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Table 1 Site coordinator perception of SBIRT implementation

From: Perceptions of the barriers, facilitators, outcomes, and helpfulness of strategies to implement screening, brief intervention, and referral to treatment in acute care

Theme

Sub-theme (# mentions)

Examples

Barriers identified related to SBIRT implementation were:

Sustainment (10)

Process complacency; difficult to coordinate with multiple clinicians

 

Data collection (9)

Difficult to navigate health record; data absent from record

 

Staff adoption (9)

Nurse adherence to SBIRT; negative attitudes

 

Unit operational challenges (8)

Leader turnover; new nurses on the unit

 

SC execution (7)

SC felt alone in implementation efforts; SC role unclear

 

Study rollout (7)

Trial originally set up on different unit; site coordinator changed

 

Training coordination (6)

Finding a training schedule that worked for staff

 

Brief Intervention (BI) (5)

Lack of understanding of intent; discomfort with BI process

 

Patient-specific (4)

Patients did not see relevance or did not want help

 

Patient referral (2)

Insurance challenges; lack of available referral sites

 

Effort duplication (2)

SBIRT activities/documentation duplicated (nursing and social work)

Facilitators identified related to SBIRT implementation were:

Leveraging support (9)

Involvement of interprofessional stakeholders; use of early adopters

 

Adapting intervention (8)

Ability to tailor/create resources; dedicated location for resources

 

SC development (8)

Learning and peer support from other SC; research team mentorship

 

Feedback loop (8)

Auditing/follow-up; reminders; rounding with staff for questions

 

Leader impact (7)

Leader engagement/support; SBIRT considered mandatory

 

Sustainment (3)

Problems anticipated ahead of time; new hire assimilation

 

Implementation efficiency (3)

Implementation planning phase; designated role (SC)

Outcomes identified related to SBIRT implementation were:

Awareness (13)

Clinician and patient awareness of risky substance use

 

Action-oriented process (11)

Ability to act on positive screen; more referral options accessible

 

Enhanced care transitions (8)

Streamline continuum of care; support collaborative communication

 

Therapeutic relationships (6)

Show clinician care; determine patient readiness in the process

 

Connection to disease process (6)

Applicability of BI to other conditions; prevention of alcohol withdrawal

 

SC development (4)

Implementation skills; organizational resource navigation

 

Comfort (4)

Clinician and patient comfort discussing substance use