Communication Review
Effective communication is widely recognized as a critical component in delivering high-quality healthcare services.
At Healthy & Home, we use the SBAR (Situation, Background, Assessment, Recommendation) framework as our standard communication tool when collaborating with physician partners. The SBAR helps ensure that information is conveyed clearly, concisely, and efficiently. It should be used whenever initiating a discussion with a physician regarding a clinical concern—for example, reporting a bilirubin result.
Below is an example of how to communicate a total serum bilirubin (TSB) result using the SBAR format:
S (Situation):
“I’m calling regarding Baby Boy Smith, who has an elevated serum bilirubin result.”
B (Background):
“Baby Boy Smith is 38 hours old with a TSB of 296 and is DAT positive. Albumin is 28 and Delta is 11.”
Include the following relevant clinical information:
- Gestational age and mode of birth
- Birth weight
- Current weight
- Hydration status, skin color, and level of alertness
- Feeding patterns
- Previous bilirubin results (if available)
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Risk factors, such as:
- Temperature instability
- G6PD deficiency
- History of sepsis or asphyxia
- DAT positive status
- Sibling with jaundice requiring phototherapy
- Significant bruising or cephalohematoma
- East Asian ethnicity
- Breastfeeding with poor weight gain
- Jaundice within the first 24 hours of life
A (Assessment):
“He appears lethargic, is not waking for feeds, and breastfeeding is not yet established. He is taking less than 20 mL per feed using a Tommee Tippee bottle.”
R (Recommendation):
“The Delta TSB suggests that phototherapy may be indicated. His TSB is within 30 µmol/L of the phototherapy threshold.”
Lab Specimens
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