Implementing a Screening and Brief Intervention Protocol for Excessive Alcohol Use in a Trauma Center: A Healthcare...

Area of Science:

• Trauma Care
• Public Health Interventions
• Healthcare Improvement

Background:

• Adult trauma centers require effective strategies for managing patients who screen positive for alcohol.
• Implementing screening and brief interventions (SBIs) is crucial for addressing alcohol use in trauma patients.

Purpose of the Study:

• To evaluate the impact of a formal screening and brief intervention (SBI) protocol on healthcare provider practices.
• To assess changes in SBI utilization for adult trauma patients screening positive for alcohol during a transition from Level II to Level I trauma center status.

Main Methods:

• A retrospective analysis of trauma registry data for 2,112 adult patients who screened positive for alcohol.
• Comparison of SBI rates across three periods: pre-protocol, first post-protocol, and second post-protocol, incorporating training and process improvements.
• Logistic regression analysis to compare intervention rates over time and between admitting services.

Main Results:

• SBI rates for the trauma admitting service increased from 32% to 90% post-protocol implementation.
• Trauma-admitted patients had significantly higher odds of receiving SBIs compared to other services across all periods (ORs ranging from 1.99 to 11.40).
• Within trauma services, SBI rates and odds increased substantially in the post-protocol periods compared to pre-protocol.

Conclusions:

• Formal SBI protocol implementation, coupled with training and process enhancements, significantly increased intervention rates for alcohol-positive trauma patients.
• The study highlights the success of structured interventions in improving healthcare provider practices.
• Findings suggest that other hospital admitting services with lower SBI rates could benefit from adopting similar approaches.