Lessons learned in developing and implementing a clinical guideline for substance abuse screening, brief intervention, and referral to treatment

A large body of evidence demonstrates that integrating screening, brief intervention, and referral to treatment (SBIRT) in healthcare settings is effective in creating behavior change and preventing adverse consequences attributable to drug and alcohol misuse. As one if the highest ranking preventative services by the American Journal of Preventative Medicine, standardized alcohol screening is a time efficient and cost effective public health approach to reducing alcohol-related morbidity and mortality. Despite this evidence, screening and brief intervention protocols have not been widely implemented in healthcare settings. In order to encourage the adoption of SBIRT protocols in hospitals and primary care clinics statewide, SBIRT Colorado created a clinical guideline for substance abuse screening, brief intervention, and referral to treatment. The guideline has been disseminated to over 5,000 physicians, nurse practitioners, and physician assistants. A series of CME presentations and rapid implementation activities have been conducted to further educate providers how to ingrate the guideline into standard practice and to utilize CPT billing codes for screening and brief intervention. This presentation will detail the guideline development process, demonstrate the rapid implementation activity methodology, and describe how to address common barriers to effective implementation. Recommendations include involving the media to disseminate information on the importance of SBIRT, offering enhanced training for healthcare providers on Motivational Interviewing skills and role-playing activities; expanding trainings to include alternative groups such as residency programs, dentists, pharmacists, and employee assistance professionals; and bridging the gap between healthcare and substance abuse treatment by improving referral networks in local communities.