January 8, 2015

Coalitions in Action: South Miami Coalition Implements SBIRT Screening in Hospitals

When Margaret Prinzavilli Sotham became director of the South Miami Drug-Free Coalition, she was already familiar with the life-saving benefits of Screening Brief Intervention Referral to Treatment (SBIRT) in hospitals and knew it would benefit her new coalition.

“I know it’s not really a prevention strategy, but we looked at data on who was using alcohol among adults and thought this would be a good way for us to reduce adult alcohol use that would have a positive impact on youth, as well,” she explained.

SBIRT is a protocol that screens who come to receive emergency services with two questions about alcohol and drug use. Depending on the answers, the patient will receive or not receive an audit. For those that receive the audit, whatever they score determines if they need a brief intervention or a referral for treatment. SBIRT also requires health professionals to receive special training.

Partnering with South Miami Hospital, a coalition member, Sotham said in the beginning SBIRT wasn’t the easiest sell.

“It’s implemented through the emergency department and they are already very busy with lots of forms and protocol,” she said. “But there was a lot of understanding that this was something that could benefit the community, the patients and therefore the hospital.”

South Miami Hospital applied for a grant to fund SBIRT implementation and through that grant, they were able to hire a coordinator.

“One of the big lessons we learned was that something like this doesn’t live on without someone dedicated to the training, implementation and then data collection and analysis,” Sotham said. “It doesn’t live on if it’s just an add-on to someone’s already overly long job description.”

The expert coordinator did follow-ups, provided ongoing training and compliance. The hospital recorded the training session and posted it on a website for employees so anyone new to the emergency department could simply go online and be trained.

SBIRT was first implemented in South Miami Hospital in 2011 and saw 30,000 patients that year, most screened for SBIRT. Since the hospital is part of a system of hospitals across south Florida, the coalition is looking at branching it out to other emergency departments and outpatient urgent care centers.

Sotham explained that when implemented consistently, SBIRT can lead to positive results.

“From the data we are looking at – 70 percent said that their drinking behavior had changed as a result of SBIRT,” she said.

Sotham said that thanks to the community-wide effort, SBIRT has become a recommended practice by the Joint Commission on Accreditation of Hospitals.

“Once something is a recommended practice, it sets the stage for it to become a requirement,” Sotham said.

“It really was the foundation for a broader countywide effort, not just hospitals, but also service providers that have groups of kids that they can screen,” she went on. “We are looking to implement screening through those providers across the country.”

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