ISBAR Clinical Handoff Communication
Key Points
- ISBAR standardizes urgent and routine clinical communication across teams.
- The sequence is Introduction, Situation, Background, Assessment, Recommendation.
- Structured handoff reduces omission and supports faster shared understanding.
- ISBAR is useful for shift reports, interunit transfers, and escalation calls.
- Adding readback (ISBARR) strengthens handoff reliability during high-risk transitions.
Equipment
- Up-to-date patient chart and current vital/lab trends
- Unit handoff template or ISBAR prompt card
- Escalation contact pathway for recommendation follow-through
Procedure Steps
- Introduction: Identify yourself, role, unit, and patient identifiers.
- Situation: State the immediate reason for communication and urgency level.
- Background: Provide concise relevant history, recent interventions, and key risk factors.
- Assessment: Report current clinical interpretation using objective and subjective cues.
- Recommendation: Specify requested action, timeframe, and contingency if status worsens.
- Confirm closed-loop understanding by asking receiver to restate key plan elements.
- Add explicit readback confirmation for high-risk transfer details (code status, lines, wounds, pending tasks).
- Document handoff content, actions requested, and response timeline.
Common Errors
- Giving unstructured narrative without recommendation → delayed action.
- Omitting key background risks → incomplete clinical context.
- Failing closed-loop confirmation → misunderstandings at transition points.
- No documentation of handoff and requests → weak accountability trail.
Related
- continuity-of-care-during-evaluation-phase - ISBAR supports safe care transitions.
- ana-nursing-documentation-principles - Handoff quality depends on accurate source data.
- source-vs-problem-oriented-documentation-workflow - Documentation structure influences handoff clarity.