Using SBAR to Communicate With Policymakers

Carolyn Jurns, DNP, MSN, RN

Disclosures

Online J Issues Nurs. 2019;24(1) 

In This Article

History of SBAR Communication

The SBAR communication tool was initially developed by the United States Navy to improve communication among personnel (Westwood et al., 2012). Sometimes preceded with an "I" for identify, SBAR neatly segments communication into the categories of situation, background, assessment, and recommendation. An evidence-based tool, SBAR has been demonstrated to guide effective and efficient verbal and/or written communication regarding patients' conditions (Marshall, Harrison, & Flanagan, 2008). Clinical use of SBAR has been promoted by the Joint Commission (n.d.); the Institute for Healthcare Improvement (in association with Kaiser Permanente) (Kaiser Permanente of Colorado, 2017); and numerous other healthcare organizations and facilities. The SBAR briefing tool was specifically developed to aid in sharing vital information in time-pressured scenarios and demonstrates positive effects on communication's flow and pace (Marshall, Harrison, and Flanagan, 2008).

"The SBAR communication tool was initially developed by the United States Navy to improve communication…"

SBAR Application in Healthcare Settings

In healthcare, (I)SBAR is used to organize communication about a patient in the following way:

(I)dentify – Stating who you are and of whom you speak

(S)ituation – Briefly describing what is happening with, or the concern regarding, a patient

(B)ackground – Sharing pertinent information and a concise patient history

(A)ssessment – Giving your expert professional assessment of what is occurring

(R)ecommendation/Request – Offering your professional recommendation for a course of action.

Given that healthcare organizations employ the clinical application of the SBAR format, use of the tool in the policy arena would likely be relatively straightforward process.

Benefits of SBAR to Policy Advocacy Time Optimization. There are significant benefits to using SBAR's focused, time-efficient, evidence based, and familiar communication format to promote policy advocacy among nurses. Nurses' perceived lack of available personal time is a demonstrated barrier to advocating (Cramer, 2002; Vandenhouten, Malakar, Kubsch, Block, & Gallagher-Lepak, 2011). Cramer's (2002) work found it to be the leading barrier. Using the SBAR tool addresses this need in several ways. Because many nurses are familiar with the tool, no additional learning is required. Additionally, because templates guide communicators, they can serve to lessen the burden of communication and potentially optimize user time.

"Nurses' perceived lack of available personal time is a significant barrier to policy advocacy."

Receiving SBAR communications is also practical from the policymakers' perspective. Policymakers have limited time to examine issues and interact with stakeholders (Brownson, Royer, Ewing, & McBride, 2006; Kingdon, 2003). Using SBAR communication provides the template for nurses to effectively and succinctly describe issues and provides policymakers with the pertinent information required to make informed healthcare policy decisions. See Table 1 for additional information about applying (I)SBAR in communication with policymakers.

Effective Communication. Nurses' perceived ability to speak and present effectively is positively correlated with increased political advocacy, while perceived lack of skill contributes to decreased advocacy involvement (Jansson et al., 2016; Jurns, 2017; Vandenhouten et al., 2011). The SBAR tool provides nurses a comfortable template for efficient and effective communication with policymakers. Applying the SBAR tool in the policy arena allows even nurses inexperienced in policy issues to stand upon the familiar ground of past experience as a seasoned communicator, enhancing their self-perception within the policy realm. Nurse comfort level in this application is explained and supported by both constructionist learning theory (Candela, 2012), which holds that new knowledge is built by viewing it through the interpretive lens of existing foundational knowledge, and Knowles (1973) adult education theory which recognizes adults thrive when connecting new knowledge with past experiences. Using SBAR may foster nurses' perceptions of competence and efficiency, thus promoting participation in future advocacy activities.

Effective Communication. Nurses' perceived ability to speak and present effectively is positively correlated with increased political advocacy, while perceived lack of skill contributes to decreased advocacy involvement (Jansson et al., 2016; Jurns, 2017; Vandenhouten et al., 2011). Communicating efficiently and succinctly has been identified as a key factor in influencing and interacting with policymakers (Brownson et al., 2006; Kingdon, 2003).

"Communicating efficiently and succinctly has been identified as a key factor in influencing and interacting with policymakers."

The SBAR tool provides nurses a template for efficient communication with policymakers. As many nurses are familiar with the SBAR communication strategy, perceptions of effectiveness using SBAR is explained by constructionist learning theory which posits that new knowledge is built by viewing it through the interpretive lens of existing foundational knowledge (Candela, 2012) and adult education theory (Knowles, 1973) which suggests adults thrive when connecting new knowledge with past experiences. Applying the SBAR tool in the policy arena may support nurses, especially those inexperienced in political advocacy, to stand upon the familiar ground of past experience as effective communicators and enhance self-efficacy in political advocacy arenas. Using SBAR may foster nurses' perceptions of competence and efficiency, thus promoting continued participation in future advocacy activities.

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