Toward an IH standard on Clinical Handover Communication
The proposed simple mnemonic to improve verbal handovers (IDRAW) blends the latest evidence from high reliability and resilience science. (Hill 2012). Based on two pilot projects (KGH / VJH), we will be creating a draft IH standard policy for handover and transfer of accountability. There is also a BC-PSQC funded UBC-O/UVIC research study on this topic. We intend to show that clinicians can be quickly and easily trained how to synthesize and prioritize complex information under time constraint. These two verbal templates are:
1. Forward focused 2. Allow for a concise synthesis from the receivers’ perspective 3. Allow for anticipatory planning modeled in practice 4. Even a brief face : face report (< 1 min/pt) can be valuable IF structured and focused forward. 5. Use a template for anticipatory verbal report using the IDRAW acronym
SBAR – Urgent communication Verbally communicate and agree on actions.
S - Situation (What is the problem ?) B - Background (Brief relevant history) A - My assessments (Vitals / other issues) R - Recommendation (What do we need to do ?)
IDRAW – Interactive hand off Verbally communicate and ask questions
I – Identify patient (2 identifiers) and MRP D – Diagnosis / Problems (Sick – Not Sick ?) R – Recent changes in last few hours / days A – Anticipated changes W – What to watch for