Implementing a Screening Tool and Referral Process for Substance Use Disorders in the Emergency Department: A Quality...

Area of Science:

• Public Health
• Emergency Medicine
• Addiction Medicine

Background:

• Substance misuse presents a significant public health challenge in the U.S.
• Substance use disorder (SUD) leads to considerable illness and injury, straining public health resources.
• Rural emergency departments face unique challenges in addressing SUD.

Purpose of the Study:

• To enhance screening and referral rates for substance use disorder in a rural emergency department setting.
• To implement and evaluate a quality improvement project focused on SUD identification and linkage to care.
• To integrate SUD screening into the existing emergency department triage process.

Main Methods:

• The CAGE-AID screening tool was integrated into the electronic health record (Meditech Expanse).
• A quality improvement initiative utilized Plan-Do-Study-Act cycles with weekly data collection.
• 1077 patients were included in the study, with screening conducted during triage.

Main Results:

• All 1077 patients underwent initial screening, with 10.7% (115 patients) screening positive for SUD.
• Of those screening positive, 45.2% (52 patients) accepted referrals for treatment.
• A subset of 17.3% (9 patients) of those accepting referrals scheduled follow-up appointments within 30 days.

Conclusions:

• Routine SUD screening and referral are implementable in emergency departments nationwide.
• Integrating SUD screening into standard emergency department care is an evidence-based practice.
• This approach can effectively identify and connect patients with substance misuse to appropriate treatment services.