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David Prior: driving improvements in the quality of care across the systemThe King's Fund
David Prior, Chair, Care Quality Commission, explains how clinicians, providers, commissioners and service users all have a role in regulation. He highlights the new responsibilities of the CQC and how they can help to support integrated care in England.
Blazing New Trails: Shifting the Focus on Alcohol and Drugsnashp
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Authors: Barbara Cimaglio, Sally Fogerty, BSN, M.Ed., John C. Higgins-Biddle, Ph.D.
The Health Home project is evaluating a new program that is part of healthcare reform in New York State. The program identifies individuals with substance use disorders who have other medical and psychiatric problems and offers them a new form of integrated care. The evaluation will study whether this program results in better quality of care and a reduction in health care costs for this vulnerable and chronically ill population.
David Prior: driving improvements in the quality of care across the systemThe King's Fund
David Prior, Chair, Care Quality Commission, explains how clinicians, providers, commissioners and service users all have a role in regulation. He highlights the new responsibilities of the CQC and how they can help to support integrated care in England.
Blazing New Trails: Shifting the Focus on Alcohol and Drugsnashp
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Authors: Barbara Cimaglio, Sally Fogerty, BSN, M.Ed., John C. Higgins-Biddle, Ph.D.
The Health Home project is evaluating a new program that is part of healthcare reform in New York State. The program identifies individuals with substance use disorders who have other medical and psychiatric problems and offers them a new form of integrated care. The evaluation will study whether this program results in better quality of care and a reduction in health care costs for this vulnerable and chronically ill population.
Dr. Mollyann Brodie: "What Soaring Drug Prices Mean for Patients," 9.3.15reportingonhealth
Dr. Mollyann Brodie's presentation from "What Soaring Drug Prices Mean for Patients," 9.3.15
http://www.reportingonhealth.org/content/what-soaring-drug-prices-mean-patients
Health Consumers' Council's Manager of Advocacy and Research and Murdoch's Dr Norman Stomski co-presented on a recent project where 60 de-identified advocacy cases were analysed for themes and to explore how advocacy supported the mental health consumer patient journey.
Kristin Gourlay: "What Soaring Drug Prices Mean for Patients," 9.3.15reportingonhealth
Kristin Gourlay's presentation from "What Soaring Drug Prices Mean for Patients," 9.3.15
http://www.reportingonhealth.org/content/what-soaring-drug-prices-mean-patients
At least one in every 20 adults who seeks medical care in a U.S. emergency room or community health clinic may walk away with the wrong diagnosis, according to a new analysis that estimates that 12 million Americans a year could be affected by such errors.
Experts have often downplayed the scope of diagnostic errors not because they were unaware of the problem, but “because they were afraid to open up a can of worms they couldn't close.
Each year, Jackson Healthcare studies trends impacting physicians' careers and medical practices.
We hope this information helps physicians make more informed, strategic decisions. And we hope these statistics help healthcare executives, industry thought leaders and media professionals better understand the attitudes, challenges and opportunities physicians face.
This presentation shares highlights from our 2014 national survey of U.S. physicians.
Dr. Mollyann Brodie: "What Soaring Drug Prices Mean for Patients," 9.3.15reportingonhealth
Dr. Mollyann Brodie's presentation from "What Soaring Drug Prices Mean for Patients," 9.3.15
http://www.reportingonhealth.org/content/what-soaring-drug-prices-mean-patients
Health Consumers' Council's Manager of Advocacy and Research and Murdoch's Dr Norman Stomski co-presented on a recent project where 60 de-identified advocacy cases were analysed for themes and to explore how advocacy supported the mental health consumer patient journey.
Kristin Gourlay: "What Soaring Drug Prices Mean for Patients," 9.3.15reportingonhealth
Kristin Gourlay's presentation from "What Soaring Drug Prices Mean for Patients," 9.3.15
http://www.reportingonhealth.org/content/what-soaring-drug-prices-mean-patients
At least one in every 20 adults who seeks medical care in a U.S. emergency room or community health clinic may walk away with the wrong diagnosis, according to a new analysis that estimates that 12 million Americans a year could be affected by such errors.
Experts have often downplayed the scope of diagnostic errors not because they were unaware of the problem, but “because they were afraid to open up a can of worms they couldn't close.
