Implementing screening, brief intervention, and referral for alcohol and drug use: the trauma service perspective.
BACKGROUND
Most trauma surgeons are unfamiliar with screening, brief intervention, and referral (SBIR) programs for substance use disorders, and few trauma centers provide them. This report describes how an urban private-teaching hospital adapted a protocol from an existing emergency department-based program to include patients treated by the trauma service.


METHODS
We recorded the rates of SBIR completion and reasons for failure during each phase of the implementation, interviewed trauma service staff and health educators to assess attitudes toward the program, and evaluated patient satisfaction surveys.


RESULTS
By adding SBIR staff to the trauma outpatient clinic and to trauma morning rounds, the capture rate increased from 12 to 71%. Most screened patients (59%) were found at risk for problems or probably dependent on alcohol or drugs. Trauma service staff and health educators reported high satisfaction with the program. Patients reported higher satisfaction with SBIR.


CONCLUSIONS
SBIR services can be effectively integrated into all components of a busy, urban trauma service by adding specially trained health educators to the trauma service staff. This collaboration provides effective SBIR services to both trauma and emergency service patients without interfering with patient flow or medical procedures. The relatively high percentage of patients at risk for alcohol or drug problems supports the inclusion of routine alcohol and drug screening for all eligible trauma patients.
Sise
Michael J
MJ
Division of Trauma and Emergency Medicine, Scripps Mercy Hospital, San Diego, CA 92103, USA. sise.mike@scrippshealth.org
Sise
C Beth
CB
Kelley
Dorothy M
DM
Simmons
Charles W
CW
Kelso
Dennis J
DJ
D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002985:Clinical Protocols; D003376:Counseling; D006801:Humans; D008403:Mass Screening; D015397:Program Evaluation; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014193:Trauma Centers; D014505:Urban Population; D014947:Wounds and Injuries / Q000209:etiology / Q000517:prevention & control*