Table 2.
Clinical workflow for substance use screening, brief intervention, referral to treatment for substance use disorder, and follow-up for update of treatment.
| Visit Type | New Patient | Existing Patient | Patient Requiring a Referral | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Provider’s Specialty | Total (n = 26) | Addiction specialty (n = 10) | Non-addiction specialty (n = 16) | Total (n = 26) | Addiction specialty (n = 10) | Non-addiction specialty (n = 16) | Total (n = 26) | Addiction specialty (n = 10) | Non-addiction specialty (n = 16) |
| Provider’s positive response | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) |
| Before patient visit | |||||||||
| Requested health risk screen while scheduling | 5 (19.2%) | 2 (20.0%) | 3 (18.8%) | 0 | 0 | 0 | 0 | 0 | 0 |
| Patient arrival and visit | |||||||||
| Screened for substance use | 25 (96.2%) | 10 (100.0%) | 15 (93.8%) | 21 (80.8%) | 7 (70.0%) | 14 (87.5%) | 17 (65.4%) | 6 (60.0%) | 11 (68.8%) |
| Assessed for substance use disorders | 22 (84.6%) | 9 (90.0%) | 13 (81.3%) | 20 (76.9%) | 9 (90.0%) | 11 (68.8%) | 11 (42.3%) | 4 (40.0%) | 7 (43.8%) |
| Explored treatment needs and options | 26 (100.0%) | 10 (100.0%) | 16 (100.0%) | 25 (96.2%) | 10 (100.0%) | 15 (93.8%) | 22 (84.6%) | 8 (80.0%) | 14 (87.5%) |
| Conducted brief intervention or counseling | 24 (92.3%) | 10 (100.0%) | 14 (87.5%) | 24 (92.3%) | 10 (100.0%) | 14 (87.5%) | 21 (80.8%) | 7 (70.0%) | 14 (87.5%) |
| Provided on-site treatment for substance use disorder(s) | 21 (80.8%) | 8 (80.0%) | 13 (81.3%) | 21 (80.8%) | 8 (80.0%) | 13 (81.3%) | 14 (53.8%) | 5 (50.0%) | 9 (56.3%) |
| Arranged the referral to a specialist | 23 (88.5%) | 7 (70.0%)* | 16 (100.0%)* | 24 (92.3%) | 9 (90.0%) | 15 (93.8%) | 23 (88.5%) | 8 (80.0%) | 15 (93.8%) |
| Check out and after visit | |||||||||
| Followed up with the uptake of specialty treatment | 20 (76.9%) | 7 (70.0%) | 13 (81.3%) | 24 (92.3%) | 9 (90.0%) | 15 (93.8%) | 23 (88.5%) | 9 (90.0%) | 14 (87.5%) |
| Conducted other after-care services or follow-ups | 8 (30.8%) | 2 (20.0%) | 6 (37.5%) | 9 (34.6%) | 2 (20.0%) | 7 (43.8%) | 4 (15.4%) | 1 (10.0%) | 3 (18.8%) |
* Exact test: P-value = 0.046 for comparing the proportion of addiction and non-addiction specialists who would arrange the referral to a specialist for new patients.