SBAR checklist outlines what to say at handoff

This is the basic framework of the SBAR (Situation, Background, Assessment, and Recommendation) checklist developed by Kaiser Permanente in Oakland, CA, to improve patient safety when handing off a patient from clinician to another. (It can be used in other situations as well.) The clinicians are expected to communicate this key information and use the checklist as the basis for their conversation about the patient:

  • (S) Situation. What is the situation you are calling about? Identify self, unit, patient, room number. Briefly state the problem, what is it, when it happened or started, and how severe it is.
  • (B) Background. Pertinent background information related to the situation could include the following:

    — the admitting diagnosis and date of admission;
    — list of current medications, allergies, intravenous fluids, and lab results;
    — most recent vital signs;
    — lab results, including the date and time test was done and results of previous tests
    for comparison;
    — other clinical information;
    — code status.

  • (A) Assessment. What is the nurse's assessment of the situation?
  • (R) Recommendation. What is the nurse's recommendation, or what does he or she want? Examples could be recommending that the patient be seen immediately or that orders be changed.

(Editor's note: Tools for implementing the SBAR checklist can be downloaded free at the web site of the Institute for Healthcare Improvement in Cambridge, MA. You must register at the site to access the resources, but the registration is free. Go to After registering, choose "topics" on the left of the home page, then "patient safety" and then "safety: general." Then choose "tools," and on that page find the tool called "SBAR Technique for Communication: A Situational Briefing Model." Click on that file and then "download file" at the top of the page.)