Situation-Background-Assessment-Recommendation Technique Improves Nurse-Physician Communication and Patient Satisfaction in Cataract Surgeries

Background

Implementation of the Situation-Background-Assessment-Recommendation (SBAR) communication technique has been shown to increase nurse-physician communication and collaboration. However, data regarding its implementation in ophthalmology settings are limited.

Objective

The purpose of this study was to evaluate the impact of implementing SBAR on nurse-physician communication and on the safety and satisfaction of patients undergoing cataract surgery.

Materials and Methods

This cross-sectional study was conducted in the Ophthalmology Department of Zhongshan Hospital, Xiamen University, Xiamen, China, from April 2016 to December 2018. SBAR was implemented through a 1-h course that was repeated every 2 months for 2 years. All nurses and physicians completed the Physician-Nurse Communication Satisfaction Questionnaire before SBAR implementation and 1- and 2-year post-implementation. In addition, all patients who underwent cataract surgery during the defined pre-implementation and 1- and 2-year post-implementation periods were invited to complete a patient satisfaction questionnaire.

Results

In total, 10 nurses and 6 physicians completed all three pre- and post-implementation surveys. In addition, 1215 patients undergoing cataract surgery participated: 358 in the pre-implementation phase, 425 in the 1-year post-implementation, and 432 in the 2-year post-implementation. Physician-nurse communication significantly improved in both 1- and 2-year post-implementation periods compared with the pre-implementation phase (P < 0.01). In addition, there was a significant increase in patient satisfaction scores (P < 0.01) and a decrease in medical complaints and malpractices (P < 0.01) between the pre- and post-implementation phases.

Conclusion

SBAR is a useful tool for enhancing nurse-physician communication and for improving the safety and satisfaction of patients undergoing cataract surgery.

From Morbidity and Mortality to Quality Improvement: Effects of a Structured and Interactive Otolaryngology Conference

Objective

Measure the effects of a structured morbidity and mortality conference format on the attitudes of resident and faculty participants.

Study Design

Prospective cohort study.

Setting

Otorhinolaryngology–head and neck surgery residency training program.

Subjects and Methods

Two changes were implemented to the structure of our morbidity and mortality conference: (1) we adopted a recently described presentation framework called situation-background-assessment-recommendation and (2) appointed a faculty moderator to lead the conference. Surveys were distributed to residents and faculty before and after these modifications were implemented to measure changes in attitude of conference attendees.

Results

After implementing the above changes to the morbidity and mortality conference, participant engagement increased from “moderately engaged” to “extremely engaged” (P < .01). Among both faculty and residents, the perceived educational value of conference also improved from “moderately educational” to “extremely educational” (P < .01). Finally in the attending cohort, the impact on future patient care increased from “no change” to “greatly enhanced” (P < .01).

Conclusion

By implementing the situation-background-assessment-recommendation framework and appointing a faculty moderator to morbidity and mortality conference, participants reported significantly enhanced engagement during the conference, increased educational value of the session, and a positive impact on future patient care.