumesh Thomas
- Department of Pediatrics, University of Calgary, Calgary, Canada
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Lo L, Rotteau L, Shojania K. Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review. BMJ Open 2021; 11:e055247. [PMID: 34921087 PMCID: PMC8685965 DOI: 10.1136/bmjopen-2021-055247] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To characterise the extent to which health professionals perform SBAR (situation, background, assessment, recommendation) as intended (ie, with high fidelity) and the extent to which its use improves communication clarity or other quality measures. DATA SOURCES Medline, Healthstar, PsycINFO, Embase and CINAHL to October 2020 and handsearching selected journals. STUDY SELECTION AND OUTCOME MEASURES Eligible studies consisted of controlled trials and time series, including simple before-after design, assessing SBAR implementation fidelity or the effects of SBAR on communication clarity or other quality measures (eg, safety climate, patient outcomes). DATA EXTRACTION AND SYNTHESIS Two reviewers independently abstracted data according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses on study features, intervention details and study outcomes. We characterised the magnitude of improvement in outcomes as small (<20% relative increase), moderate (20%-40%) or large (>40%). RESULTS Twenty-eight studies (3 randomised controlled trials, 6 controlled before-after studies, and 19 uncontrolled before-after studies) met inclusion criteria. Of the nine studies assessing fidelity of SBAR use, four occurred in classroom settings and three of these studies reported large improvements. The five studies assessing fidelity in clinical settings reported small to moderate effects. Among eight studies measuring communication clarity, only three reported large improvements and two of these occurred in classroom settings. Among the 17 studies reporting impacts on quality measures beyond communication, over half reported moderate to large improvements. These improvements tended to involve measures of teamwork and culture. Improvements in patient outcomes occurred only with intensive multifaceted interventions (eg, early warning scores and rapid response systems). CONCLUSIONS High fidelity uptake of SBAR and improvements in communication clarity occurred predominantly in classroom studies. Studies in clinical settings achieving impacts beyond communication typically involved broader, multifaceted interventions. Future efforts to improve communication using SBAR should first confirm high fidelity uptake in clinical settings rather than assuming this has occurred. PROSPERO REGISTRATION NUMBER CRD42018111377.
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Affiliation(s)
- Lisha Lo
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
| | - Leahora Rotteau
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
| | - Kaveh Shojania
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Abdelmawla M, Hansen G, Narvey M, Whyte H, Ilodigwe D, Lee KS. Evaluation of transport-related outcomes for neonatal transport teams with and without physicians. Paediatr Child Health 2021; 26:e290-e296. [PMID: 34880960 DOI: 10.1093/pch/pxab019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/18/2021] [Indexed: 11/14/2022] Open
Abstract
Objective The aim of this study was to evaluate if the presence of a physician in the neonatal transport team (NTT) affects transport-related outcomes and procedural success. Design Retrospective cohort study with propensity score matching. Setting Canadian national study. Patients Neonatal transports from nontertiary centres between January 2014 and December 2017. Interventions Comparison of transports conducted by NTTs with physicians (MD Group) and without physicians (noMD Group). Main outcome measures The primary outcome was the change in patient acuity as measured by the transport risk index of physiologic severity (TRIPS) score. Secondary outcomes included mortality within 24 hours of NICU admission, clinical complications during transport, procedural success, and stabilization time. Results Among 9,703 eligible cases, 899 neonatal transports attended by NTTs with physicians were compared to 899 neonatal transports without physicians using propensity score matching. No differences were seen in the improvement of TRIPS score or mortality ≤24 hours of NICU admission. The MD Group had more clinical complications (7.7% versus 5.0%, P=0.02). No differences were seen in success rates of invasive procedures. The MD Group had shorter stabilization times. In multivariable analysis, the MD Group was not a significant predictor for the improvement in TRIPS score after adjustment for covariates. Conclusions Neonatal transports conducted by teams including physicians compared to teams without physicians, did not have higher improvement in TRIPS scores and had similar success rates for procedures. These results provide insights for the planning of the structure and training of specialized interfacility neonatal transport programs.
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Affiliation(s)
- Mohamed Abdelmawla
- Division of Neonatology, Children's Hospital of Manitoba, Winnipeg, Manitoba, Canada
| | - Gregory Hansen
- Division of Critical Care, Royal University Hospital, Saskatoon, Saskatchewan, Canada.,Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Michael Narvey
- Division of Neonatology, Children's Hospital of Manitoba, Winnipeg, Manitoba, Canada.,Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hilary Whyte
- Division of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Don Ilodigwe
- Division of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kyong-Soon Lee
- Division of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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