Implementing Evidence-Based, Electronic, Substance-Use Screening in a Primary Care Clinic.

Substance use is common among adolescents, and among those with substance use disorders; use often persists into middle age, underlying the importance of early detection and treatment. The goal of this quality improvement project was to increase the electronic substance use screening rate of adolesc...

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Publicado en:Journal of Adolescent Health Vol. 73; no. 1; pp. 127 - 133
Autores principales: Ebersole, Ashley M., Gallup, James, Rockwell, Aparna, Patel, Anup D., Bonny, Andrea E.
Formato: research Journal Article
Publicado: Elsevier B.V. Jul2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2023
      vid: 73
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.jadohealth.2023.02.010
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        atl: Implementing Evidence-Based, Electronic, Substance-Use Screening in a Primary Care Clinic.
      aug:
        au:
          Ebersole, Ashley M.
          Gallup, James
          Rockwell, Aparna
          Patel, Anup D.
          Bonny, Andrea E.
        affil: Division of Adolescent Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
      sug:
        subj:
          Implementation Science
          Medical Practice, Evidence-Based
          Quality Improvement
          Electronic Health Records
          Substance Use Disorders Diagnosis
          Health Screening Methods
          Primary Health Care
          Preventive Health Care
          Human
          Adolescence
          Record Review
          Descriptive Statistics
          Early Diagnosis
          Clinical Assessment Tools
          Adolescent: 13-18 years
      ab: Substance use is common among adolescents, and among those with substance use disorders; use often persists into middle age, underlying the importance of early detection and treatment. The goal of this quality improvement project was to increase the electronic substance use screening rate of adolescents presenting for preventative health visits from 0% to 50% between March 2021 and September 2021. This is an ongoing quality improvement project. Participants included patients ≥12 who presented to the Adolescent Medicine Clinic for preventative health visits. We incorporated the Screening to Brief Intervention into the existing Car, Relax, Alone, Forget, Friends, Trouble tool within the electronic health record. We completed a Plan-Do-Study-Act cycle by reviewing every patient's chart who did not receive screening and identified that a common reason for missed screening was designating the visit as "establishing care" rather than preventative health visit. We modified our eligible patient criteria to include all adolescents presenting to establish primary care. We achieved a statistically significant center-line shift with a p value (<.001) from approximately 0% at baseline to a new baseline of 85% from June 2021 to June 2022. After broadening our eligibility criteria, our electronic screening rate improved from 78% in November 2021, to 83% in December 2021. Electronic health record integration of the Screening to Brief Intervention/Car, Relax, Alone, Forget, Friends, Trouble is an effective method to systematically and electronically screen adolescents for SUD at preventative health visits. Integration using similar approaches may benefit other institutions interested in providing standardized SUD screening.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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