Communication
CPSA · Communication · Information giving
Telephone referral to a senior or specialty
A performance station in disguise. Use SBAR and state the ask explicitly — the commonest failure is giving a narrative and leaving the listener to work out what you want.
The framework
Prepare before dialling
- Notes, observations, bloods and imaging in front of you. Know the drug chart and the resuscitation status.
- Decide what you are asking for: advice, review, or acceptance of care.
S — Situation
- Who you are, where you are, who the patient is, and in one sentence why you are calling.
B — Background
- Presenting problem, relevant history, what has been done so far.
A — Assessment
- Your observations and your interpretation. Commit to an impression — “I think this is…”.
R — Recommendation
- The explicit ask, with a timeframe. Then confirm what was agreed and by whom.
Close the loop
- Document the call, the name of the person, and the plan. Escalate if you remain concerned.
Phrases that work
- “I am the FY1 on ward 12. I am calling about Mrs Ahmed in bed 6, and I am worried she is septic.”
- “I think this is a biliary source. I have taken cultures and started co-amoxiclav.”
- “I would like you to come and review her within the next thirty minutes, please.”
- “Just to confirm — you are happy for me to give a further fluid bolus and you will attend by six?”
Pitfalls that lose marks
- Giving Situation and Background then stopping, so the senior must interview you.
- No impression — “I do not know what is going on” without saying what you have considered.
- Not stating a timeframe, so “I will come later” goes unchallenged.
- Accepting a refusal you are still worried about, instead of escalating.
- Not documenting the call.