Post on 28-May-2020
GPRA Data Report: April 2020
Pennsylvania Screening, Brief Intervention, and Referral to Treatment (PA SBIRT) is a five-year initiative that will provide SBIRT services
throughout the Commonwealth through September 2021. Funding for the project is granted through the Substance Abuse and Mental
Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT).
PA SBIRT aims to provide SBIRT services to 20,778 unduplicated patients during the grant period. All data is collected and reported in
accordance with the Government and Performance Results (GPRA) Act of 2010. The purpose of this report is to outline key findings and
recommendations based upon GPRA analyses for the PA SBIRT initiative to date.
6 Active Project Sites
14,866 Unduplicated Screenings
→ 17,629 GPRA Target
→ 84.3% Coverage Rate
→ 85.5% Scored “Negative” (Figure 1)
56,062 Total Screenings Conducted
4,303 Brief Interventions Conducted
797 Connections to Speciality Resources
Screening
and
Feedback,
85.5%
Brief
Intervention,
11.2%
Brief
Treatment,
1.2%Referral to
Treatment,
1.5%
Figure 1. Screening Score Distribution
Report Summary
• PA SBIRT project sites have provided SBIRT services to 14,866 (84.3%) of the 17,629 unique patients intended
to be served to date. This is a 0.81% increase since the month of March 2020.
• The overall follow-up enrollment rate is 9.94%, just below the 10% requirement. PERU will work with each site
to address this decrease. Patients continue to report significant decreases in days of use after SBIRT services.
• EMPOWER3 Center for Health (EMP – Pg. 3) provided 100% of the necessary brief interventions in April despite
workflow modifications. The site will work to increase the screening rate and move forward with opportunities
to promote sustainability.
• Altoona Family Physicians (AFP – Pg. 4) implemented screening during telehealth appointments in April. The
Pregnancy Care Center (PCC – Pg. 5) is exploring opportunities to increase the screening rate.
• Primary Health Network (PHN) sites convened a sustainability workgroup. Greenville Community Health
Center (GCHC – Pg. 7) is exploring opportunities to increase the screening rate and Sharon Medical Group
(SMG – Pg. 6) is exploring methods to improve patient connections to the Care Coordinator.
• Allegheny Health Network’s Forbes Family Medicine (FFM – Pg. 8) continues to maintain a high screening rate.
The site is working to improve the follow-up enrollment rate and expand screening efforts through telehealth
services.
Project to Date
2
The PA SBIRT initiative is committed to following-up with 10% of patients who score in the BI, EI, or RT ranges. CSAT requires grantees to
conduct a 6-month follow-up interview with at least 80% of these patients. Six-month follow-up interviews can be conducted between 5
and 8 months after initial patient intake.
23% increase in patients who report no use at follow-
up compared to reported use at intake (Figure 2).
28% 33%
32% 22%
33%
16%
14%
37%
0%
25%
50%
75%
100%
Intake (n=179) Follow-Up (n=179)
Figure 2. Substance Use at Intake &
Follow-Up
Alcohol Only Drugs Only
Both Alcohol and Drugs No Use
Patient Follow-Up
Focus of the Month
• The results reported on the left (Figure 3) show a decrease
in almost 2 and a half days of alcohol consumption and a
decrease in 5 and a half days of drug use when asked about
frequency of use in the past 30 days at follow-up.
• Complete and immediate abstinence is not always a
realistic strategy when decreasing substance use.
• This finding supports SBIRT services as a harm reduction
strategy to gradually decrease a change in use behavior
2 of 6 implementation sites have enrolled at least
10% of eligible patients in follow-up. 2,153 Eligible for Enrollment
→ 214 Paients Enrolled
→ 9.94% Enrollment Rate
198 Eligible for Interview
→ 179 Interviews Completed
→ 90.4% Completion Rate
17% decrease in patients who report poly-substance
use at follow-up compared to reported use at intake.
Patients who receive SBIRT services report
significant decreases in reported days of substance
use between the initial appointment and 6-month
follow-up interview.
6.7
10.67
4.38
5.19
0 2 4 6 8 10 12
Alcohol
Drugs
Figure 3. Average Days of Use in Last 30
Days, Including Abstentees (N=192)
Follow-Up Intake
3
16,076 Screens to Date
12.7% Eligible Patients
Enrolled in Follow-Up
Success from April Goal for May
EMPOWER3 Center for Health (EMP) began SBIRT implementation on March 6, 2017. The site has reached a steady state
of implementation, as clinical staff screened 90% of patients over the past month. The site continues to move forward
with conversations and actions to promote SBIRT sustainability.
Intervention Outcomes Services Completed Eligible Patients Completion Rate
Brief Intervention (BI) 1,129 1,223 92.3%
Early Intervention (EI) 38 142 26.8%
Referral to Treatment (RT) 383 163 235.0%
Monthly CQI Goal
• Increase the screening rate to 90% by the end
of May.
