Tool: STAR
STAR is a mnemonic tool that is used extensively to help elicit and share key information about activities and their consequences. Its key elements include:
Situation monitoring often requires analyzing situations in which tasks were assigned, were completed, and resulted in outcomes that might or might not have fully resolved the situation. STAR is a device for providing a succinct summary of these four key elements. Asking specific questions to elicit information about the four key elements helps team members quickly understand key decisions and actions required to maintain a shared mental model.
Frequently team members are asked to respond to a change in a patient's status when expected improvements have not occurred. Understanding exactly what was done is key to good decision making about what might be done next. Patients and family caregivers also may need to explain actions they have taken in response to a medical condition and what resulted from these actions. STAR provides a simple way to organize key information and efficiently share it with other team members.
An example of STAR’s use in an outpatient setting illustrates its broad applicability. A heart patient could use STAR to describe their efforts to manage an arrhythmia in the following way:
- Situation: I emailed my doctor to let him know that the frequency and intensity of my arrythmia has increased.
- Task: In response, my cardiologist recommended that I increase the dosage of the medication I take for the arrythmia and to schedule an appointment to see him.
- Action: As instructed, I increased the dosage from 100 to 150 milligrams, which I’ve taken for the past few weeks, except for 2 or 3 days when I forgot to take it at all. I also scheduled an appointment, but the first one I could get was 4 weeks out.
- Review: My arrythmia still hasn’t improved and occasionally I feel lightheaded.
To apply STAR, consider the following reflective actions:
- In the past week, when could you have used STAR to either elicit or share information about a task in an efficient way?
- For any one of these circumstances, how would you have described the situation, task, actions, and results?
- In the next week, look for at least two opportunities to use STAR either at work or at home to gain experience with it and reinforce its value.
