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Implementation and Quality Improvement of a Screening and Counseling Program for Unhealthy Alcohol Use in an Academic General Internal Medicine Practice

Jonas, Daniel E.; Miller, Thomas; Ratner, Shana; McGuirt, Brooke; Golin, Carol E.; Grodensky, Catherine; Sturkie, Emily; Kinley, Jennifer; Dale, Maureen; Pignone, Michael

doi: 10.1097/JHQ.0000000000000069
Original Article
Continuing Education

Abstract: Unhealthy alcohol use is the third leading cause of preventable death in the United States. The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use but little is known about how best to do so. We used quality improvement techniques to implement a systematic approach to screening and counseling primary care patients for unhealthy alcohol use. Components included use of validated screening and assessment instruments; an evidence-based two-visit counseling intervention using motivational interviewing techniques for those with risky drinking behaviors who did not have an alcohol use disorder (AUD); shared decision making about treatment options for those with an AUD; support materials for providers and patients; and training in motivational interviewing for faculty and residents. Over the course of one year, we screened 52% (N = 5,352) of our clinic's patients and identified 294 with positive screens. Of those 294, appropriate screening-related assessments and interventions were documented for 168 and 72 patients, respectively. Although we successfully implemented a systematic screening program and structured processes of care, ongoing quality improvement efforts are needed to screen the rest of our patients and to improve the consistency with which we provide and document appropriate interventions.

Supplemental Digital Content is Available in the Text.

The authors declare no conflicts of interest.

Financial Support: C. E. Golin and C. Grodensky's efforts were partially supported by NIH grant P30 AI50410; S. Ratner was supported by Access Care North Carolina.

Preliminary results of this work were presented as a poster titled Implementation of a Screening Program to Address Unhealthy Alcohol Use in an Academic General Internal Medicine Clinic at the SGIM 37th Annual meeting, San Diego, CA, April 25, 2014.

For more information on this article, contact Daniel E. Jonas at .

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and in the HTML and PDF versions of the article at .

© 2017 National Association for Healthcare Quality
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