Screening for Recovery: Screening, Brief Intervention, Referral to Treatment (SBIRT)

MedStar Franklin Square Medical Center, MedStar Good Samaritan Hospital, MedStar Harbor Hospital, MedStar Union Memorial Hospital

Substance abuse is a public health crisis and has reached epidemic proportions nationally and in the Baltimore region. MedStar Health’s 2015 Community Health Needs Assessment identified addiction as a priority for its four Baltimore hospitals in collaboration with community partners. Data show that patients who have been diagnosed with substance use disorders have more health complications, experience higher costs of care and are readmitted to the hospital more frequently. Implementing the Screening Brief Intervention Referral to Treatment (SBIRT) evidence-based practice is one way MedStar is addressing this epidemic.

SBIRT consists of three main components: screening, brief intervention, and referral to treatment.

Baltimore City Statistics:

• Opioid overdose is a major public health crisis. In 2014, 303 people died of drug and alcohol overdoses, a 19 percent increase from 2013 in Baltimore City.
• Of those who died of overdose in 2014, 192 people died as a result of heroin intoxication. This is more than the number of homicides in Baltimore City that same year.

The SBIRT program is currently offered at MedStar Franklin Square Medical Center, MedStar Good Samaritan Hospital, MedStar Harbor Hospital, and MedStar Union Memorial Hospital. All patients who arrive at the Emergency Departments (ED) at the four hospitals are screened for substance use disorders as part of patient intake through the electronic health record. Patients with positive screens for high-risk behaviors are sent to peer recovery coaches embedded in the EDs to conduct a brief intervention, and to refer to treatment if appropriate.

“Our patients seem more willing to engage in an honest conversation about substance abuse when the discussion is with a peer with lived experience, instead of a healthcare professional who cannot necessarily relate to their lifestyle,” says MedStar Harbor Hospital Emergency Department nurse Cara Miller.

Mosaic Group, a nationally recognized public health consulting firm with expertise in SBIRT implementation in Maryland, partners with MedStar to execute the SBIRT program.

“Having SBIRT allows the Emergency Department to not only take care of the patient’s acute medical issue, but address the underlying substance misuse problem as well,” says Mosaic Group President Marla Oros.

In 2016, MedStar conducted more than 27,000 SBIRT substance use screenings, more than 8,000 brief interventions and made 5,200 referrals to treatment across the four MedStar Baltimore region hospitals.