Collaborative implementation of screening, brief intervention, and referral to treatment within the medical community of Blair County, PA

摘要

BackgroundThis report provides an overview on the planning andimplementation of Screening, Brief Intervention andReferral to Treatment (SBIRT) training programs in onecommunity healthcare system so that it can be a modelfor other systems who wish to implement similarprograms.The goal was to reduce the impact of substance usedisorders (SUD) on the criminal justice system andcommunity by implementing SBIRT in local medicalclinics to improve the early identification of and evidence-based intervention on SUD by the medicalcommunity.Material and methodsTwo leading healthcare organizations in the communityformed a committee that managed and spearheaded theSBIRT training program implementation. An InnovationModel used by the authors guided implementation. Thecommittee completed organization assessments and businessanalyses for each training site. The committee andtraining sites became knowledgeable of SBIRT protocols,training program implementation, and infrastructuredevelopment. Once the program began, quality metricswere compiled and reviewed on a weekly basis.ResultsInfusing SBIRT practices into clinics increased in difficultyas the complexity of the system increased, however, benefitswere still obtained. Through the screening of over 280new patients, training sites found that SBIRT exposed problematicsubstance use within their patient populationthat previously would have gone unnoticed. Identificationpresented opportunities to improve patient care. Knowledgeand skills developed on screening, brief interventions;medical and psychiatric complications; and communityD&A resources, were fundamental to implementation.ConclusionsThe project revealed key factors relevant to the InnovationModel that related to successful implementation:champion preparedness; a highly specified protocol; acultural shift signifying a reduction in negative stigmaattached to working with patients with SUD; clear roledefinition for each member of the team; continuousactivity tracking; and regular contact between physicaland behavioral health providers and institutions.