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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 clinicClinicians 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
Project 2: GA-TX “Improving Brief Intervention” Project
Timeline: 2005-2007Aim: 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)
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
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
SBIRT Grants by State, 2008
Missouri
W. Virginia
Georgia
Medical School Residency Grants
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
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
Project 5: SECSAT for Advanced Practice Registered NursesRationale: 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
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
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
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