Each year, Jackson Healthcare studies trends impacting physicians' careers and medical practices.
We hope this information helps physicians make more informed, strategic decisions. And we hope these statistics help healthcare executives, industry thought leaders and media professionals better understand the attitudes, challenges and opportunities physicians face.
This presentation shares highlights from our 2014 national survey of U.S. physicians.
Presentation at 2016 Fuel Ethanol Workshop, describing U.S. regulatory pathways for approval of use of modified microorganisms in animal feed, and a proposal for making such pathways simpler and more efficient for modified strains of common microorganisms.
Enhancing Satellite & Terrestrial Networks Integration through NFV/SDN techno...Harilaos Koumaras
This presentation discusses the ambitious goal to transform convergence between SatCom and terrestrial networks, leveraging the SDN/NFV paradigm. While the SDN/NFV concepts are starting to pave its way into the carrier network domain, allowing more flexible control of communication networks, it is not yet explored within the SatCom domain. Furthermore, the integrated network management infrastructure to achieve flexible and easier hybrid inter-networking between the two domains and in combination with the intelligent NFV infrastructure will create an innovative step in the terrestrial-satellite interworking space with opportunities to create applications offering seamless delivery across the domains. Standards bodies like ETSI, IETF and ONF dealing with SDN/NFV technologies have acknowledged the priority and interests of seeking innovative approaches to address multi-domain network infrastructure management. The presentation is prepared within the framework of VITAL project and delivered at NCSR Demokritos Summer School 2015 and Panhellenic Conference on Informatics (PCI) 2015.
Closing the treatment gap in alcohol dependence thessalonika 2015Antoni Gual
Lecture on the treatment gap (underdiagnose & undertreatment) of alcohol use disorders. Presented at the 5th Conference of the Greek Psychiatric society in Thessalonika, march 21st, 2015.
SBIRT and SAMHSA's 8 Strategic Initiativessideponytail
Slides from a webinar held by the National SBIRT ATTC. Video is on TheIRETAChannel on Youtube: http://www.youtube.com/watch?v=f6NrKuGlGRs&feature=share&list=PLiML4AFpuB72LBaPShcu2yQv_WpsGY9a9
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
17 million working days are taken off sick due to excessive drinking. We explore approaches to encourage responsible attitudes to drinking outside of working hours - creating a win-win for businessess and employees. .
The prevalence of the alcohol and drugs abuse is notably more than cancer and heart disease collectively in the US cost $328billion a year (2005)
Research has observed that despite additions treatment, most addicts do not seek medical attention.
Two main factors are attributed to this fact;
Limited access
Uncoordinated system of care. Causing relapse after detoxification
This essay is prepared with an aim to investigate into the difficulties arises while dealing
with alcoholic patients in primary care in Europe. In this context, the researcher will evaluate the
issues concerned with doctors in tackling the psychological character of alcoholic patients.
Moreover, the discussion will provide how doctors motivate such patient to recover from their
lethal conditions. In spite of declining in the wine-producing nations, Europe remains the
province on the globe with largest production as well as consumption of alcoholic beverages
along with commensurately more levels of harm related to alcohol. In the survey of North
America it was found that over 4.5% of women and 23% of men are involved in the alcohol use
or dependence throughout their lifetime. The country is about the middle of the worldwide
league of intoxicating consumption. Thus, in all European Union’s member states the alcoholic
harms are considered as a major public health problem. The use of alcohol and its harm are
increasing sharply in the some recently independent regions of Eastern Europe.
go to www.medicaldump.com to download this file and check out other medical powerpoints, medical powerpoint templates, medical pdfs and all other medical documents.
Drugs & Society SOC 204
Drugs Across the Spectrum
By Raymond Goldberg
Chapter 2 Drugs in Contemporary Society
Chapter 3 Motivations for Drug Use
Chapter 4 Drugs & the Law
go to www.medicaldump.com to download this medical powerpoint presentation. You can find medical templates, medical pdfs and medical powerpoints on all specialties
For more free medical powerpoints, visit www. medicaldump.com, Free updates everyday on all specialties including cardiology, nephrology, neurology, pulmonology, etc.
