Section of toolkit | Tool name | Purpose of the tool | Implementation strategy [12] | Phase during which the tool was developed |
---|---|---|---|---|
Introduction | Introduction to The Toolkita | Provide toolkit introduction including the purpose of implementation and timeframe | Develop a formal implementation blueprint | Phase 1 |
Definitions | Acronyms and Abbreviations | List acronyms and abbreviations used throughout the toolkit | Develop an implementation glossary | Phase 1 |
Engagement/communication | Chief Nursing Officer Letter of Support | Obtain a commitment from leaders to participate in the study and mandate the change | Obtain formal commitments, mandate change | Phase 1 |
Chief Nursing Officer Talking Points | Provide information and talking points for each chief nursing officer | Obtain formal commitments | ||
E-mail Template for Providers | Provide a template site that coordinators can use to share information with local healthcare providers | Inform local opinion leaders; build a coalition | ||
Indiana SBIRT Information Sheet | Summarize SBIRT and the outcomes associated with SBIRT use | |||
Advisory Council Agenda Template | Provide a template for meetings with the advisory board | Use advisory boards and workgroups | ||
Assessment | Capacity Self-Assessmenta b | Assess capacity, local needs, and barriers and facilitators to implementation | Assess for readiness and identify barriers and facilitators; conduct local needs assessment | Phase 1 |
Planning | Gantt Chart for Site Coordinatorsa | List site coordinator responsibilities and projected study activities timeline | Prepare champions | Phase 1 |
Information for Shared Electronic Platform | Create a common resource to assemble and share information among investigators and site coordinators | Centralize technical assistance | ||
Site Coordinator Roles and Responsibilitiesa | Describe the study and anticipated site coordinator roles and responsibilities in order to select a site coordinator | Identify champions | ||
How to Identify a Site Coordinator | Describe characteristics of site coordinators that may facilitate implementation | Identify champions | Phase 3 | |
Training Initial Clinical Nurses and Providing Ongoing Training | Provide a worksheet to inform development of a process to train clinical nurses | Conduct ongoing training | ||
Communicating with Stakeholders | Provide a worksheet to help site coordinators identify key talking points and plan for ongoing communication with stakeholders | Build a coalition; create new clinical teams | ||
Facility Resources for SBIRT Implementation | Reflect and identify a list of supporting resources already available at the facility | Assess for readiness and identify barriers and facilitators | ||
Back-up Plan for Site Coordinator | Develop a process to support SBIRT implementation when the site coordinator is not available | Create new clinical teams | ||
How to Adapt the Intervention | Identify the core components of the intervention and the components of the intervention that may be adapted | Promote adaptability | ||
Training | Pre-course Training | Provide a short introduction to SBIRT and the study before site coordinators attend the 8-h training | Develop and distribute educational materials; prepare champions | Phase 1 |
Training Agenda | Provide an agenda and objectives of the site coordinator training | |||
List of Investigators | Familiarize the site coordinators with the study investigators | Create new clinical teams; prepare champions | ||
List of Site Coordinators | Generate a list of names and contact information | |||
Study Overview | Provide a brief description of the study that site coordinators may share with stakeholders | Distribute educational materials; use train-the-trainer strategies, prepare champions; make training dynamic | ||
Study Timeline | Provide a timeline of all study activities including training and data collection | |||
Study Introduction | Provide detailed information about the study | |||
Substance Abuse Overview | Teach site coordinators about substance use disorders, including epidemiology, risk factors, and the neurobiology of addiction | |||
SBIRT Introduction | Educate site coordinators regarding the evidence supporting SBIRT and the value of implementing SBIRT | |||
Screening for Substances | Describe tools used to screen for drug and alcohol use and demonstrate how to screen patients | |||
Motivational Interviewing | Describe stages of change and the principles of motivational interviewing; explain the goals and components of brief interventions | |||
Stages of Change Exercise | Discuss different stages of change and demonstrate potential responses | |||
System Issues and Implementation | Guide discussion regarding implementation at each facility | |||
Additional SBIRT Resources | List websites, online videos, and other resources that provide additional information about substance abuse and SBIRT | |||
Documentation Process | Describe a standard process to document SBIRT in the electronic medical record and provide examples of documentation | |||
Protocol for Missed Site Coordinator Training | Describe the steps to complete training if the site coordinator was unable to attend the 8-h training session | |||
Patient Education Brochure- Ordering Info | Provide information to order patient education brochures | |||
Brief intervention Cheat Sheet | Provide a one-page guide to motivational interviewing | Distribute educational materials; capture and share local knowledge; Tailor strategies | Phase 2 | |
Brief Intervention Guide Using the 5 A’s | Provide a guide to intervening using (Ask, Assess, Advice, Assist, and Arrange) | |||
Documentation Badge Reference | Provide a quick guide to documentation that can be worn with the nurse’s identification badge | |||
REWARD Smoking Cessation | Provide patient education using the REWARD acronym with benefits of quitting smoking | |||
Education Express | Notify direct care nurses of the new SBIRT process and go-live date | |||
Motivational Interviewing Article | Provide additional details about motivational interviewing | Conduct ongoing training, distribute educational materials | Phase 3 | |
Evaluation of training | SBIRT Knowledge Assessmentb | Assess knowledge of SBIRT after the completion of training | Distribute educational materials; use train-the-trainer strategies, prepare champions | Phase 1 |
Brief Intervention Adherence and Competence Scaleb | Demonstrate competency providing a brief intervention using motivational interviewing techniques | Distribute educational materials; capture and share local knowledge | ||
Policy and procedure for training (non-localized) | SBIRT Documentation Form | Provide a paper document for completion of the screening tools and brief intervention (note: SBIRT is not located in the electronic medical record at this time) | Distribute educational materials; use train-the-trainer strategies, prepare champions | Phase 1 |
SBIRT Flowchart | Provide a step-by-step flowchart of the components of SBIRT | |||
Evaluation of implementation and intervention fidelity | Chart Data Abstraction Tool | Collect data from patient’s electronic medical records regarding screening, brief intervention, and referral to treatment | Audit and provide feedback | Phase 1 |
Implementation Fidelityb | Assess fidelity to the implementation process | |||
Monthly Meeting Agenda Template | Provide a template for the monthly site coordinator/investigator meeting | Create a learning collaborative; capture and share local knowledge; ongoing consultation; organize clinician implementation team meetings | ||
Monthly Worksheet** | Collect information regarding site coordinator time spent implementing SBIRT, barriers/facilitators to change, and lessons learned from implementation | Identify barriers and facilitators; capture and share local knowledge | ||
SBIRT Fidelityb | Assess fidelity to the SBIRT process | Develop and implement tools for quality monitoring | ||
Policy and procedure (localized) | SAMSHA-Approved Providers | List treatment centers (including the address and phone number) throughout the state | Tailor strategies | Phase 1 |
SBIRT Process 2 (localized to a specific facility) | Describe the process for completing SBIRT, including the people responsible and hand-off between providers | Promote adaptability | Phase 2 | |
Documentation Form with Barcode (multiple versions localized to different facilities) | Provide a document for completion of the screening tools and brief intervention (note that screening tools are not located in the electronic medical record at this time) | Promote adaptability; change record systems; tailor strategies | ||
SBIRT Process (multiple versions localized to different facilities) | Describe the process for completing SBIRT, including the people responsible and hand-off between providers | Promote adaptability; tailor strategies | ||
Fiscal and funding | SBIRT Reimbursement Resources | List billing codes that have been used for SBIRT | Make billing easier | Phase 2 |