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There is limited literature evaluating the integration of the electronic health record (EHR) to a structured communication template such as the SBAR (Situation, Background, Assessment, and Recommendation) model to improve physician documentation of significant in-patient events.We hypothesized that an electronic SBAR template within the EHR would improve interdisciplinary communication with more frequent, higher quality physician documentation compared to traditional paper charting.We reviewed 542 PICU admissions over 9 months, collecting 84 documented patient events. Three time periods were studied: 1) paper chart documentation only, 2) only electronic free-text notes after EHR implementation, and 3) electronic documentation with an SBAR template option. Each event note was scored to assess quality by allotting 1 point for each completed element of the SBAR, totaling 4 points. Documentation pre- and post- implementation of the EHR and SBAR template note was examined using ANOVA and chi-square analysis to assess quality and frequency, respectively.The frequency of event notes showed an increasing trend from paper documentation (12.7%), to EHR free-text notes (14.2%), and greater after instituting the electronic SBAR note (19.8%, p = 0.071). Mean scores assessing quality were 2.23 points (95% CI = 1.96-2.50) with paper documentation, 2.57 pts (95% CI 2.17 -2.97) with EHR free-text notes, 3.24 pts (95 CI = 2.90 – 3.57) after initiation of the SBAR template note, and 4.0 pts when only the SBAR template was used (p<0.0001). Nurses were never identified (0%) with paper documentation, identified 7.1% with free-text EHR and 44.1% post-SBAR template note (p<0.0001). Analysis of the SBAR notes alone showed 100% identification (p = 0.006). The attending physician was notified 18.2% with paper documentation, 53.6 % with EHR free-text note, 79.4% post- SBAR template (p<0.0001) and 100% notified when only the SBAR template note was used (p < 0.0001).The implementation of an SBAR template within the EHR resulted in higher frequency and higher quality documentation of significant patient events, with increased multidisciplinary communication.