Guidelines for Communicating with Physicians Using the SBAR Process

Use the following modalities according to physician preference, if known. Wait no longer than five minutes between attempts

o Direct page (if known)

o Physician’s Call Service

o During weekdays, the physician’s office directly

o On weekends and after hours during the week, physician’s home phone

o Cell phone

Before assuming that the physician you are attempting to reach is not responding, utilize all modalities. For emergent situations, use appropriate resident service as needed to ensure safe patient care. Start by defining the first and the last step in the process — so that everyone has a shared understanding of where the process you’re working on begins and ends

Prior to calling the physician, follow these steps:

o Have I seen and assessed the patient myself before calling?

o Has the situation been discussed with resource nurse or preceptor?

o Review the chart for appropriate physician to call.

o Know the admitting diagnosis and date of admission.

o Have I read the most recent MD progress notes and notes from the nurse who worked the shift ahead of me?

o Have available the following when speaking with the physician:

- Patient’s chart

- List of current medications, allergies, IV fluids, and labs

- Most recent vital signs

- Reporting lab results: provide the date and time test was done and results of previous tests for comparison

- Code status

When calling the physician, follow

the SBAR process

S) Situation: What is the situation you are calling about?

o Identify self, unit, patient, room number.

o Briefly state the problem, what is it, when it happened or started, and how severe.

(B) Background: Pertinent background information related to the situation could include the following:

o The admitting diagnosis and date of admission

o List of current medications, allergies, IV fluids, and labs

o Most recent vital signs

o Lab results: provide the date and time test was done and results of previous tests for comparison

o Other clinical information

o Code status

A) Assessment: What is the nurse’s assessment of the situation?

follow nurse

(R) Recommendation: What is the nurse’s recommendation or what does he/she want?

o Notification that patient has been admitted

o Patient needs to be seen now

o Order change

4) Document the change in the patient’s condition and physician notification.

document