Volume 10 Supplement 1

Abstracts from the 2014 Addiction Health Services Research (AHSR) Conference

Open Access

Building sustainable SBIRT in an integrated hospital system in New York

  • Megan A O'Grady1Email author,
  • Sandeep Kapoor2,
  • Mark Auerbach2,
  • Jeanne Morley2,
  • John Yu3,
  • Veronica Salvas3,
  • Charles Neighbors1,
  • Jon Morgenstern1, 2,
  • Joe Conigliaro2,
  • Nancy Kwon2,
  • Tom McGinn2 and
  • John Kane2
Addiction Science & Clinical Practice201510(Suppl 1):A44

https://doi.org/10.1186/1940-0640-10-S1-A44

Published: 20 February 2015

Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use has received a great deal of empirical support. Despite the evidence for effectiveness of SBIRT and a compelling rationale for its integration into health-care settings, the circumstances under which it is likely to be implemented and sustained remain elusive. In this project, SBIRT was implemented into emergency departments (EDs) and primary care practices (PCPs) within a large, integrated health system in New York serving areas heavily affected by Hurricane Sandy. The SBIRT model was implemented in the following way: 1) Front-line staff (e.g., nurses and medical office assistants) administered a five-item SBIRT prescreen for alcohol, drug, and tobacco use to all patients during triage; 2) If a positive prescreen resulted, a health educator conducted a full screen using the AUDIT and/or DAST-10; and 3) The health educator conducted a brief intervention and referral to addiction treatment as indicated by the full-screen score. To assist in building the SBIRT process into the normal site workflow, prescreening questions were integrated into the electronic medical record (EMR) in a user-friendly way for front-line staff to administer. The EMR automatically scored the prescreen. As of May 2014, SBIRT was implemented in three EDs and two PCPs within the health system, with services starting on 12/1/13. Implementation was evaluated by reviewing EMR data as well as patient data collected at each site. Approximately 13000 patients were prescreened (13% positive). More women than men were prescreened (61% female), and there was a significant older population (9% were 18–24; 39% were 55 or older), as well as diversity in ethnicity (24% Latino) and race (19% African American). Almost 900 full screens were conducted (50% positive), which resulted in 284 brief interventions and 149 referrals to brief or formal addiction treatment. Further analysis revealed that multiple substances were an issue for many patients. For example, 20 percent of patients were positive on both the AUDIT and the DAST-10, and 39 percent of patients who full-screened positive for drugs or alcohol also screened positive for past-year tobacco use. Severity of full-screening scores was greater in the ED setting as compared to the PCP setting. Thirty-nine percent of patients who full-screened positive reported marijuana use in the past 30 days, and 14 percent were daily marijuana users. Overall, results suggest that SBIRT was successfully implemented in several busy sites within this large health system.

Declarations

Acknowledgements

This project is funded by the Substance Abuse and Mental Health Services Administration, grant number: 5U79TI025102.

Authors’ Affiliations

(1)
Department of Health Services Research, National Center on Addiction and Substance Abuse at Columbia University (CASAColumbia)
(2)
North Shore-Long Island Jewish Health System
(3)
New York State Office of Alcoholism and Substance Abuse Services (OASAS)

Copyright

© O'Grady et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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