ArticleCureus2026
Improving the Quality and Completeness of Clinical Handover Using the Situation, Background, Assessment, Recommendation (SBAR) Framework: A Closed-Loop Quality Improvement Study at Almanagil Teaching Hospital, Sudan.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
10 authors.
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Abstract
Background Effective communication during clinical handover is essential for patient safety, yet deficiencies in structured communication remain common, particularly in resource-limited settings. The Situation, Background, Assessment, Recommendation (SBAR) framework has been widely recommended to standardize communication and reduce errors. Methods A closed-loop quality improvement project was conducted at Almanagil Teaching Hospital, Managil, Gezira State, Sudan, using a two-cycle audit design structured around the Plan-Do-Study-Act (PDSA) framework. Compliance with SBAR communication standards was assessed among doctors involved in clinical handover. Data were collected from 48 handover events in cycle 1 (baseline) and 44 events in cycle 2 (post-intervention). A multifaceted intervention, including structured education, standardized SBAR templates, visual reminders, and continuous feedback, was implemented between cycles. Data were analyzed using descriptive statistics and the chi-square test, with a p-value of <0.05 considered statistically significant. Results A total of 92 handover events were analyzed. Significant improvements were observed across most SBAR components following the intervention. Documentation of key elements such as patient identifiers, clinical status, diagnosis, and vital signs increased markedly, with several parameters reaching near-complete compliance (p < 0.001). Critical communication elements, including escalation plans, actions, and response to treatment, also demonstrated substantial improvement. However, some variables, including documentation of treatment given, patient location, and gender, remained below the target compliance threshold. Conclusion The implementation of a structured SBAR-based quality improvement intervention significantly enhanced the completeness and quality of clinical handover documentation. These findings support the use of simple, low-cost, and scalable interventions to improve communication practices and patient safety, particularly in resource-constrained settings. Ongoing monitoring and reinforcement are required to sustain improvements and address remaining gaps.
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