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UMD teaching tool · AHRQ adaptation

A more useful
clinical handoff

A discussion guide for helping the next team understand the concern, the clinical story, and the next responsibility.

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UMD teaching tool · Not approved agency policy.Reviewed by Jason A. Murray, MD, FACEP on October 19, 2026. No CME or CE credit. Organizational review and authorization are required before agency use.

About this adaptation

This is a Unified Medical Direction adaptation of AHRQ’s TeamSTEPPS SBAR guidance. AHRQ provides the underlying communication framework: Situation, Background, Assessment, and Recommendation or Request.

The wording, teaching prompts, and practice exercise below are UMD adaptations. This is not an official AHRQ tool or a replacement for your organization’s approved handoff process, clinical protocols, or transfer-of-care requirements.

The goal is shared understanding—not simply finishing your report

Use these prompts to practice explaining the concern, providing relevant context, and clarifying what needs to happen next.

Make the concern clear

Start with why the receiving team needs to pay attention now. Identify yourself and the relevant context using the organization’s required identification process.

Tell the important story

Share the background and observations that explain the current situation. Describe important changes and the patient’s response to care, rather than relying on an isolated value or a long list without context.

State your assessment—and uncertainty

Explain the concern you are carrying forward. Distinguish observed facts from your interpretation, and name important information that remains unknown.

Make the next responsibility explicit

State what you are requesting or what needs attention next. Invite clarification and confirm that the receiving team has understood the important point.

Practice as a team

Use a fictional or appropriately de-identified scenario. Have one person give the handoff and another summarize what they understood. Compare the intended concern with what was heard.

What was clear?

What needed clarification?

This guide does not define transfer-of-care requirements. Follow local documentation, handoff, escalation, and patient-care procedures.

Sources and context
Adapted from AHRQ TeamSTEPPS: Tool—SBAR.

AHRQ provides the underlying SBAR communication guidance. The specific teaching language and practice exercise above are UMD adaptations. Citing the source does not establish validation or approval of this particular UMD guide.


AHRQ retains authorship of its source material. This adaptation is not issued or endorsed by AHRQ.