SBIRT Implementation: Steps for Preparing

The goal of SBIRT integration is to make SBIRT a new standard of care. Integration of SBIRT should not disrupt existing patient flow in your organization or supplant existing procedures. Successful integration implements SBIRT into your current patient flow in a way that minimizes disruption and maximizes time efficiency. Integration is efficacious when SBIRT is a regular part of an organization’s process. Below is a step-by-step process that can be used to successfully integrate SBIRT in primary care.

Step 1: Form an SBIRT workgroup

  • It is recommended that an SBIRT workgroup be comprised of key stakeholders, such as medical, clinical, administrative, and technical leaders.
  • Distribute responsibilities among this workgroup. Consider who will be involved in:
    • Changing organizational policy and practice to include SBIRT
    • Ongoing oversight and sustainability
    • Evaluation and improvement

Step 2: Modify organization policies and practices

  • Assess organizational readiness
    • All organizations have individual characteristics that demonstrate a level of preparedness and some areas that may need additional focus to increase successful implementation of SBIRT. By assessing readiness at the beginning of an organizational change process, it is more likely that weaknesses can be identified and resolved. Click here for the Indiana SBIRT readiness assessment for integrated care.
  • Determine patient flow
    • Determine how and by whom the following components of SBIRT will be completed:
      • Prescreening
      • Full screening
      • Intervention
      • Referral
  • Assign oversight responsibilities & determine quality management policies
    • Determine who will ensure that the SBIRT process is taking place
    • Problem solve when needed
    • Ensure all staff understand the patient flow
    • Communicate with staff and oversight team about successes and barriers
    • Determine how staff competency will be maintained

Step 3: Determine needs for supplies and resources

  • Electronic Health Record (EHR) modification needs
  • Referral information
  • Supply needs
  • Patient materials

Step 4: Training and Capacity

Step 5: Community messaging

  • Community messaging can be used to normalize SBIRT. This can be achieved through posters or flyers within clinics, websites and media, as well as having an “elevator speech” prepared to briefly explain why SBIRT is a standard of care.

Step 6: Launch SBIRT

  • Set a goal start date and be sure to pilot test the EHR modifications before launching SBIRT.

Step 7: Evaluation and adjust

  • It is important to set goals for implementation as well as examine patient outcomes. Ongoing evaluation will support long term sustainability. Determine how the evaluation data will be used to improve outcomes and efficacy.

The Indiana SBIRT team has published an SBIRT Training and Implementation Guide that can be purchased here. This guide provides a comprehensive overview on SBIRT and Motivational Interviewing, and how to prepare for SBIRT implementation. The guide also includes a variety of resources that are recommended by Indiana SBIRT.

E-mail: sbirt@indiana.edu
© Indiana SBIRT. All Rights Reserved.
IU School of Public Health Bloomington         IPRC: Indiana Prevention Resource Center         SAMHSA