Using process indicators to optimize service completion of an ED drug and alcohol brief intervention program

Joanna Akin, J Aaron Johnson, J. Paul Seale, Gabriel P. Kuperminc

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective The strongest evidence for effectiveness of screening, brief intervention, and referral to treatment (SBIRT) programs is in primary care settings. Emergency department (ED) studies have shown mixed results. Implementation of SBIRT into ED settings is complicated by the type of patients seen and the fast-paced, high-throughput nature of the ED environment that makes it difficult to reach patients flagged for SBIRT services. This study uses data from an ED-based SBIRT program to examine the relationship between screen-positive rate, ED patient flow, and SBIRT service delivery.

Methods Data for the study (N = 67 137) were derived from weekly reports extracted directly from one hospital's electronic health record. Measures included time and day of patient entry, drug/alcohol screen result (positive or negative), and whether the patient was reached by SBIRT specialists. Factorial analysis of variance compared variations in screen-positive rates by day and time and the percentage of patients reached by SBIRT specialists during these periods.

Results Overall, 56% of screen-positive patients received SBIRT services. Only 5% of patients offered SBIRT services refused. Day and time of entry had a significant interaction effect on the reached rate (F 12,14 166 = 3.48, P <.001). Although patient volume was lowest between 11 pm and 7 am, screen-positive rates were highest during this period, particularly on weekends; and patients were least likely to be reached during these periods.

Conclusions When implementing an ED-based SBIRT program, thoughtful consideration should be given to patient flow and staffing to maximize program impact and increase the likelihood of sustainability.

Original languageEnglish (US)
Pages (from-to)37-42
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume33
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Hospital Emergency Service
Alcohols
Referral and Consultation
Pharmaceutical Preparations
Therapeutics
Electronic Health Records
Primary Health Care
Analysis of Variance

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Using process indicators to optimize service completion of an ED drug and alcohol brief intervention program. / Akin, Joanna; Johnson, J Aaron; Seale, J. Paul; Kuperminc, Gabriel P.

In: American Journal of Emergency Medicine, Vol. 33, No. 1, 01.01.2015, p. 37-42.

Research output: Contribution to journalArticle

@article{308cbf0305df4148ba91706800d21d71,
title = "Using process indicators to optimize service completion of an ED drug and alcohol brief intervention program",
abstract = "Objective The strongest evidence for effectiveness of screening, brief intervention, and referral to treatment (SBIRT) programs is in primary care settings. Emergency department (ED) studies have shown mixed results. Implementation of SBIRT into ED settings is complicated by the type of patients seen and the fast-paced, high-throughput nature of the ED environment that makes it difficult to reach patients flagged for SBIRT services. This study uses data from an ED-based SBIRT program to examine the relationship between screen-positive rate, ED patient flow, and SBIRT service delivery.Methods Data for the study (N = 67 137) were derived from weekly reports extracted directly from one hospital's electronic health record. Measures included time and day of patient entry, drug/alcohol screen result (positive or negative), and whether the patient was reached by SBIRT specialists. Factorial analysis of variance compared variations in screen-positive rates by day and time and the percentage of patients reached by SBIRT specialists during these periods. Results Overall, 56{\%} of screen-positive patients received SBIRT services. Only 5{\%} of patients offered SBIRT services refused. Day and time of entry had a significant interaction effect on the reached rate (F 12,14 166 = 3.48, P <.001). Although patient volume was lowest between 11 pm and 7 am, screen-positive rates were highest during this period, particularly on weekends; and patients were least likely to be reached during these periods. Conclusions When implementing an ED-based SBIRT program, thoughtful consideration should be given to patient flow and staffing to maximize program impact and increase the likelihood of sustainability.",
author = "Joanna Akin and Johnson, {J Aaron} and Seale, {J. Paul} and Kuperminc, {Gabriel P.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.ajem.2014.10.021",
language = "English (US)",
volume = "33",
pages = "37--42",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Using process indicators to optimize service completion of an ED drug and alcohol brief intervention program

AU - Akin, Joanna

AU - Johnson, J Aaron

AU - Seale, J. Paul

AU - Kuperminc, Gabriel P.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective The strongest evidence for effectiveness of screening, brief intervention, and referral to treatment (SBIRT) programs is in primary care settings. Emergency department (ED) studies have shown mixed results. Implementation of SBIRT into ED settings is complicated by the type of patients seen and the fast-paced, high-throughput nature of the ED environment that makes it difficult to reach patients flagged for SBIRT services. This study uses data from an ED-based SBIRT program to examine the relationship between screen-positive rate, ED patient flow, and SBIRT service delivery.Methods Data for the study (N = 67 137) were derived from weekly reports extracted directly from one hospital's electronic health record. Measures included time and day of patient entry, drug/alcohol screen result (positive or negative), and whether the patient was reached by SBIRT specialists. Factorial analysis of variance compared variations in screen-positive rates by day and time and the percentage of patients reached by SBIRT specialists during these periods. Results Overall, 56% of screen-positive patients received SBIRT services. Only 5% of patients offered SBIRT services refused. Day and time of entry had a significant interaction effect on the reached rate (F 12,14 166 = 3.48, P <.001). Although patient volume was lowest between 11 pm and 7 am, screen-positive rates were highest during this period, particularly on weekends; and patients were least likely to be reached during these periods. Conclusions When implementing an ED-based SBIRT program, thoughtful consideration should be given to patient flow and staffing to maximize program impact and increase the likelihood of sustainability.

AB - Objective The strongest evidence for effectiveness of screening, brief intervention, and referral to treatment (SBIRT) programs is in primary care settings. Emergency department (ED) studies have shown mixed results. Implementation of SBIRT into ED settings is complicated by the type of patients seen and the fast-paced, high-throughput nature of the ED environment that makes it difficult to reach patients flagged for SBIRT services. This study uses data from an ED-based SBIRT program to examine the relationship between screen-positive rate, ED patient flow, and SBIRT service delivery.Methods Data for the study (N = 67 137) were derived from weekly reports extracted directly from one hospital's electronic health record. Measures included time and day of patient entry, drug/alcohol screen result (positive or negative), and whether the patient was reached by SBIRT specialists. Factorial analysis of variance compared variations in screen-positive rates by day and time and the percentage of patients reached by SBIRT specialists during these periods. Results Overall, 56% of screen-positive patients received SBIRT services. Only 5% of patients offered SBIRT services refused. Day and time of entry had a significant interaction effect on the reached rate (F 12,14 166 = 3.48, P <.001). Although patient volume was lowest between 11 pm and 7 am, screen-positive rates were highest during this period, particularly on weekends; and patients were least likely to be reached during these periods. Conclusions When implementing an ED-based SBIRT program, thoughtful consideration should be given to patient flow and staffing to maximize program impact and increase the likelihood of sustainability.

UR - http://www.scopus.com/inward/record.url?scp=84918499000&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84918499000&partnerID=8YFLogxK

U2 - 10.1016/j.ajem.2014.10.021

DO - 10.1016/j.ajem.2014.10.021

M3 - Article

VL - 33

SP - 37

EP - 42

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

IS - 1

ER -