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Let’s Take a Moment: Brief Interventions in Trauma

Author(s): Zahra Hussein, Megan Oakey

Slidedeck Presentation Only (no paper submitted):

3B Hussein_Oakey_Lets Take a Moment Brief Interventions in Trauma

Abstract:

Context
The mission of the Vancouver General Hospital (VGH) Trauma Services’ Injury Prevention Program is to reduce the number and severity of injuries presenting in our community.  Motor vehicle collisions are the leading cause of unintentional injury death across all ages in BC. Impaired driving (alcohol, drugs or medications) is a risk factor for motor vehicle collisions.  Trauma centers have a role to play in identifying and helping patients who are problem drinkers and are in the ideal position to take advantage of the teachable moment.  Research has shown that many screened patients cut down on their drinking simply because they were asked about their alcohol use.  Brief alcohol interventions (BI) conducted in trauma centers have been shown to reduce trauma recidivism by as much as 50%.

Objectives

  1. To screen all VGH trauma patients for alcohol misuse and dependency
  2. To provide a brief intervention and patient handouts to those with low to moderate risk of alcohol abuse
  3. To refer patients who qualify for further treatment
  4. To follow up with all patients during their post discharge visit
  5. To develop a standard protocol for addressing alcohol use with all trauma patients
  6. To develop a standard protocol for collecting routine blood alcohol concentrations on all trauma patients
  7. To create patient handouts
  8. To train all trauma staff to deliver BI
  9. Revise appropriate trauma physician/nursing forms

Target Group
The pilot program is directed towards VGH Trauma Services’ patients.  Our goal is to eventually expand the program to all patients at VGH and to other Trauma Centers across B.C.

Activity(ies)
1. Screening and Policy - The objective of our SBIRT (Screening, Brief Intervention and Referral to Treatment) program is to capitalize on the teachable moment.  The aim is to ensure that each trauma patient is screened for at risk use of alcohol and alcohol dependency by standardizing our screening questions and ensuring that they are included on all pertinent forms.

2. Intervention and Policy - To define what a BI means for our patients/providers and to ensure that there is a method to document whether a BI has been conducted so that this information may be captured by our Trauma Registry.  This component will, also, involve creating patient handouts that providers can distribute to patients and their families.

3. Follow up and Policy – In partnership with our Social Work and Mental Health and Addiction colleagues we are mapping out what appropriate referral would entail for patients requiring in-depth support.  Together all above three components will result in a coordinated, structured, standardized, system-wide protocol that will become part of routine care for every patient who comes in to our facilities.

4. Education - Following the finalization of the SBIRT protocol, extensive training will take place in collaboration with our Clinical Educators to ensure that all staff are comfortable and confident using SBIRT.

Deliverables

The information collected during this pilot phase will help to inform the quality improvement process of the VGH SBIRT Program.  It will identify any gaps, challenges and the successes of the Program.  The information will be valuable in spreading the Program across the hospital and to other sites.