For more free medical powerpoints, visit www. medicaldump.com, Free updates everyday on all specialties including cardiology, nephrology, neurology, pulmonology, etc.
This is a power point presentation titled "Chronic Stable Angina" . For more medical power points, PDFs, ECGs, X-rays, please visit www.medicaldump.com
This is a power point presentation titled Hypercalcemia of malignancy. For medical power point, x-rays, CT scans, medical projects or other downloads, visit www.medicaldump.com
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
2. SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for people with substance use disorders and those at-risk of developing them. Primary care, trauma centers, emergency departments, and other settings provide opportunities BEFORE more severe consequences occur. What is SBIRT?
3. To encourage healthcare providers to screen and provide advice or counseling to their patients who misuse alcohol or other drugs. To influence risky behavior patterns and reduce exposure to the negative consequences of misuse. To improve linkages between general community health care and specialized substance abuse providers to facilitate access to care when needed www.ireta.org Goals of SBIRT
4. Screening Brief Intervention Referral Treatment PA SBIRT Project
5. “The most common contributory factor to injury occurrence is alcohol abuse”. “Alcohol is responsible for approximately half of all trauma deaths and nonfatal injuries in the United States…” 15-25% of injured patients in the ED are BAC positive, where 50% are male trauma patients and 40% are female trauma patients. About half the time, illicit drugs are also used with alcohol. American College of Surgeons Committee On Trauma, “Alcohol and Injury”, presented by the Subcommittee on Injury Prevention and Control. The Problem
7. Risks of Use… “Even though, on average, the problems of individual risky or problem drinkers are less severe than the problems of harmful and dependent drinkers, the number of risky and problem drinkers is vastly larger and creates enormous social, legal, medical, and economic problems. Of all the alcohol-related problems seen in EDs and trauma centers, the majority of these problems are experienced by risky and problem drinkers – not addicted patients.” Hungerford DW. Interventions in Trauma Centers for Substance Use Disorders: New Insights on an Old Malady. Journal of Trauma. 2005;59:S10-S17.
8. Research Outcomes for SBI Brief interventions may reduce mortality rates among problem drinkers by 23% to 26% (Cuijpers, Riper, & Lemmers, 2004). Compared to a control group, an intervention group had significantly fewer accidents, hospital visits, and other events related to drinking; BI provided a 5.6:1 benefit to cost ratio (Fleming et al, 2000).
9. More Outcomes… Out of 8500 patients who received a BI: 71%of drinkers reduced the number of days they drank alcohol. 85%of binge drinkers reduced number of heavy drinking days, and 68% reported no heavy drinking days in the past 30 days. 89%of drug users reduced the number of days they used drugs; 80% reported no usage in the past 30 days. 76%of patients assessed as needing more specialized services saw an improvement in their general health after receiving SBI services. (www.insightforhealth.com)
10. More Outcomes… In a trauma center analysis1: Every dollar spent on SBI saved $3.81 in direct injury-related costs Potential net savings of offering interventions to eligible injured adult patients would approach $1.82 billion per year In community clinic analysis2: Of 800 heavy drinking patients, those who received intervention had significantly fewer accidents, hospital visits, and adverse events related to drinking Generated nearly $56,300 in savings for every $10,000 invested In medical costs alone, the benefit-to-cost ratio of brief intervention was 3.2 to 1 over a 12-month period. 1Gentilello et al. Alcohol interventions for trauma patients treated in emergency departments and hospitals: a cost benefit analysis. Ann Surg. 2005; 241:541-440. 2 Dr. Michael Fleming, Jan. 2000, Project Treat.
11. Barriers to Screening & Intervention Discomfort with initiating discussion about substance- use/misuse. Lack of education and training about the nature of substance use, misuse and/or dependence or treatment. Uncertainty about referral resources. Sense of not having enough time to carry the out interventions. No insurance company reimbursement for the screening. Fear of losing or alienating patients.
12.
13. Lapses in performance at school, work, parenting, home etc (DUI or possession charge).
14. Repeated use of alcohol even when it’s physically dangerous to do so.
19. Experiences repeated problems at work, school, home (ex/multiple DUI’s).Amount/duration of use greater than intended. Unsuccessful efforts to control or reduce use. Spending much time using, recovering from its effects, or trying to obtain it.
