Leadership Priority Setting Sbar

Priority setting begins with the threat to physiology, not the order in which requests arrived. ABCs first: airway obstruction, breathing failure, and circulation compromise take priority over routine care. A patient who cannot maintain an airway, is developing respiratory failure, or has inadequate perfusion may deteriorate within minutes; a delayed bath, routine vital-sign collection, or nonurgent teaching can wait. Maslow’s hierarchy provides a second filter: address physiological needs such as oxygenation, circulation, and fluid balance before safety, belonging, esteem, or self-actualization needs. This does not mean psychosocial concerns are unimportant. It means they cannot displace an immediate threat to life. Acute before chronic: a new symptom in a patient with a chronic disease is treated as an acute problem until assessed. New chest pressure in a patient with diabetes, sudden confusion in a patient with dementia, or a new oxygen requirement in a patient with chronic lung disease may represent a dangerous change rather than the expected baseline. Life-threatening before non-life-threatening: postoperative bleeding with falling blood pressure takes priority over a stable postoperative patient awaiting routine vital signs. Severe pain...