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Georgia: National Leader in Training an SBIRT Workforce

Georgia: National Leader in Training an SBIRT Workforce. J. Paul Seale, MD Family Physician Professor & Director of Research Dept. of Family Medicine Navicent Health/Mercer University Macon, GA, USA. Healthy Habits Project 2002-3. Macon Family Medicine clinic

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Georgia: National Leader in Training an SBIRT Workforce

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  1. Georgia: National Leader in Training an SBIRT Workforce J. Paul Seale, MD Family Physician Professor & Director of Research Dept. of Family Medicine Navicent Health/Mercer University Macon, GA, USA

  2. Healthy Habits Project 2002-3 • Macon Family Medicine clinic • Clinicians trained: 25 residents, 8 faculty and 2 physician assistants (now 108 residents after 13 years) • Screened 3,041 patients, 241 (8%) positive screens, 115 (3.8%) received BIs • Demonstrated SBIRT’s feasibility Seale, Shellenberger et al, Substance Abuse 2005; Seale, Shellenberger et al, BMC Family Practice 2005

  3. Project 2: GA-TX “Improving Brief Intervention” Project • Timeline: 2005-2007 • Aim: Replicate results of Healthy Habits Project in 8 residency programs (4 in GA, 4 in TX) • Engaged “early adopter” faculty to serve as site coordinators: Rome (Floyd Medical Center), Atlanta (Morehouse Family Medicine), Albany (Phoebe Putney Family Medicine), Savannah (Memorial Family Medicine)

  4. Dissemination Results • 189 residents & 6 faculty trained • Broad geographic distribution across Georgia Shellenberger, Seale et al, Academic Medicine 2009; Seale, Velasquez et al, Substance Abuse 2012

  5. Project 3: Georgia BASICS State SBIRT Initiative 2008-2013 • Aim: Implement alcohol/drug SBIRT in 2 largest hospital systems in GA • Partnered with state health dept, Grady Health Systems, Emory & GA State U. • Focused on SBIRT in emergency departments • New: “specialist model” of SBI delivery • $15 million over 5 years Johnson et al. Use of AUDIT-based measures, ACER 2013; Johnson et al. Integration of screening question…Annals of Emerg Med 2013

  6. SBIRT Grants by State, 2008 W. Virginia Missouri Georgia Medical School Residency Grants

  7. Project 4: Southeastern Consortium for Substance Abuse Training • Rationale: limited SBI/substance abuse initiatives in the southeastern US • Aim: Implement alcohol/drug SBIRT in primary care residencies GA/NC/SC • Recruited 4 Family Medicine, 3 Internal Medicine residencies & PA program

  8. Dissemination Results • 9 new clinics in 8 training programs, 434 residents & 200+ faculty trained in 3 states • Added SBI training in new discipline: Physician Assistant training program • Training, systems intervention & strong QI component led to increased SBI rates in clinics • Pioneering work on coding & billing Seale, Johnson et al, Academic Medicine 2015; Le, Johnson et al, JGIM 2015

  9. Project 5: SECSAT for Advanced Practice Registered Nurses • Rationale: as primary care delivery changes to serve more patients, nurse practitioners are in ideal role to do SBI and bill for services provided • Engaged 6 GA advanced practice nursing programs (Mercer, Emory, UNG, Armstrong Atlantic, GCSU, South U.) • Recruited 2 other “top ten” nursing programs—Johns Hopkins, UAB

  10. Dissemination Outcomes • Training in 8 new nursing programs, 587 students, 74 faculty and preceptors trained in initial 2 years (goal: 900) • Creation of online training materials for distance learners • Very high level of interest, engagement and ownership of this important preventive practice • Major efforts toward establishing national SBIRT training standards

  11. Newest Wave of SBIRT Trainees (63 new US grants) • Augusta University • Medical students, nurse practitioners, residents in Family Medicine and psychiatry, & psychology students • Morehouse School of Medicine • Training students in medicine, nursing and social work

  12. GA Workforce—Poised for SBIRT Dissemination • 13 years of training projects • >2,600 students/residents & 118 faculty in medicine, nursing and PA programs across Georgia & nearby states • Follow-up interviews indicate these trainees use SBI after graduation • Opportunities to accelerate use of this important preventive service by “turning on” and funding SBIRT codes

  13. Thanks! Questions? seale.paul@navicenthealth.org (478) 633-5910

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