Fixation on Histology

The Joint Commission established National Patient Safety Goals in 2002 to address patient safety in healthcare.  One of these goals is to improve the effectiveness of communication among caregivers.  SBAR (Situation, Background, Assessment, Recommendation) was recommended by The Joint Commission as one tool to achieve this goal.


SBAR is a communication tool that has been around for many decades, designed to communicate information quickly and concisely.  It originated in the military, but has become widespread in healthcare, promoting a way to standardize communications and improve teamwork and patient safety. 

What does SBAR stand for?

Situation (a brief and factual statement regarding the situation/issue)

Background (important, relevant information related specifically to this situation)

Assessment (precise evaluation, analysis, and considerations)

Recommendation (action recommended, next step and timeline)

SBARs are focused, time-efficient, evidence based and familiar to many in a leadership role.  The use of SBAR ensures that information is conveyed quickly and reduces time spent by both the person preparing the document and the ultimate decision maker.  The SBAR guides users to provide succinct and effective communication, and information can be shared in written form or a verbal report.

Know Your Audience

Once you understand the SBAR framework, you must consider your audience.  When preparing a SBAR for leaders, you may need to include different details that would not be necessary when reporting an issue to a coworker.  For example, if describing a hematoxylin shortage to the director of supply chain, you should include more information in the “Background” section as to the affect such a shortage has on daily operations and the ability to make a diagnosis. 

Below is an example of an SBAR for a proposed change to an existing staffing model.

Situation:   The Histology laboratory has had a nationally advertised overnight position, open for 6 months without a single applicant.

The hours are 7pm-3:30am.

Background:   The only local Histology training program closed in 2015.  Nationwide there is a shortage of trained and certified Histology technicians.

Assessment:   Histology staff currently working the overnight shift do not want to change shifts and would leave the position if moved to a day shift role.

The overnight shift performs most of our biopsy grossing due to late courier drops, and most of our biopsy embedding due to shorter processing times.

Recommendation:   I recommend that the job posting be changed to an evening shift position, as 2pm-10:30pm.  This change provides overlap with both the day and night shifts, while still supporting the grossing and embedding needs.

When to Use a SBAR

In the organization where I am employed, we utilize the SBAR format to request additional equipment, communicate supply shortages, suggest quality improvement projects, inform change management, and request new testing. It is recommended that we keep each SBAR to one page, to ensure it remains concise.

SBARs have been around for many years, but the framework remains a great method to communicate, both with coworkers and with leaders.  You may consider it the next time you want to request a process improvement in your lab.

Written by Jennifer Schumacher, HTL(ASCP)