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Translation of alcohol screening and brief intervention guidelines to pediatric trauma centers
Michael J Mello1, Julie Bromberg, Janette Baird
1From the Injury Prevention Center at Rhode Island Hospital/Hasbro Children's Hospital (M.J.M., J.Br., JBa., T.N., T.C., J.G.L.), Department of Emergency Medicine (M.J.M., J.Br., J.Ba., T.N., T.C., J.G.L.), Department of Health Service, Policy and Practice (M.J.M.), Department of Psychiatry and Human Behavior (T.N.), Center for Alcohol and Addiction Studies (T.N.), and Department of Pediatrics (T.C., J.G.L.), Warren Alpert Medical School of Brown University, Providence, Rhode Island; and Northeastern University (C.L.), Boston, Massachusetts.
Background:
As part of the American College of Surgeons verification to be a Level 1 trauma center, centers are required to have the capacity to identify trauma patients with risky alcohol use and provide an intervention. Despite supporting scientific evidence and national policy statements encouraging alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT), barriers still exist, which prevent the integration of SBIRT into clinical care. Study objectives of this multisite translational research study were to identify best practices for integrating SBIRT services into routine care for pediatric trauma patients, to measure changes in practice with adoption and implementation of a SBIRT policy, and to define barriers and opportunities for adoption and implementation of SBIRT services at pediatric trauma centers.
Methods:
This translational research study was conducted at seven US pediatric trauma centers during a 3-year period. Changes in SBIRT practice were measured through self-report and medical record review at three different study phases, namely, adoption, implementation, and maintenance phases.
Results:
According to medical record review, at baseline, 11% of eligible patients were screened and received a brief intervention (if necessary) across all sites. After completion of the SBIRT technical assistance activities, all seven participating trauma centers had effectively developed, adopted, and implemented SBIRT policies for injured adolescent inpatients. Furthermore, across all sites, 73% of eligible patients received SBIRT services after both the implementation and maintenance phases. Opportunities and barriers for successful integration were identified.
Conclusion:
This model may serve as method for translating SBIRT services into practice within pediatric trauma centers.
