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

Ebersole, Ashley M.; Gallup, James D.; Rockwell, Aparna; Patel, Anup D.; Bonny, Andrea E.

doi:10.1016/j.jadohealth.2023.02.010

Cited by 2 publications

(3 citation statements)

References 19 publications

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“… 26 , 27 Eversole demonstrated success using similar tools on a small scale in a single Adolescent Medicine clinic. 28 Harder et al 29 described the use of a learning collaborative composed of seventeen nonintegrated practices in Vermont to increase depression screening in adolescents. Their project, using the same processes and population as substance use screening projects, has the additional strength provided by a control group of similar practices not participating in the project.…”

Section: Discussionmentioning

confidence: 99%

Substance Use Screening in a Large Pediatric Primary Care Network: A Quality Improvement Project

Karas,

Eggleston,

Goldman

et al. 2024

Pediatric Quality &Amp; Safety

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Background: This project aimed to introduce substance use screening, using the CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble) screening tool, into the routine care of adolescents using quality improvement strategies and tools. Methods: We expanded a single-site project showing the successful introduction of CRAFFT screening into adolescent care to include the entire 34-site primary care network of a children’s hospital in Northeastern Ohio. We deployed quality improvement methodology to facilitate the acceptance and use of the screener. Data showing the percentage of eligible adolescents screened were collected and shared monthly with network providers. Results: The single-site phase increased the screening rate from 3.5% to 72%. The percentage screened for the network phase rose from 0% to >90% in the first 2 months of the project and remained at that level. Of those screened, 85% were low risk, 3% were medium risk, and 2% were high risk. Ten percent of the results were not recorded in a way that allowed for post hoc risk assessment. During the network phase, 35,750 of 38,427 (93%) eligible patients completed the screening form. Conclusions: This project resulted in the highly reliable use of the CRAFFT screener in a large primary care network.

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Section: Discussionmentioning

confidence: 99%

Substance Use Screening in a Large Pediatric Primary Care Network: A Quality Improvement Project

Karas,

Eggleston,

Goldman

et al. 2024

Pediatric Quality &Amp; Safety

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“…Information from various projects was disseminated through publications, NCH Pediatric Grand Rounds, and the nursing team shared project results at the Chief Nursing Officer's (CNO) annual Nursing Congress meeting. [31][32][33]…”

Section: Staff Development and Empowermentmentioning

confidence: 99%

“…This coupling allowed for academic productivity, sustaining physician engagement. 31,32,35 Effective Team Management Behavioral economics is an underutilized tool for maximizing QI participation in health care. 36 Although initially unintentional, our team found engagement of the entire interdisciplinary team and a strengthened culture of QI participation by employing behavioral economics principles.…”

Section: Ensuring Physician Engagementmentioning

confidence: 99%

Developing a Sustainable Quality Improvement Program in an Academic Center: The Experience of an Adolescent Unit

McKnight,

Ebersole,

Gallup

et al. 2024

Pediatric Quality &Amp; Safety

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Introduction: Successful quality improvement (QI) efforts use a comprehensive, institutional QI framework and professional development, but literature describing implementing QI frameworks in Adolescent Medicine practices is sparse. We aimed to implement and increase the number of formally structured QI projects (primary aim) and the number of projects achieving a centerline (CL) shift (secondary aim) in our hospital’s Adolescent Medicine Clinic. Methods: We used formal QI methodology to improve health outcomes by increasing the number of faculty with formalized QI education, creating interdisciplinary QI teams, and improving staff motivation. QI education was mandatory for Adolescent Medicine fellows and pediatric residents and encouraged for faculty and staff. The Divisional QI leadership team attended monthly meetings to review key driver diagrams, run and control charts, and receive intervention updates. All providers and staff received monthly updates, and the Hospital Quality and Safety Committee received biannual updates. We used run charts to share progress with primary and secondary aims. Results: Since Q3 2014, the Adolescent Medicine team consistently achieved the primary aim of having 5 active projects in process, with 9 projects from Q1 2018–Q4 2020. For the secondary aim, a target of 50% of active QI projects attaining a sustained centerline shift was achieved in Q2 2018 and maintained in 16 of 20 quarters since. Conclusions: Clinicians can use QI methodology to improve health outcomes while facilitating professional development. For this initiative to succeed, institutional leadership must provide an infrastructure prioritizing meaningful QI involvement.

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

Cited by 2 publications

References 19 publications

Substance Use Screening in a Large Pediatric Primary Care Network: A Quality Improvement Project

Substance Use Screening in a Large Pediatric Primary Care Network: A Quality Improvement Project

Developing a Sustainable Quality Improvement Program in an Academic Center: The Experience of an Adolescent Unit

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