1. 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

2. 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

3. 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 X- matching but he has just had further fresh haematemesis…” Clinical Governance – Pursuing Quality, Safety and Excellence ISBAR In Our Communication

4. 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

5. 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

6. 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…” Clinical Governance – Pursuing Quality, Safety and Excellence ISBAR In Our Communication