1. SBAR
TREK
To boldly improve communication when reporting incidents
Welcome

2. S – Situation B – Background A – Assessment R - Recommendation
What is SBAR?
S – Situation
B – Background
A – Assessment
R - Recommendation

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Incident Reporting
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Within Somerset Partnership incidents and near misses are reported using the Datix system. Alerts go to relevant people by when a report is submitted. Some reports are for information and some require action.
To boldly go
where no SBAR has gone before…

4. Datix The Life-Cycle of a Datix Report Main title slide page
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The
Life-Cycle of a
Datix Report

5. What the Risk Team receive
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What the Risk Team receive
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6. For example… Main title slide page
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Patient did not attend yesterday for monthly medication, phone message left on his mobile to make contact and letter put through his door with another appointment for today. He did not attend this appointment, staff went to patient’s address, no response to door knocking or calling out to him. Flat was in darkness, there was a plank against the inside of the door, only one door to the property, a fan heater could be seen switched on through the door.

7. Feedback… No context? Not clear what the outcome was?
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Feedback…
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No context?
Not clear what the outcome was?
Not clear if any immediate action is required by another party

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Aim of QI Project
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To improve communication and understanding of incident reporting using SBAR tool to effect timely and appropriate responses.

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Rationale
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As a result, Staff who review Datix often find it quite hard to understand what is happening, what has been done and what needs to be done within a Datix report. It is anticipated that using a recognised communication tool will improve this.

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Driver Diagram
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11. PDSA Cycle Main title slide page PLAN:
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PLAN:
To send an out to the whole staff team to check if staff are aware of SBAR and what it means
DO:
sent to staff.
8 out of 31 staff members responded with feedback.
STUDY:
1 member of staff was aware of SBAR and what it meant
7 members of staff were unaware of what SBAR was/meant
ACT:
Is the best method of communication?
Although provides an easy way to communicate to a whole staff team, can hinder an immediate response.

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Action Plan
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Provide staff education surrounding SBAR as a communication tool and set a start date for staff to begin using the tool within Datix reporting
Hold staff meeting 10/02/17
Follow up to be sent including example of SBAR 13/02/17
Ward team to use SBAR on all Datix reports from 13/02/17

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Staff Prompts
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Example of Datix Completed by Staff Member
S: Patient was found with a jumper tied around her neck - this was not anchored to anything and was being held in place by the patient. She was discovered in her bedroom on an ad hoc observation.
B: Patient has been admitted to hospital for diagnostic review and since admission has restricted food and fluids and held ligatures around her neck as a means of managing her emotional pain
A: That the patient was using this behaviour as a dysfunctional coping strategy to manage her emotional health. Some reddening to her neck once jumper removed, and physical observations monitored and all within normal range
R: Patient advised to utilise her drawing or writing skills as a means to show her feelings and emotions or to speak with staff and she has agreed to try and do this. Level 2 observations continue.

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Feedback
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“I valued the reflective nature of the SBAR, which aides empathy and understanding within the team. The additional SBAR proforma has been helpful too as an aide-mémoire.” Staff Nurse

17. Feedback from Reporters
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Feedback from Reporters
Did you find the SBAR format easy to use?
Not initially but found process easier with each Datix that I completed.
Did you have any problems when using the SBAR format whilst completing a Datix?
No. Guidance and prompts were made available to staff to assist with using SBAR format.
Did you find the SBAR format useful to use when completing a Datix?
It has helped to add context to Datix forms. More specific and factual.

18. Any Suggestions? Main title slide page
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Any suggestions on how to improve reporting a Datix using SBAR format?
Change the assessment to response and change the recommendation to plan. This way I feel it would be much easier for staff to follow the format.
Any suggestions on how to improve reporting a Datix using SBAR format?
None

19. Feedback from Datix Reviewers
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Feedback from Datix Reviewers
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“I can honestly say from my point of view, if all Datix reports were to be completed using SBAR it would vastly improve the quality of them and enable us here in Safeguarding to have a clearer picture of concerns, risks, actions, planning etc when it comes to determining whether safeguarding response/referral is required.” Safeguarding Adults Professional

20. Testing Metrics Main title slide page Datix reference number
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Datix reference number
Easy to understand context
Easy to understand what happened
Easy to understand who was involved and what they did
Easy to understand if urgent action is required at more senior level than reporter
** Score in the boxes: Agree = 2 / Partly = 1 / Disagree =0

21. Testing Metrics: Results
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Testing Metrics: Results
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Where SBAR not used:
(12 incidents reviewed against the 4 criteria overleaf on a scale from 0 - 2)
The average score for all 4 metrics was 1.42
Score of 2 (agree) used 60.42% of the time
Score of 1 (partially agree) used 20.83% of the time
Score of 0 (disagree) used 18.75% of the time
Where SBAR was used:
(10 incidents reviewed against the 4 criteria overleaf on a scale from 0 - 2)
The average score for all 4 metrics was 2.00
Score of 2 (agree) used 100% of the time
(Based on feedback from one reviewer)

22. Difficulties Main title slide page
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Protected time to focus on the project
Gaining staff feedback
Ensuring staff were consistent in reporting Datix using SBAR format
Many alerts are first seen on smart phones (in this situation ‘action’ section does not appear
To see the whole report the user needs to login to Datix on a computer

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Next Phase
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Risk Team will be working on the configuration of Datix to support application of SBAR
Risk team will be working configuration of Datix so that SBAR components all appear in alerts going to handheld devices
Spread the practice across the Trust!

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Questions?
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Thank You
‘Beam me up Scotty’

26. Thank you for listening
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Thank you for listening
Welcome
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