Northwell's effort to implement SBIRT in both the ER setting and at primary care practices is a significant achievement, Conigliaro says. "This in itself is a measure of success, demonstrating organizational awareness and acceptance that substance use needs to be handled as any other disease process."
The universal nature of SBIRT screening at Northwell's primary care practices and ERs is also crucial, he says.
"We screen everybody. We don't try to pick out people who are more likely to be addicted. So, if you are a 75-year-old nun, you are going to get screened for alcohol and drugs."
Opioid Crisis Task Force
Another addiction initiative at Northwell is starting to roll out new programs.
Launched in 2016 with six members drawn from interdisciplinary fields, Northwell's Opioid Management Steering Committee is developing a "battery of solutions" to help address the opioid crisis in New York, Kapoor says.
The steering committee has four focal points:
- Limiting the supply of opioids
- Raising awareness of opioid addiction
- Identifying and managing the dependent population
- Treating the opioid-addicted population
Several steering committee work groups have been formed:
- Community and school-based outreach
- Pain management
- Data mining to help monitor and evaluate Northwell's opioid-addiction programs
- Addiction protocols for standardizing inpatient treatment
- Practice guidelines for opioid-medication prescriptions
- Emergency medicine not only to identify patients who are addicted to opioids but also to start treatment in the ER before handing off patients for specialty care
Currently, two of the steering committee's pilot programs that focus on the safe disposal of opioid medications are being expanded.
Christopher Cheney is the senior clinical care editor at HealthLeaders.