An examination of the workflow process of the screening, brief intervention, and referral to treatment program

Background Substance abuse and dependence are widely recognized as widespread societal problems, and most people who engage in risky substance use do not recognize it as a problem. The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program in 2003 to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs among individuals who would not typically seek treatment. Following the evidence base, SBIRT programs were implemented in general health-care settings, with the aim of integrating behavioral health services in locations that provide an opportunity to identify risky patients and provide them with an appropriate level of treatment. In 2008, SAMHSA sponsored an evaluation of the SBIRT program among its third cohort of grantees. A key focus of the evaluation was to understand the SBIRT workflow process, or the process by which clients interact with health-care personnel to obtain SBIRT services. SBIRT has been implemented in many treatment settings, and each setting has adjusted the workflow process to meet its respective needs. This study focuses on the overall workflow process, adaptations, and key observations in emergency departments and ambulatory clinics.