1. Welcome Using SBAR in handovers Main title slide page
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Welcome
Using SBAR in handovers

2. Situation
Welcome
Magnolia took on the initiative to improve the quality of their handovers in April 2017.
Prior to the changes the standard of handovers varied in quality. The previous SBAR tool often included 'cut and pastes' of progress note entries and often did not include all relevant details and recommendations or plans for the person
Recommendation from Nurse Consultant for WAA to trial a more reliable version of the SBAR handover tool
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3. Welcome Benefits to patient and staff Main title for slide set
Staff are more informed of relevant needs, risks, and plans for the people using services for the next 24hour period
All staff will be more confident in their knowledge of the patient
Having a good handover will propel staff to proactively and purposefully engage with people
Improved outcomes for people on the ward as a result of people feeling reassured that staff know about their care and treatment plans and awareness of their needs.
Reduction in incidents, Reduction in complaints
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4. 3 Key questions What are we trying to accomplish?
To work with staff to improve the quality of clinical handovers by using the SBAR tool in 100% of all clinical handovers by 30th August 2017.
How will we know that a change is an improvement?
Outcome measures of average reliability of handover
Reduction in length of handovers
Effectiveness of SBAR in informing staff to focus on key priorities for the day from perspectives of different members of MDT
Self rating of the quality of the handovers received using counter system
What changes can we make that will result in improvement?
Implementing new SBAR. Set of standards and expectation for delivery of SBAR. Observer Reliability questionnaires. Self rating counter system.

5. Welcome Assessment Main title for slide set Optional sub title or name
AIM PRIMARY DRIVERS SECONDARY DRIVERS
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Whole team approach and involvement
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All staff to understand the SBAR
Improvement Lead/ Champion and QI nurse providing guidance and teaching of SBAR to all staff including temporary staff
Set of standards for the delivery of the SBAR
To work with staff to improve the quality of clinical handovers by using the SBAR tool in 100%of all clinical handovers by 30th August 2017.
Clear Standards and Expectations for delivery of SBAR
Guidance and rationale for the use of the SBAR Tool
Handover evaluation/ audit tool with a clear system for Data collection with clear responsibilities
Clear Process of Evaluating Handovers
Use of feedback from team members
Team members to see the project as their own within a positive culture of psychological safety to enable change
Staff Motivation to succeed
Positive changes to be shared with the teams

6. Welcome SBAR is embedded
Update
Welcome
SBAR is embedded
Staff are engaged and motivated to be involved in Qi initiatives on their ward
Sustained improvement in reliability and hence quality of handovers
Staff experience of handovers is good
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7. Welcome Outcome Measurement Main title for slide set
Special cause variation – May 2017
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Project started April 2017
Graph showing the average reliability scores from observed handovers from April 2017 when the project began.
Graph demonstrates a shift in reliability at the beginning of May which has been sustained. Average reliability has not fallen below 80%.
We continue to work towards improving this score.

8. Welcome PDSA Testing Ramps for:…… Main title for slide set
DATA FEEDBACK TO FRONTLINE STAFF
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1E: Collate information review PDSA
Cycle 1D: To observe the impact of this tool in informing the MDT of their key priorities
Cycle 1C: Using the SBAR to a better standard
Cycle 1B: Nursing Staff using the SBAR
Cycle 1A: Introduction to SBAR

9. Welcome Recommendations Some challenges and barriers:
Positive aspects of the team’s keenness and motivation to implement the tool meant baseline data was unavailable.
Overcoming this by getting retrospective feedback of staff experience prior to the changes
Steps since then were embedded before moving forward.
Use of the SBAR has been limited to the nursing handovers and as yet has not included rest of MDT. One of our next test of change would be to observe the impact of this tool would have on informing the MDT of their key priorities
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10. “get everyone on board and involve everyone in the improvements”
Key improvement message learnt
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“Sustaining Quality Improvements is a process, start small from the beginning, learn from the changes and ensure embedded before moving on to the next challenge.”
“get everyone on board and involve everyone in the improvements”
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