Area for Improvement
• The screening rate for April (82%) is lower
than the EMP average yet has shown signs of
improvement since the steep decline in March
(74%) (Figure 5).
Accomplishment
• The rate of completed brief interventions has
increased (100%) since a decline in services
during March 2020 (63%) (Figure 4).
Actions
• PERU will assist the site with ongoing
monitoring of rates and workflow
modifications due to COVID-19.
EMPOWER3 Center for Health PA SBIRT GPRA Data Report: April 2020
Lesson Learned
• Despite workflow modifications, strong
communication between the Site Champion
and Care Coordinator have allowed for the
continuation of SBIRT and successful patient
referrals.
60%
65%
70%
75%
80%
85%
90%
95%
100%
Figure 4. EMP Successful BI Rate
Completed BI Rate
Completed BI Target
Linear (Completed BI Rate)
70%
75%
80%
85%
90%
95%
100%
Figure 5. EMP Screening Rate
Screening Rate
Screening Target
Linear (Screening Rate)
4
19,474 Screens to Date
7.6% Eligible Patients
Enrolled in Follow-Up
Success from April Goal for May
Altoona Family Physicians (AFP) began full SBIRT implementation on June 11, 2018. Implementation calls increased to
weekly to evaluate the new changes in workflow. AFP quickly transitioned to screening during telehealth appointments
this month and is continuing to train staff in this process and adapt the workflow as needed.
Intervention Outcomes Services Completed Eligible Patients Completion Rate
Brief Intervention (BI) 1,197 1,816 69.2%
Early Intervention (EI) 14 144 9.7%
Referral to Treatment (RT) 72 111 64.9%
Monthly CQI Goal
• Increase the screening rate to 90% by the end
of May.
Accomplishment
• During the month of April, the rate of
completed brief interventions increased from
45% to 82% (Figure 6).
Area for Improvement
• The site transitioned to telehealth rapidly and
worked to continue SBIRT screening during this
transition. However, the screening rate has
declined to 79% (Figure 7).
Actions
• PERU will assist the site with ongoing
monitoring of rates and workflow
modifications due to COVID-19.
Altoona Family Physicians
Lesson Learned
• SBIRT services halted due to COVID-19, but the
site had a strong line of communication which
made the transition to screening via telehealth
and SBIRT implementation successful.
PA SBIRT GPRA Data Report: April 2020
70%
80%
90%
100%
Figure 7. AFP Screening Rate
Screening Rate
Screening Target
Linear (Screening Rate)
40%
50%
60%
70%
80%
90%
100%
Figure 6. AFP Successful BI Rate
Successful BI Rate
Successful BI Target
Linear (Successful BI Rate)
5
4,630 Screens to Date
13.3% Eligible Patients
Enrolled in Follow-Up
Success from April Goal for May
UPMC Pregnancy Care Center (PCC) began full SBIRT implementation on June 11, 2018. Biweekly calls continue to occur
with PERU to assess SBIRT services. PCC recently moved their office to a new location, but quickly began offering SBIRT
services.
Intervention Outcomes Services Completed Eligible Patients Completion Rate
Brief Intervention (BI) 353 457 77.2%
Early Intervention (EI) 2 49 4.1%
Referral to Treatment (RT) 231 279 82.8%
Monthly CQI Goal
• Increase the rate of accepted and completed
patient screenings to 80% of eligible patients by
the end of May.
Accomplishment
• The Care Coordinator was able to enroll a
patient into the follow-up pool during April
2020, maintaining the required 10% for the
4th month in a row this year (Figure 8).
Area for Improvement
• The rate of accepted screens has increased
since March 2020 (74%) but remains below the
goal of 80% (Figure 9).
Actions
• PERU will assist the site with ongoing
monitoring of rates and workflow
modifications due to COVID-19.
UPMC Pregnancy Care Center PA SBIRT GPRA Data Report: April 2020
Lesson Learned
• With the PCC Care Coordinator working
remotely, open and constant communication
with the Site Champion has been an important
facilitator to the SBIRT process.
9.5%
10.0%
10.5%
11.0%
11.5%
12.0%
12.5%
13.0%
13.5%
Figure 8. PCC Follow-Up Enrollment Rate
Follow-up Enrollment Rate
Follow-up Enrollment Target
Linear (Follow-up Enrollment Rate)
60%
65%
70%
75%
80%
85%
90%
Figure 9. PCC Accepted Screening Rate
Accepted Screening Rate
Accepted Screening Target
Linear (Accepted Screening Rate)
6
9,761 Patients Served
to Date
9.8% Eligible Patients
Enrolled in Follow-Up
Success from April Goal for May
Sharon Medical Group (SMG) implemented on September 5, 2017. Bi-weekly calls continue to occur with PERU to assess
SBIRT services and continue to monitor warm hand-offs between the providers and Care Coordinator.
