In Safe Hands - releasing the potential of clinical teams

Structured Interdisciplinary
Bedside Rounds (SIBR™)

SIBR™ is a key tool of the In Safe Hands program, providing the structure for interdisciplinary teams to be developed, while assisting these teams in meeting the first seven of the '10 functions'.

It is a process for rounding that ensures effective communication between team members occurs regularly. All relevant healthcare team members, including the patient, the bedside nurse, doctors and allied health team members, gather at the patient's bedside to discuss and develop a plan of care which is inclusive and patient-based. Each member is encouraged to contribute and collaboratively cross-check important information so that the decisions made are up-to-date and based on all of the information available.

During SIBR™, relevant patient safety concerns are identified, discussed and actioned within an appropriate time frame. This in turn reduces the risk of error and potential adverse events. As a consequence, better coordination of care is achieved, prompting improved patient flow through the unit.


Pre-implementation of SIBR™

For wards or units that are preparing to implement SIBR™, it is recommended that a minimum time of six weeks is allowed. More or less time may be required depending on the needs of the unit. There are six stages to consider when implementing SIBR™, as outlined in the below diagram.


In Safe Hands - releasing the potential of clinical teams

Within these six stages there are several steps which will need to be completed, which include:

  1. Form the leadership team The team will be co-led by the Nursing Unit Manager (NUM) and the unit medical director and will include representatives from each discipline, along with a consumer representative. Establish governance arrangements such as a meeting, reporting and communication schedule.
  2. Assess unit-specific needs Evaluate the unit against the 10 functions of In Safe Hands and teamwork, as well as current patient and clinician experiences - see assessment resources below. Visiting similar units who have implemented In Safe Hands will also greatly assist this process. Contact the CEC In Safe Hands team for referral to these units.
  1. Preparation and customisation of resources As a team, develop tools and resources such as prompt sheets and a documentation form, as well as ground rules for the team itself. An education strategy will need to be developed comprising staff meetings, in-service presentations and simulation training.
  2. Establish program evaluation Create an evaluation for the program using the assessment resources below, as well as IIMS data.
  1. Implementation Pilot the SIBR™ process and evaluate after one month. Be sure to celebrate the wins, address any concerns and make any changes as agreed by the team.
  2. Sustain and evaluate the program Continue to monitor, evaluate and improve for sustainability of the program.

Monitoring and Evaluation

Monitoring and evaluating the performance of the unit in relation to the In Safe Hands program is vital to ensure the program is improving in the agreed areas for development. It is essential that initial data gathering of the agreed areas for evaluation be done at the pre-implementation stage to establisha benchmark for post-implementation data.

The CEC recommends the following areas to be monitored:

Process measures: Average Length of Stay, Unplanned Readmissions, Day and Time of Discharge, Mortality. A minimum data set outlines recommended indicators.


Patient and staff experience:
identified through regular teamwork, patient and staff experience questionnaires (see Pre-Implementation).

Patient safety: items as reflected in the patient safety checklist identified through the Incident Information Management System.


Acknowledgement

SIBR was created by Dr. Jason Stein of Emory University in Atlanta, Georgia and is a registered trademark of Centripital, Inc. Any commercial use of the mark without the express written consent of Centripital is strictly prohibited. For more information, please visit Centripital