Situation

[Healthcare provider identification: name, role, service, and location] (Begin with who you are and where you are calling from.)

[Intended recipient and role] (Specify who the message is for.)

[Patient identifiers: full name, age, [MRN / DOB], and location/room] (Include only if patient-related.)

[Mode of communication: phone / in-person / secure message / telehealth] (Include if relevant.)

[Urgency: STAT / urgent / routine] (State priority clearly.)

[Primary issue statement] (In 1–2 sentences, clearly state the immediate problem or reason for contact. For operational issues, briefly state the scheduling or coordination problem.)

Background

[Pertinent history and context] (Include only information directly relevant to the current issue; for clinical issues, include key diagnoses and relevant past history. For operational issues, include pertinent administrative context.)
[Recent events or care provided] (E.g., admissions, procedures, treatments, transfusions, or operational events; include timing when known.)
[Objective data] (For clinical: most recent vital signs, exam findings, and completed test results with times. For operational: appointment time/date, travel constraints, current schedule availability.)
[Current therapies, devices, or constraints] (For clinical: medications, drips, oxygen, lines, code status. For operational: clinic resources, staffing, or policy constraints.)
[Outstanding information or uncertainties] (Note key data not available or pending.)

Assessment

[Working assessment] (Concise clinical impression or operational judgment. Include a brief differential only if explicitly considered and relevant.)

[Risk or acuity statement: unstable / potentially unstable / stable] (Include if relevant.)

Recommendation

[Specific request or action] (State exactly what is needed from the recipient and by when: diagnostics, treatments, disposition decisions, or operational actions.)
[Testing or interventions requested] (E.g., labs, imaging, ECG; include timing: [now / today / within 24h].)
[Disposition or scheduling plan] (E.g., evaluate at bedside, transfer, same-day visit, overbook/alternate provider.)
[Contingency plan] (Clearly state next steps if the recommendation cannot be completed or the situation changes.)
[Escalation pathway] (Who to contact if no response by a specified time.)
[Follow-up and ownership] (Identify responsible party for each task and when to reassess or close the loop.)

Specialties

SBAR Communication Note

Specialties

Template Preview

Want to use this template?

Start using Scope today