Table 1.
Implementation Strategy |
Description | Target Audience | Schedule |
---|---|---|---|
Electronic Medical Record (EMR) Modification |
Substance use screening (CRAFFT) and documentation fields addressing follow-up services provided (e.g., BI provided) were added to the EMR. |
Administrators, Primary Care Providers, Behavioral Health Counselors, Nurses, Medical Assistants |
Prior to Implementation Phase and repeated when the new EMR was adopted |
Initial Staff Trainings |
In-person trainings addressing adolescent substance use prevalence and incidence, SBIRT overview, items and scoring of CRAFFT, service delivery protocol, and EMR documentation. A list of adolescent substance use providers in the community was also provided. Trainings were conducted at each site for all staff. BHCs were trained as a group, independent of site. |
Primary Care Providers, Behavioral Health Counselors, Nurses, Medical Assistants |
Start of Implementation Phase |
Bi-monthly Feedback |
De-identified encounter data from the EMR were aggregated by site and summarized into a single page overview. Feedback compared the site’s rates of screening and BI completion over time and in comparison to the other clinics completion rates. |
Administrators | Repeated every other month for duration of Implementation Phase |
Quarterly Booster Trainings |
On-site quarterly boosters provided the site’s EMR data for screening and BI completion and presented an opportunity to clarify confusion regarding service delivery processes by Implementation Approach, identify and overcome barriers to screening, BI/BA delivery, and warm handoff completion. |
Primary Care Providers, Nurses, Medical Assistants |
Repeated every 3 months for duration of Implementation Phase |
Quarterly Feedback to Providers |
EMR data for each adolescent patient seen by each provider were summarized and provided in a quarterly single page letter to demonstrate performance trends and offer reminders for adherence to their assigned Implementation Approach. |
Primary Care Providers |
Repeated every 3 months for duration of Implementation Phase |