The tool is used to standardize clinical handoffs for patients and provide the opportunity for health care providers to ask and respond to questions. The standard in the hospital is that all handoff communications will occur for all patients traveling throughout the organization with the use of ISBAR/Trip Tick (the exception is the adult ED and PACU). ISBAR is used for communication with all disciplines, including, but not limited to, reporting a change in patients status, transfer of care, Trip Tick, and Rapid Response Team.

ISBAR = A method of communication that provides an opportunity to ask and respond to questions:

I = Identity

S = Situation

B = Background

A = Assessment

R = Recommendation of a patient’s status so that the most critical information is efficiently shared, resulting in a mutually acceptable plan of care

The Trip Tick tool and utilization of the ISBAR format was implemented at Rhode Island Hospital to meet the The Joint Commissions National Patient Safety Goal 2E "Implement a standardized approach to 'hand off' communications, including an opportunity to ask and respond to questions."

Since the hospital began printing the ISBAR Trip Tick on goldenrod-colored paper, the tool inherited the buzz phrase of "The Golden Ticket."

Download the tool for complete instructions. The tool contains two files:

• ISBAR Trip Tick Guidelines for Use (Word document)
• ISBAR Trip Tick Tool (Excel document)

**Please note that the downloadable tool file is in ZIP format, and contains two files. Windows XP will automatically open the ZIP file; for other operating systems a tool like WinZip (or other free alternatives) should be used.