SBAR Implementation Change Plan for Labor & Delivery Units
This paper presents a change proposal for sustaining SBAR (Situation-Background-Assessment-Recommendation) implementation in the Labor, Delivery, Recovery, and Postpartum Unit of a university birth center. Despite repeated training efforts, nursing staff consistently revert to informal verbal reporting. The paper outlines the benefits of the SBAR framework, identifies organizational and individual barriers to lasting adoption, and proposes Golden's (2006) four-stage change model as a structured pathway to close the performance gap. Action research methods, including surveys and interviews, are recommended to gather implementation data. Ambrose's change management framework and Kotter's sequencing principles are also incorporated to support a comprehensive, sustainable change strategy.
- Introduction and Change Issue: SBAR adoption repeatedly fails in birth center unit
- Benefits of SBAR Communication: Five key benefits of the SBAR framework
- Implementation Variables and Barriers: Survey-identified drivers of SBAR implementation failure
- Golden's Four-Stage Change Model: Four structured stages for organizational change
- Organizational and Individual Barriers to Change: Structural and personal resistance factors in healthcare
- Action Research Approach: Surveys and interviews to guide change planning
- Conclusion: Ambrose and Kotter frameworks reinforce change sustainability
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- The paper grounds its change proposal in a specific, real-world clinical setting, making the argument concrete and context-sensitive rather than generic.
- It draws on multiple change management frameworks (Golden, Ambrose, Kotter) and synthesizes them into a coherent, multi-stage plan rather than relying on a single theory.
- The paper distinguishes clearly between organizational barriers and individual barriers to change, demonstrating nuanced understanding of implementation challenges in complex healthcare environments.
Key academic technique demonstrated
The paper demonstrates applied theoretical reasoning: it does not simply describe change models in the abstract but maps each stage of Golden's framework onto the specific conditions of the birth center unit. This integration of theory with practice context is a hallmark of graduate-level healthcare management writing and shows the student's ability to operationalize academic concepts.
Structure breakdown
The paper opens by defining the problem and the benefits of SBAR, then introduces the theoretical change model and describes each stage. It follows with dedicated analysis of organizational and individual resistance, proposes action research as a data-gathering mechanism, and closes by incorporating Ambrose's and Kotter's complementary frameworks. This progression moves logically from problem identification through framework selection to implementation strategy and sustainability.
Introduction and Change Issue
The benefits of SBAR are apparent to the nursing staff in the Labor, Delivery, Recovery, and Postpartum Unit of a university birth center. All nursing staff receives training in SBAR, and it has been implemented successfully for a few months at a time. However, nursing staff soon revert to historical ways of communicating about patient care, which have predominantly consisted of giving a verbal report. This change proposal addresses how to move toward sustained, consistent implementation of SBAR as standard operating procedure in the unit.
Benefits of SBAR Communication
SBAR stands for Situation-Background-Assessment-Recommendation and is a framework for communication about patients' conditions used by members of a healthcare team. The following discussion draws from the Institute for Healthcare Improvement (2011). The benefits of using SBAR by hospital staff include:
(a) It is an easy-to-use, easy-to-remember mechanism; (b) it is a concrete way to frame conversations that fosters effective and timely communication; (c) it permits information to be easily accessed and recorded with fidelity, which is particularly important for communicating about patients with critical care issues or those requiring immediate attention and action by members of the healthcare team; (d) it helps healthcare team members stay focused on the standards and expectations for patient communication; and (e) it fosters a "culture of patient safety" and supports the development of effective teamwork (Institute for Healthcare Improvement, 2011).
References
Ambrose, D. (1987). Managing complex change. Pittsburgh, PA: The Enterprise Group Ltd.
Drucker, P. F. (1993). The new realities. New York, NY: Harper & Row.
Golden, B. (2006). Transforming healthcare organizations. Healthcare Quarterly, 10(Spring), 10–19.
Kotter, J. P. (1996). Leading change. Boston, MA: Harvard Business School Press.
SBAR technique for communication: A situational briefing model. (2011). Institute for Healthcare Improvement. Evergreen, CO: Kaiser Permanente of Colorado.
Create your account
Always verify citation format against your institution’s current style guide requirements.