Transcript Briefing for Secretary Dennis Braddock on WASBIRT

Overview of WASBIRT
WA State Screening, Brief Intervention,
Referral and Treatment
Five-year project: Oct. 2003 – Sept. 2008
October 2004
INTRODUCTION TO WASBIRT
• Traumatic injury inflicts enormous medical and
psychosocial harm on its victims.
• The greatest underlying cause of injury is the
misuse of alcohol and drugs.
• A wide range of effective treatments have been
developed for mild, moderate, and severe drug and
alcohol problems.
INTRODUCTION (CONT.)
• Prior studies have shown that interventions,
when delivered to injured patients in
hospital emergency departments (ED) and
on inpatient units of hospitals, can:
– Reduce alcohol and drug consumption.
– Prevent re-injury.
– Help patients with more severe problems access
intensive, community-based chemical
dependency treatment.
The Goals of WASBIRT are …
1. Identify ED patients Substance Use, Abuse,
and Dependency Disorder
2. Provide Screening and Brief Interventions
in the EDs
3. Provide Brief Therapy on an outpatient
basis
The Goals of WASBIRT are …
4. Increase referrals of patients with substance
dependency disorder
5. Create Systems Change
6. Reduce
• Subsequent ED visits
• Future injuries
• Medical costs
• Criminal justice costs
•
Death
How will WASBIRT do this?
Six of the busiest trauma hospitals will host Chemical
Dependency Professionals (CDPs) in their ED:
• Harborview … 5 CDPs – Initiated services 4/12/04
• Tacoma General … 3 CDPs – Initiated services 4/26/04
• SW Medical Center Vancouver… 3 CDPs – Initiated
services 5/5/05
• Providence Everett … 3 CDPs – Initiated services 7/5/04
• Yakima Regional and Toppenish … 4 CDPs – Anticipate
services will be available on 10/28/04
What will the CDPs do?
• Screen trauma and other medical emergency patients to
determine their level of abuse or dependence on alcohol or
drugs.
• Based on screening results, patients will be:
– screened out or
– provided a brief intervention or
– referred for assessment and brief therapy or
– referred for assessment and full CD treatment.
• Since April 12, 2004, WASBIRT CDPs have provided
services to 4,300 patients whom have received screening,
brief interventions, and referral for brief therapy, or chemical
dependency treatment.
Washington Screening, Brief Intervention and Treatment Project (WASBIRT)
Client Flow Diagram
March 15,2004
Emergency Department WASBIRT Program




CDP Screens case for drug use, abuse or CD issues
Using DAST 10 or the AUDIT
Determines initial course of action-screen, brief
intervention or referral
Enters screening data into RDA dataset
WASBIRT Brief Intervention Process




Patient referred for Brief Intervention (BI)
This service is 100% WASBIRT funded
CDP completes Max four sessions in ED or clinic
Data on BI services entered in RDA data set
Patient arrives at ED
Brief Intervention
Patient
CDP screener
Emergency
Department
REFERRAL
WASBIRT Brief Therapy Process





Patient referred to CD tx agency for Brief Therapy (BT)
This service is 100% WASBIRT funded
Program consists of 5 to 12 sessions
Data on BT reported to TARGET2000 using Client Support Activities using
Contract Type and Support Activity codes
Tx Provider Assessment Survey Competed on each client - data to RDA
CD Treatment
WASBIRT Chemical Dependency Treatment Program






Patient referred for regular CD Tx
Service may be funded by WASBIRT or not
Enters contracted CD Tx agency
Program is existing CD tx program
Data is reported to TARGET2000 like any other CD tx client
using Contract Type and County Special Project codes
Tx Provider Assessment Survey Competed on each client data to RDA
Brief Therapy
New Items for TARGET2000



03/12/04
Client Support Activity Type:

Brief Therapy - Individual

Brief Therapy - Group

Brief Therapy - Family

Brief Therapy - Conjoint
Contract Type = WASBIRT
County Special Project Code = "WASBIRT"
What system needs will be met in Washington
State?
Building the “I” into PITA
Prevention – Intervention Treatment – Aftercare
New Collaborative
Substance abuse treatment
community and health care
system
What system needs will be met in Washington
State?
TX as a prevention strategy
Cost Offset Study
Brief Interventions for those
with a substance use or abuse
disorder
Demonstrate cost
effectiveness of WASBIRT
How will we evaluate outcomes?
• Compare baseline and follow-up data on drug and
alcohol use
• Examine costs offsets for Medicaid clients
• Measure hospital savings from reduced ED visits
Screenings, Brief Interventions and Referrals to Brief
Therapy or CD Treatment
April 12 – October 2, 2004
120
Tacom a
Southw est
Everett
9/26/2004
9/19/2004
9/12/2004
9/5/2004
8/29/2004
8/22/2004
8/15/2004
8/8/2004
8/1/2004
7/25/2004
7/18/2004
7/11/2004
7/4/2004
6/27/2004
6/20/2004
6/13/2004
6/6/2004
5/30/2004
5/23/2004
5/16/2004
5/9/2004
5/2/2004
4/25/2004
4/18/2004
4/11/2004
0
Harborview
100
80
60
40
20
Type of Participation by Hospital
Number of Participants Approached by
Hospital
Participants
Harborview
Tacoma
Southwest
Everett
TOTAL
Nonparticipants
TOTAL
3,410
1,790
1,620
52.5%
47.5%
1,118
423
72.6%
27.4%
967
526
64.8%
35.2%
100.0%
152
224
376
40.4%
59.6%
100.0%
4,027
2,793
59.0%
41.0%
100.0%
1,541
100.0%
1,493
6,820
100.0%
Technical Notes:
•
HOSPITAL START DATES
•
•
•
•
Harborview Medical Center began interviewing patients on April 12, 2004.
Tacoma General Hospital began interviewing patients on April 26, 2004.
Southwest Washington Medical Center started interviewing on May 5, 2004.
Providence Everett Medical Center began interviewing on July 5, 2004.
•
INTERVENTIONS DESCRIPTION
•
•
Screening Only – Patient Screened for alcohol /drug use, brief intervention not given.
Brief Intervention – Patients received a Screen for alcohol /drug use and received a
Brief Intervention in the Hospital.
Brief Therapy – Patient received a Brief Intervention by the CDP plus Brief Therapy
sessions.
CD Treatment – Patient received a Brief Intervention by the CDP plus chemical
dependency treatment.
Held for Referral – Patient received a Brief Intervention by the CDP and was referred
for further assessment and treatment. Patient records
are held up to 28 days for resolution.
•
•
•
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