ISBAR Clinical Handover Project
Identifying and Solving Barriers to Effective Handover in Inter-hospital Transfer Project
Hunter New England Area Health Service
What is the project?
A group of Hunter New England clinicians, managers and senior staff in Clinical Governance are seeking to assess whether a standardised format for communication can improve patient outcome and increase clinician job satisfaction. The project will test the impact of the ISBAR communication format on the transfer of patients from The Maitland Hospital to John Hunter Hospital.
Enhancing Clinical Communication pdf (48 KB) - Presentation by Nigel Lyons, Chief Executive, Hunter New England Area Health Service, 27 February 2009.
What is the problem?
Inter-hospital transfer (IHT) is an everyday part of clinical practice. Poor communication can risk patient safety and contribute to adverse outcomes, as confirmed by Hunter New England Health Incident Information Monitoring System (IIMS) data. These findings are also consistent with national and international data and demonstrate that there is a clear need for improvement. As yet there is no single strategy known to help clinicians improve the IHT process.
What is ISBAR?
ISBAR is an acronym. It stands for:
I – Introduction
S – Situation
B – Background
A – Assessment
R – Recommendation
ISBAR provides a framework for the exchange of information between people in a consistent and reliable way. Evidence shows that when a standardised approach is implemented, the effectiveness of that approach increases. The listener knows what to expect and becomes more attuned and the speaker, knowing what is expected, can participate fully to meet the listeners needs. ISBAR has been adopted by a number of high-risk industries, including health, and so it does have an evidence background.
How will the project be implemented?
The planned project design is a prospective observation and intervention study. There will be four phases to the project:meet the listeners needs. ISBAR has been adopted by a number of high-risk industries, including health, and so it does have an evidence background.
- an establishment phase to introduce the project,
- a development phase to characterise existing handover practices and ask clinicians their views on how to improve the process,
- an implementation phase to test the subsequently developed standardised format for handover communication, and
- an evaluation phase to evaluate the effectiveness of the implemented solution, disseminate the findings and assess the wider transferability of the solution.
Information gained from clinicians who transfer patients between hospitals will be used to develop, implement, and evaluate a communication tool to assist clinicians in handover of patients transferred between the Maitland Hospital and the John Hunter Hospital, Newcastle.
Implementation strategies
- Widespread communication strategy dissemination to develop engagement
- Senior champions identified as part of a HNEH Reference Group
- Area Executive Briefing template converted into ISBAR format
- Local ISBAR tools created and disseminated to those who have attended training
- ISBAR training in medical and nursing student university training, and junior medical, nursing and allied health staff in-service
- Area Managers trained through Area Management Forum in 2008
- HNEH Clinical Governance received grant funding from the National Commission in Safety and Quality in Health Care to undertake trial of ISBAR in inter-hospital transfer situation.
Who is involved in the project?
The Australian Commission on Safety and Quality in Healthcare has funded the 12-month project.
- Dr Kim Hill, Director of Clinical Governance, is the HNEH Project Sponsor.
- A/Prof Anne Duggan, Clinical Lead Acting Associate, Director Clinical Governance.
- Kim Lane, Senior Project Officer.
- Dr Margaret Sanger, Director Medical Services, Maitland
- Dr Rosemary Aldrich, Associate Director Clinical Governance
- Prof Kichu Nair, Director of Continuing Medical Education
There will be broad consultation with consumers, carers and clinicians across the Maitland and John Hunter sites.
What will this mean for Hunter New England Health?
The results of this project will inform subsequent decisions about the application of the standardised format more broadly, as well as recommendations about the wider transferability of the solution.
Additional resources
ISBAR Information sheet (pdf 99 KB) - Hunter New England Area Health Service, May 2008. The information sheet gives an overview of the project.
More information
For further information on the Clinical Handover Program supported by ACSQHC please refer to
www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/PriorityProgram-05
Date created: 17th Mar 2009 | Date reviewed: 16th Sep 2010
