Clinical Handoff Using SBAR and I-SBAR-R

Clinical handoff communication is the transfer of essential patient information, responsibility, and authority between health-care providers during a transition of care. It is not simply a report of what has already happened. The receiving clinician must understand the patient’s current risk, unfinished work, expected next steps, and what change would require escalation. SBAR—Situation, Background, Assessment, Recommendation—gives the conversation a predictable structure. I-SBAR-R adds Identify at the beginning and Read-back at the end. The added steps address two common failure points: the wrong patient or unclear caller, and an unverified message or order. SBAR is endorsed in Canadian practice for standardized handover communication among registered nurses, registered psychiatric nurses, licensed practical nurses, and other health-care providers. Provincial policies and accreditation expectations support structured handoff processes, but the approved tool and documentation requirements may vary by employer and setting. Use the local policy when it specifies a particular format. A structured tool does not replace clinical judgment. It prevents the nurse’s most important reasoning from being buried in a long, unprioritized list of facts.