EM Vivas · Handover (ISBAR)
ISBAR and the failed ICU transfer
Clinical viva on structured clinical handover.
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Study tools
Target exams
ACEMFRCEMABEM
Prompt
An ED-to-ICU handover omits a drug allergy and a rising lactate. Expand ISBAR, name the commonest failure mode, and state the step that closes the loop.
Interpretation
Reveal interpretationShowHide
ISBAR = Identify, Situation, Background, Assessment, Recommendation. Handover is information plus responsibility. Commonest failure is information omission from verbal-only unstructured handoff. Loop closure = receiver readback/synthesis plus explicit transfer of responsibility. System anchors: NSQHS Standard 6; I-PASS evidence for error reduction.[1]
References1ShowHide
- [1]Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med, 2014.PMID 25372088