MASBIRT Experience Applying NIATx principles to SBIRT referrals from health care

MAssachusetts SBIRT screens healthcare patients for unhealthy substance use; those screening positive get a brief intervention, those whose scores indicate possible abuse/dependence are either referred to Brief Treatment (6-12 sessions of manualized treatment based on motivational interviewing and cognitive behavioral therapy) or to more traditional treatment. The Brief Treatment/Referral to Treatment (BT/RT) workgroup found that fewer people were accessing treatment services than were referred. The group chose to focus on Brief Treatment (BT) because MASBIRT funds the BT provider, there is more data available, and outcomes resulting from process changes can be more easily measured. The goal was to improve the percentage of those referred to BT who actually attended sessions. The group invited a NIATx consultant to assist with the change project focused on improving appropriate referrals to BT, and minimizing barriers to treatment. Using NIATX process improvement principles – primarily seeing the problem from the consumer's viewpoint; focusing on an important problem; using data; and working with rapid cycle change – the team reviewed screening data at multiple points in time, conducted multiple “walk-throughs” of the referral process, and conducted patient surveys of perceived and actual barriers. Actions were proposed and the most favorable changes were instituted, one change at a time, as the NIATx model specifies. This session will present the results of those efforts and suggest other ways that NIATx principles and practices might work with in conjunction with SBIRT processes.