The ISBAR framework represents a standardised approach to communication which can be used in any situation. ISBAR is based on ‘SBAR’ a system which was developed by the US Navy for use in nuclear submarines.

Why ISBAR?

ISBAR is currently well recognised in the current Safe Clinical Handover implementation plans of a number of Area Health Services
ISBAR aligns with Between the Flags and DETECT training
ISBAR is a generic communication framework that is applicable to both clinical and non-clinical settings
A single communication framework will increase the consistency of practice for Junior Medical Officers

See Toolkits & Resources for ISBAR resources.

2. Senior leadership: deciding who and what to hand over at shift change

Shift handover should result in a clear understanding of:

sick, deteriorating and unstable patients
significant changes in condition or management plan during the previous shift
outstanding actions, procedures, tests or results to be reviewed
other important factors that will affect work on the following shift
new patients
any patient you are worried about – do not discount your clinical acumen

Senior clinicians have experience that can help JMOs to deliver the most important key messages relating to effective transfer of patient care in a complete yet concise manner.

Do not wait for shift handover:

According to the escalation protocols of DETECT and Between the Flags, JMOs should recognise and escalate the awareness of such concerns to senior clinicians immediately, rather than waiting for shift handover, to the potential detriment of patient care.

3. Shift to shift handover: key principles for locally appropriate implementation

Safe and quality of care dictates that the fundamentals of handover are constant, regardless of the time, or day. However, facilities should consider variables that impact shifts across 24 hours of the day and 7 days per week, when determining locally appropriate clinical handover solutions.

Principles for JMO handover map directly to the Safe Clinical Handover standard key principles and fall under 4 high level categories:

Handover Happens
Handover Leadership
Handover Set-up
Handover Process

See the Toolkits & Resources page for further detail on implementing the key elements of JMO handover.