Health Care Teams and Delivery System Leaders

With a focus on Healthcare Teams and Delivery System Leaders, this page highlights current strategies for best practice implementation and performance improvement.

The Screening, Brief Intervention and Referral to Treatment (SBIRT) Projectis studying how different members of the healthcare team can implement a screening, brief intervention and referral to treatment protocol to identify individuals at risk for drug and alcohol use.  Funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), SBIRT is an evidence-based alcohol screening and intervention methodology for rapidly screening patients about and drug use. SBIRT has been validated in emergency rooms, Primary Care clinics, campus health centers and other health care venues.  The SBIRT project is a theoretically-informed implementation trial conducted by the CHEDIR Investigators and utilizes models, theories, and frameworks such as Diffusion of Innovations, RE-AIM framework, and PRISM (Practical, Robust Implementation and Sustainability Model).

SBIRT consists of a small number of questions that a healthcare provider asks of a patient, to determine risk behavior.  After the initial screening, at-risk members receive a brief intervention focusing on raising their awareness of substance abuse and motivating them to change their behavior.  The tone of the discussions is conversational, frequently beginning with patients being defensive or tentative, and then becoming more comfortable as the provider asks them questions about their lifestyle and affirms the importance of their behavior.  Higher-risk patients may receive brief treatment in a community setting, or referral to treatment in a specialty setting. 

SBIRT represents a collaboration between Kaiser Permanente Colorado (KPCO), SBIRT-CO, Kaiser Permanente Northern California, SAMHSA, and the Human Interaction Research Institute (HIRI). The SAMHSA/SBIRT project will end in September 2012. Principal Investigator, James Dearing, PhD is joined by Co-Investigators Alanna Rahm PhD, Arne Beck PhD, David Price MD, and HIRI consultant Thomas Backer PhD. This is a qualitative project designed to understand stakeholder reactions to SBIRT in integrated healthcare systems and determine effectiveness and unintended consequences of implementation. The findings from this study will inform the broad effective dissemination of SBIRT. For more information about this project, please contact James Dearing, PhD)