The handover station (ISBAR)

What it is

Hand-overs are moments of high risk: when care passes from one clinician or team to another, missing or misunderstood information causes errors and harm. The World Health Organization recommends a standardised approach, such as SBAR (Situation, Background, Assessment, Recommendation), with time for questions and confirmation. ISBAR adds Identify at the start: who you are, where you are calling from and which patient you are talking about. In the ECOE, the handover station gives the candidate a short case (a ward patient who has deteriorated, a patient to pass to the night team) and asks them to phone a senior or hand over to a colleague played by an actor or the examiner. Marks go to a clear structure, the right patient identifiers, the key vital signs and findings, a stated impression of what is wrong, and a specific request (review now, advice, transfer) with a time frame. The candidate should then read back the agreed plan, confirm who does what, and document the handover. Concise and complete beats long and wandering.

What is assessed

• Identify: your name and role, the ward or unit, and the patient's name with a second identifier.
• Situation: the problem now, in one or two sentences.
• Background: reason for admission, relevant history, current treatment, allergies and resuscitation status.
• Assessment: current vital signs and findings, and your interpretation of what is going on.
• Recommendation: what you need, how urgently, and what you will do in the meantime.
• Closing: read-back, questions, clear responsibility for pending tasks, and documentation.

How to do it (and why)

1. Read the case and put the facts into ISBAR before you speak — a plan makes the call short and complete.
2. Identify yourself, your unit and the patient with two identifiers — wrong-patient errors begin here.
3. State the situation in one sentence: «I am calling because…» — the listener knows at once why it matters.
4. Give only the background that matters to this problem — relevance shows judgement and saves time.
5. Report vital signs and key findings, then your impression — the assessment is where reasoning is marked.
6. Make a clear request with a time frame: «Please review her within…» — vague requests cause delay.
7. Say what you will do while waiting and when you will call again — it closes the safety loop.
8. Ask for and give a read-back of the plan, then document it — confirmation prevents misunderstanding.

Mistakes that cost marks

• Starting without identifying yourself or the patient.
• A long story with no clear situation or request.
• Listing numbers with no interpretation of what they mean.
• Forgetting allergies, resuscitation status or pending results.
• No time frame for the request and no plan while waiting.
• No read-back, so the plan is never confirmed.

Self-check list

• I identified myself, my unit and the patient with two identifiers.
• I stated the situation in one sentence.
• I gave relevant background only.
• I reported vital signs and findings and gave my impression.
• I made a specific request with a time frame.
• I said what I would do while waiting.
• I confirmed the plan by read-back.
• I documented the handover.

Test yourself

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Elsewhere in DurgiPedia

• Handoff and SBAR communication
• Recognising deterioration and calling the rapid response team

Connections

← All clinical skills

Educational content; it does not replace supervised hands-on training, your institution's protocols or a prescriber's order. A procedure is learnt with a teacher and done only once you are trained to do it.

Sources: Communication During Patient Hand-Overs (Patient Safety Solutions, vol. 1, solution 3) (World Health Organization, WHO Collaborating Centre for Patient Safety Solutions, 2007).

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Representative model, for educational purposes only.