SBAR Technique for Communication: A Situational Briefing Model

The SBAR (Situation-Background-Assessment-Recommendation) technique provides a
framework for communication between members of the health care team about a patient’s
condition. This downloadable tool from the Institute for Healthcare Improvement contains two
• “Guidelines for Communicating With Physicians Using the SBAR Process” explains how
to carry out the SBAR technique.
• “SBAR Report to Physician About a Critical Situation” is a worksheet/script that a
provider can use to organize information in preparing to communicate with a physician
about a critically ill patient.

Hand Hygiene in Healthcare Settings

The Centers for Disease Control and Prevention’s Hand Hygiene in Healthcare Settings provides
healthcare workers and patients with a variety of resources including guidelines for providers,
patient empowerment materials, the latest technological advances in hand hygiene adherence
measurement, frequently asked questions, and links to promotional and educational tools
published by the WHO, universities, and health departments.

AHRQ – SBAR Technique for Communication: A Situational Briefing Model

The SBAR (Situation-Background-Assessment-Recommendation) technique and tools provide a framework for communication between members of the health care team about a patient’s condition. SBAR is an easy-to-remember, concrete mechanism for framing any conversation requiring a clinician’s immediate attention and action. Free registration and login are required to download the tool.

CDC: Adult Falls

Each year, millions of older people—those 65 and older—fall. In fact, one out of three older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again. This Fact Sheet provides information on the serious and costly impact of falls.

Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation

Many organizations are uncertain about how to proceed with designing a workable solution for medication reconciliation. This link provides helpful information and tools for designing or redesigning a medication reconciliation process.

Leaders’ Role in Medical Device Safety (IHI)

This article provides recommendations and resources for improving medical device safety, including guidance for leaders, who are in a key position to ensure that medical device purchasing decisions engage core staff in the process, incorporating their input and device use experience to inform the process.

Medical Equipment Management

Medical equipment plays a vital role in healthcare; however, when equipment is not properly
used or maintained, it also can cause harm. In many instances, patient injuries occur because
of assumptions about who may use, calibrate, modify, or repair equipment.

Injuries from medical equipment also might arise from training gaps that don’t address preuse testing, preventive maintenance, malfunction reports (and incident reports), and repair

A commitment to safety is an essential element of any process related to the use of medical
equipment — whether the medical equipment is purchased, rented, borrowed, or leased.

-MedPro Group

SAFER Guides

The SAFER Guides consist of nine guides organized into three broad groups. These guides enable healthcare organizations to address EHR safety in a variety of areas. Most organizations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern. The guides identify recommended practices to optimize the safety and safe use of EHRs. The content of the guides can be explored here, at the links below, or interactive PDF versions of the guides can be downloaded and completed locally for self-assessment of an organization’s degree of conformance to the Recommended Practices. The downloaded guides can be filled out, saved, and transmitted between team members.

Top CDC Recommendations to Prevent Healthcare-Associated Infections

This printable factsheet provides key tips to prevent healthcare-associated infections, including CAUTIs, SSIs, CLABSIs, C. difficile, and MRSA.

Healthcare – associated Infections Guidelines and Recommendations

This site includes guidance documents from the CDC to prevent healthcare-associated infections.


PSO Case Law: Ungurian v. Beyzman, et al., 2020 PA Super 105:

A recent Pennsylvania case shows how courts narrowly interpret the PSQIA, ignoring the D & A pathway and the clear language of the Final Rule. (Ungurian v. Beyzman, et al., 2020 PA Super 105). The cour

Joint Commission New Sentinel Event Alert 61: Managing the Risks of Direct Oral Anticoagulants:

The Center for Patient Safety wants to share this important harm-prevention advice from The Joint Commission and its Sentinel Event Alert: Managing the Risks of Direct Oral Anticoagulants. The Joint Commis

CPS Safety Watch/Alert – Culture Can Improve the Control of Multi-Drug Resistant Organisms:

Issue: A number of events reported co CPS’ Patient Safety Organization (PSO) demonstrate poor handoff communication about the patients’ infectious disease status Examples include: Patient with

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The Center for Patient Safety believes that collaboration and sharing are the best ways to drive improvement. We strive to provide the right solutions and resources to improve healthcare safety and quality.