SBAR (Situation, Background, Assessment, Recommendation) is a structured format for communicating clinical information concisely, often used at handoffs and when escalating concerns. It is intended to standardise what is conveyed; this entry describes the concept for reference rather than prescribing its use.

Why are handoffs a focus of patient safety?

Transitions of care, where responsibility passes between clinicians, are points at which information can be lost or distorted, contributing to error. Standardised handoff programmes have been associated with fewer medical errors, which is why they receive particular attention; this entry summarises that evidence for reference.

Interdisciplinary Team Communication and Collaboration

Interdisciplinary team communication and collaboration is the topic concerned with how the many professionals caring for a critically ill patient — nurses, physicians, respiratory therapists, pharmacists, and others — coordinate their work and share information. Because critical care is delivered by teams under time pressure, the quality of teamwork and communication is itself a determinant of safety and outcome.

Definition

Interdisciplinary team communication and collaboration in critical care is the coordinated interaction among the different health professions caring for a patient, through which information is shared and tasks aligned, supported by team behaviours and structured communication tools intended to make care reliable and safe.

Scope

The topic covers interprofessional collaboration, team behaviours such as closed-loop communication and shared mental models, structured communication and handoff tools (for example SBAR and standardised handoff programmes), interdisciplinary rounds, and the contribution of teamwork to patient safety. It is framed as reference education on how collaboration is understood and supported, not as a directive for any particular team.

Core questions

How does teamwork among different professions affect the safety and quality of critical care?
What communication behaviours and structures make information transfer reliable, including at handoffs?
How can interdisciplinary collaboration be strengthened in practice?

Key concepts

Interprofessional collaboration
Closed-loop communication
Shared mental model
Structured communication (SBAR)
Handoff / handover communication
Interdisciplinary rounds
Team training and crew-resource-management principles
Flattened hierarchy and speaking up

Clinical relevance

Nurses coordinate much of the communication that holds the critical care team together, including handoffs and rounds, and communication failures are a recognised contributor to adverse events. This entry describes the concepts and evidence as background; it explains how collaboration is approached rather than prescribing how a specific team should operate.

Evidence & guidelines

Reviews have argued that effective teamwork and communication are central to safe care and have synthesised evidence linking teamwork to patient safety in dynamic clinical settings (Leonard et al., 2004; Manser, 2009). A prospective study found that implementing a standardised handoff programme (I-PASS) was associated with a reduction in medical errors and preventable adverse events without lengthening handoffs (Starmer et al., 2014). The systems view of error also frames communication failures as latent contributors to harm (Reason, 2000).

History

Influenced by crew resource management in aviation, healthcare in the 2000s increasingly treated teamwork and communication as trainable competencies and as safety-critical. Structured tools such as SBAR were promoted to standardise the transfer of information, team-training programmes were introduced, and standardised handoff bundles were developed and tested as transitions of care were recognised as a frequent point of failure.

Debates

How much do structured communication tools alone improve outcomes?: Tools such as SBAR and standardised handoffs are associated with safer information transfer, but their benefit depends on adoption, training, and the wider team culture; whether the tool or the surrounding behaviour change drives improvement is debated.

Key figures

Michael Leonard
Tanja Manser
Amy J. Starmer
Christopher P. Landrigan

Seminal works

leonard-2004
manser-2009
starmer-2014

Frequently asked questions

What is SBAR?: SBAR (Situation, Background, Assessment, Recommendation) is a structured format for communicating clinical information concisely, often used at handoffs and when escalating concerns. It is intended to standardise what is conveyed; this entry describes the concept for reference rather than prescribing its use.
Why are handoffs a focus of patient safety?: Transitions of care, where responsibility passes between clinicians, are points at which information can be lost or distorted, contributing to error. Standardised handoff programmes have been associated with fewer medical errors, which is why they receive particular attention; this entry summarises that evidence for reference.