ISBAR+ a communication tool to advocate for patients

IntroductionRecognising the importance of social determinants of health is a key part of the curriculum for health practitioners. The ability to advocate on behalf of patients is a competency that demonstrates enacting this understanding in practice. Communication frameworks are used to structure difficult conversations in multiple settings, notably handover. There is no commonly accepted communication framework to structure a patient advocacy conversation.ApproachWe assembled a team with skills in patient advocacy, healthcare communication, community advocacy, education and business negotiation to identify the knowledge, skills and attitudes required and to develop a framework suitable for this purpose. We chose to adapt the ISBAR framework as an existing communication framework commonly used for handover.OutcomesISBAR+ is a framework that is based on a person-centred approach and ‘integrated negotiation’. ‘Intention and Inquiry’ involves a compassionate understanding of the patient’s position. ‘Situation’ is a succinct framing of the problem. ‘Background’ is the information required for the decision-maker to make a person-centred decision. The next step is ‘alignment’ of the priorities of the patient, practitioner and decision-maker. ‘Response’ is the proposed solution, and ‘+’ (‘plus’) is the actions taken for implementation.ConclusionsISBAR+ provides a framework for conversations advocating on behalf of patients that draws from the literature around advocacy inside and outside health. A communication framework allows the development and evaluation of interventions to teach and promote this critical function to promote person-centred care

OceanView Medical: It Wasn’t Meant to Be like This

A life-changing event prompted marketing professional Stacey Thomas to leave her successful career in media and entertainment to join dynamic, fast-growing healthcare provider, OceanView Medical. Initially drawn to, and inspired by, the company’s mission and values, Thomas quickly discovered that the role for which she had been hired had expanded drastically in terms of responsibilities and challenges in the five weeks since her interview. The events that ensued became increasingly frustrating for Thomas, leaving her to decide whether to stay with the team she had built at OceanView Medical or to find a new job