Transcript Doctor to Doctor medical concern

Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
• Introduction
– Who, what and where you are and why are you
calling
– Is this a good time to talk?
• Situation
– What is happening now
• Background
– What led to the situation
• Assessment
– What you consider the problem is
• Recommendation
– What should we do to correct the problem
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Introduction
Who, what and where you are and why are you calling
Establish you are talking to the right person and that it is
convenient to have the conversation at that time
“Hello I am Mark Zed, ED CMO at The Maitland Hospital. Is
this Dr Duggan?
“I am calling because I have a unstable patient I wish to
discuss - is now a good time?
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Situation
Give the situation as of now, including key information
such as patient’s age and gender, and current status
“The situation is that Mr Whye is a 76 year old man,
who has just presented with ongoing haematemesis
and melaena. He has fluids, pantoprazole and
octreotide started and we have sent blood for Xmatching but he has just had further fresh
haematemesis…”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Background
Give the relevant background details such as presenting
factors and complications
• “ By way of background Mr Whye has risk factors for
both varices and ulcer disease as he is on aspirin for
previous MI and reports a long history of 60gm
alcohol intake daily
• “ He has no other co-morbidities and reports he is
quite well…”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Assessment
– What do you consider is going on
• “My assessment is that clinically he is unstable
with tachycardia (105) and hypotension (95/60)
on presentation
• “The bleeding appears to be ongoing as he has
had fresh H&M since presentation…”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Recommendation
Be clear about your recommendation or what you are
asking of the other person
• “I think he may need urgent endoscopy and we don’t
have those facilities or an on call gastroenterologist
here.
• “I’m ringing to ask if you will accept him under your care
at JHH as soon as possible please.
• “If you agree I will discuss his transfer with the retrieval
team…”