20. Who are targets for SBI? Note: represents the general adult population in the US. The % of high-risk drinkers is likely to be much higher in certain settings such as emergency or trauma departments.
21. Additional Benefits Does not require drug and alcohol specialist Views alcohol and drug use as a continuum – not simply “addicted” or “not addicted” Provides an active systematic way to screen and provide BI or a referral for more services Provides approach and language to address drug and alcohol issues and reduce resistance Approach is non-confrontational and puts the responsibility for change on the patient
22.
23. Multiple options – various tools that can be administered by self-report or interview, paper and pencil or computerized.Screening
24. BAC (or other medical tests such as liver function) AUDIT ASSIST DAST CRAFFT T-ACE/TWEAK 4 or 5 P’s www.projectcork.org Screening Tool Examples
26. Basic Steps in Screening Step #1: Introduce the screen. Step #2: Be specific in your questions. Step #3: Make sure you are speaking the same language as the patient: probe and use reflective listening to make sure you understand. Step #4: Convey non-judgmental attitude throughout screen no matter what the answers are.
27. How often do you drink anything containing alcohol? How many drinks do you have on a typical day when you are drinking? How often do you have four or more drinks on one occasion? In the last year, have you used drugs other than those required for medical reasons? In the last year, have you used prescription or other drugs more than you meant to? Which drug do you use most frequently? Initial Screening Questions
31. Women: > 2 drinks per occasion; > 7/week Over 65: > 2 drink per occasion; > 7/week Men: > 4 drinks per occasion; > 14/week Any use is risky when: Pregnant Driving Taking certain medications Having certain medical conditions In recovery from addiction/cannot control drinking Hazardous: Pattern that increases risk for adverse consequences Harmful: Negative consequences have already occurred What is Risky Drinking?
32. Paper vs. Interview Exercise 1: Complete screen and AUDIT as Self-Report. Do you have enough information to respond? What would you ask to get more if needed? Exercise 2: Complete screen and AUDIT as interview. How is the experience different or similar?
33. Substance use disorders range from no use to dependence Looking for opportunity for intervention Changing our perception about those at-risk or dependent “Meeting patients where they are” Paradigm Shift
Editor's Notes
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) has funded the Pennsylvania Department of Health (PA SBIRT) at $9.8 million for 5 years to provide services in general medical and other community settings. The grantees provided SBIRT services to adolescents and adult patients with substance abuse and dependence disorders.
SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for people with substance use disorders and those at-risk of developing them.Primary care, trauma centers, emergency departments, and other settings provide opportunities BEFORE more severe consequences occur.
There are three goals that SBIRT has set out to accomplish: The First is to encourage healthcare providers to screen and provide advice or counseling to their patients who misuse alcohol or other drugs.The Second is to influence risky behavior patterns and reduce exposure to the negative consequences of misuse.And finally to improve the linkages between the general community health care and specialized substance abuse providers to facilitate access to care when needed.
Additional outcomes as shown here can be found at www.insightforhealth.com. This report indicates the outcomes for patients that participated in the Texas insight for health project.
There are multiple barriers to screening and brief intervention in the medical community. Some of those include not having enough time to carry out interventions or not being reimbursed for Screening and Brief Intervention. Others include discomfort with initiating the discussion of substance use/misuse or physicians lack of training or education about the nature of substance use, misuse, or dependence. Unfortunately many physicians are uncertain about referral resources within their communities.
Traditional Substance Abuse Treatment Programs focus on patients with Alcohol or other Drug abuse or dependent diagnosis. As noted on the slide, there are differences between abuse or dependence which include withdrawal and tolerance. It is important to note that in order for the diagnosis to be made, patients must experience these symptoms for at least one year.