Intervention Outcomes Services Completed Eligible Patients Completion Rate
Brief Intervention (BI) 1,391 1,446 96.4%
Early Intervention (EI) 16 101 15.8%
Referral to Treatment (RT) 24 67 35.8%
Sharon Medical Group
Accomplishment
• SMG maintains a high BI completion rate
(100%) (Figure 10).
Lesson Learned
• SMG’s providers have normalized the
integration of brief interventions in the medical
appointment, and this allowed the providers to
build exceptional rapport with patients.
Area for Improvement
• Beginning in January, SMG experienced a
disruption in connecting patients to the Care
Coordinator using electronic referrals (Figure
11).
Monthly CQI Goal
• The team will work to increase the electronic
referral rate to 40% by the end of May.
Actions
• PERU will report this rate on a weekly basis
so that the Site Champion can explore gaps in
close to real-time and discuss barriers in
referrals with the site providers.
PA SBIRT GPRA Data Report: April 2020
75%
80%
85%
90%
95%
100%
Figure 10. SMG Successful BI Rate
Brief Intervention Rate
Brief Intervention Target
Linear (Brief Intervention Rate)
0%
10%
20%
30%
40%
50%
Figure 11. SMG Elctronic Referral Rate
Connection Rate
Connection Target Rate
Linear (Connection Rate)
7
250 Patients Served
to Date
9.8% Eligible Patients
Enrolled in Follow-Up
Success from April Goal for May
Greenville Community Health Center (GCHC) implemented SBIRT on January 8, 2020. Bi-weekly calls continue to occur
with PERU to assess SBIRT services and discuss quality improvement opportunities. Network sustainability meetings are
scheduled to occur monthly.
Intervention Outcomes Services Completed Eligible Patients Completion Rate
Brief Intervention (BI) 10 21 48%
Early Intervention (EI) 2 4 50%
Referral to Treatment (RT) 1 2 50%
Monthly CQI Goal
• GCHC will aim to reach an 80% screening rate
by the end of May.
Accomplishment
• The distribution of SBIRT scores (Figure 12)
aligns closely with the expected distribution
during the beginning stages of
implementation (Figure 1).
Area for Improvement
• The screening rate for eligible patients is below
the 80% target (Figure 13).
Actions
• GCHC will continue distributing the
introduction flyer to patients who check in at
the clinic. The team will continue to explore
new opportunities to increase the eligible pool
of patients for screening.
Greenville Community Health Center PA SBIRT GPRA Data Report: April 2020
Lessons Learned
• PHN leadership met to discuss the opportunity
of implementing additional routes of
electronic screening through at-home check-
in procedures, which will increase patient
reach during a period of decreased in-person
visits.
Screening
and
Feedback,
90.8%
Brief
Intervention,
6.0%
Brief
Treatment,
1.6%
Referral to
Treatment,
0.8%
Figure 12. GCHC Screening Distribution
30%
40%
50%
60%
70%
80%
90%
100%
Figure 13. GCHC Monthly Screening Rate
January 2020-April 2020
Screening Rate Screening Target
Linear (Screening Rate)
8
5,902 Screens to Date
7.0% Eligible Patients
Enrolled in Follow-Up
Success from April Goal for May
Forbes Family Medicine (FFM) began SBIRT implementation on May 29, 2019. PERU is working with the Site
Champion to update the site's internal training materials. The site is exploring opportunities to transition
telehealth appointments and incorporate SBIRT screening. Currently, screening and brief interventions are
occurring for any in-person appointments.
Intervention Outcomes Services Completed Eligible Patients Completion Rate
Brief Intervention (BI) 223 261 85.4%
Early Intervention (EI) 9 28 32.1%
Referral to Treatment (RT) 6 19 31.6%
Monthly CQI Goal
• Decrease the rate of patients scoring negative
to 90% by the end of May.
Accomplishment
• The screening rate has remained above the
80% target, despite workflow modifications
due to COVID-19 (Figure 14).
Area for Improvement
• The rate of patients scoring negative has been
above the target over the first several months
of 2020 (Figure 15).
Actions
• PERU will complete an in-depth analysis of
contributing factors and propose actions to
the project site.
Forbes Family Medicine PA SBIRT GPRA Data Report: April 2020
Lessons Learned
• With the FFM Care Coordinator working
remotely, open and constant communication
has been an important facilitator to the SBIRT
process.
75%
80%
85%
90%
95%
100%
Figure 14. FFM Screening Rate
Screening Rate Rate
Screening Rate Target
Linear (Screening Rate Rate)
80%
85%
90%
95%
100%
Figure 15. FFM Negative Screening Rate
Negative Screening Rate
Negative Screening Target
Linear (Negative Screening Rate)