Communication with patients and families as a global determinant of health: Lessons from care of children with special health care needs

Until recently, patients and families were not considered by all providers to be valued members of the health care team. Many providers made decisions away from the bedside and then told the patient and family what they could expect from the plan of care. This top-down approach is not limited to one country or culture but reflects an attitude prevalent in biomedicine around the globe. However, the paradigm is beginning to shift. Skyrocketing health care costs have prompted value-based purchasing, in which third-party payment is linked to patient outcomes and satisfaction. Providers and health care organizations are scrambling for evidence-based models to improve communication and other satisfaction-related criteria. This article proposes that teaching patients and families use of the Situation/Background/Assessment/Recommendations (SBAR) tool, traditionally used among health care professionals, will improve communication, enhance patient and family satisfaction, and potentially improve patient outcomes overall. The SBAR4Patients project demonstrates the positive impact SBAR can have on parents of chronically ill children.