Screening instruments vary in their ability to detect different patterns and levels of drinking and in the degree of which they apply to specific subpopulations and settings.Some examples include:The BAC - Blood Alcohol Content- Blood test for level of ETOH in blood or other medical tests such Liver FunctionThe (AUDIT) - Alcohol Use Disorders Identification Test whichincorporates questions about quantity and frequency of alcohol use. ASSIST - Alcohol, Smoking and Substance Involvement Screening Test.. Which was developed by the World Health Organization (WHO) and covers:• tobacco,• alcohol,• cannabis,• cocaine,• amphetamine type stimulants,• sedatives,• hallucinogens,• inhalants,• opioids, and• other drugs.DAST-Drug Abuse Screening Test which consists of 28 questionsor is modified to 10 questions. This self-administered or interview tool is used to detect drug problems and also, assists with “staging” the patients level of possible dependence. The CRAFFT is intended specifically for adolescents. It draws upon adult screening instruments and covers alcohol or other drugs, in situations that are suited to adolescents. The questions are:1. Have you ever ridden in a Car driven by someone (including yourself) who was high or had been using alcohol or drugs?2. Do you ever use alcohol or drugs to Relax, feel better about yourself, or fit in?3. Do you ever use alcohol or drugs while you are by yourself Alone?4. Do you ever Forget things you did while using alcohol or drugs?5. Do your Family or Friends ever tell you that you should cut down on your drinking or drug use?6. Have you ever gotten into Trouble while you were using alcohol or drugs?Scoring: 2 or more positive items indicate the need for further assessment.Tools such as the T-ACE/TWEAKAre use to Screen pregnant women for alcohol use has become increasingly important in light of new research showing that even low levels of prenatal alcohol exposure can harm the fetus. 4 or 5 P’sAre based on the work of Hope Ewing and Ira Chasnoff, and are screening insturments that can be used to screen women of childbearing age or those that are pregnant. Much like the CRAFFT for adolescents, the 4 or 5 P’s detects the risk the woman may be exposed to AOD use and thus at-risk of use. The cage is not listed here however the questionnaire has been evaluated in several studies, showing sensitivities ranging from 43 to 94 percent for detecting alcohol abuse and alcoholism . CAGE is well suited to busy primary care settings because it poses four straightforward yes/no questions that the clinician can easily remember and requires less than a minute to complete. However, the test may fail to detect low but risky levels of drinking . In addition, CAGE often performs less well among women and minority populations.
SBIRT uses the following guidelines developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) for the definition of a “standard drink”. These guidelines are also depicted on the screening tool. Because the screening requests patients to report their level of alcohol use, it is important that each respondent has a clear understanding of what constitutes a “standard drink”. Some patients may mistakenly believe that a 16-oz beer or a martini, for example, is a single standard drink. This illustration provides a clear description of the equivalents of a standard drink.
The purpose of screening in SBIRT is to assist individuals in recognizing preventable risks. These screenings are intended to be a simple and unobtrusive part of the office visit that may be included with other routines such as blood pressure checks, weight, vitals etc. By incorporating the initial screening questions listed here, into the other triage routines of the practice, the questions are normalized into the day to day operations of the providers.These six short questions can be self administered via questionnaire or asked by the staff.
This diagram provides an illustration of how to match between the level of risk and the type of intervention. However, clinical judgment should always be used and can override these recommended protocols.
For women and those over the age of 65 consuming more than 2 drinks per occasion or 7 or more per week is considered risky drinking.For men consuming more than 4 drinks per occasion or 14 or more drinks per week is considered risky drinking.Any use is risky when your patient is: Pregnant Driving Taking certain medications Has certain medical conditions Or is in recovery from addiction/can not control drinkingIt is important to note that there is no safe level of alcohol consumption during pregnancy. So it is advisable that no patient should drink any level of alcohol during pregnancy.
This exercise will give you the opportunity to experience which screening method will be most effective for you.For exercise 1, you can grab a partner or just complete the screen yourself. Record your answers while completing the front and back side of the Behavioral Health Assessment. Do you have enough information to respond? What questions would you ask to get more information?You will need a partner for exercise 2:This time complete the Behavioral Health Assessment Screen and AUDIT as an interview. How is this experience different or similar? Were you able to get more information by engaging your partner in conversation? Which method do you think works best for you?
SBIRT is a unique approach. It is a true paradigm shift that expands the continuum of care to include not only those that are abusing or dependent on a substance, but to those who are misusing or considered to be at-risk for substance use disorders and delivering early intervention to prevent the progression to a dependence. Much like other medical conditions that have adopted a public health perspective, SBIRT within the medical setting employs a simple universal screen to identify those at-risk as well as those who are dependent, and to intervene to avoid expensive hospitalizations for long term treatment. .