Adopt, Adapt, or Develop Tools
Got Protocol. Need Stuff!
So, you know who is doing what to whom… the next question is: With what resources?!
Having the screening forms available in paper or in your EMR or online is crucial to beginning the process of screening. Adapting these forms for your patient population may ease use for your patients and staff but may affect validity of the screening form since the language used in these forms has been tested for reliability and reproducibility. It is best to use the available instruments without modification.
You may have to get approval of the form from a larger governing body, such as a hospital or health system Forms Committee. You may need to acquire access for certain healthcare team members if the online form is housed on a secure website.
Knowing how to resupply the forms and where to put the forms when they have been completed is also important. Will they be scanned into a computer or placed in a paper chart? Who will make copies? Who will record, review or track the data? A breakdown in any one of these areas can mean the loss of important data to help you carry out the process of screening, know who needs intervention or know if your entire system is effective.
The forms in our project are continually evolving as they are integrated with other data collection and tracking efforts and with migration toward paperless electronic records. Some examples of our forms however include:
We found it very helpful to create a poster (available at iusbirt.org) that was prominently displayed, saying “We Ask Everyone.” We wanted to be sure that no one felt stigmatized by being screened. An additional patient resource is the NIAAA pamphlet entitled “Rethinking Drinking” that might be made available in the waiting rooms. We feel that simply reminding patients of safe limits to drinking may help them avoid hazardous drinking – it doesn’t matter if this results from seeing a poster, reading a brochure, or filling out a screener. Remember that the BHS is also a resource to provide education to the patient. Often, the BHS has had not only college education in behavioral health, but career experience in substance use treatment.
Most individuals leading an implementation of SBIRT will not have the time or resources to create their own training modules, and there are many available, including those we created at IU. However, it will be necessary to create some educational content describing the specifics of the process you design. A combination of online modules (covering principles) with face-to-face training (to demonstrate the process and patient flow you create) seems optimal.
You are inside some of those modules right now, but we also had face-to-face training sessions and handouts for introducing the effort. For example, for the launch at one site, we used the following presentation and handouts.
Ready, right? Not Quite.
So, now you have who, what they do, and with what they do it, ready, right? Not quite! You have one final pre-launch checklist item. If you haven’t already, you have to decide what to track and how to track it, not just for helping the patients, but for evaluating your progress.