SBIRT in Boston Medical Center

History

Project ASSERT employee at patient's bedside in emergency room.

HPA Brent Stevenson speaking with a patient in the emergency department.

In 1993, a demonstration grant was awarded to Boston Medical Center by SAMHSA’s (the Substance Abuse and Mental Health Services Administration) Center for Substance Abuse Treatment (CSAT) to test the feasibility of a staff of multicultural health promotion advocates (HPAs).

These advocates were trained by emergency department (ED) personnel to screen patients using a health needs history, administer a brief negotiated interview based on readiness-to-change principles, and use an active referral process to capture the marginal capacity of the substance abuse treatment system.

Project ASSERT wins 1996 City of Boston Customer Service Award.

Project ASSERT wins 1996 City of Boston Customer Service Award.

Outcome data showed success in referrals, reduction of alcohol and drug use, and patient satisfaction.

The services provided by Project ASSERT were so valued by the patients and staff at Boston Medical Center, that the program became a hospital budget line item in 1998.  The success of Project ASSERT lead to the dissemination of the collaborative in-reach model to seven hospitals throughout Massachusetts in 1997.

Fast Facts

Project ASSERT has…

Patient in counseling with Project ASSERT employee.

HPA Ludy Young conducts a decisional balance exercise.

  • Screened over 60,000 patients
  • Provided services to 27,101 patients
    • 32% female, 46% Black, 16% Hispanic
    • 27% without primary care
    • 28% unable to afford medications
    • 61% smoked tobacco
    • 31% with an alcohol- or drug-related injury
    • 20% mildly or moderately depressed

  • Referred patients to various services. Among the 15,786 patients who drank in excess of NIAAA guidelines, or used drugs within 30 days:
    • 44% were placed in detox
    • 9%  placed in outpatient programs
    • 42% referred to AA / NA
  • Referred 11,315 patients who screened negative for substance abuse to primary care appointments (of which 42% received an array of other mental health and preventive referrals)
  • Has trained more than 2,000 health care professionals across the nation in this model as part of the BU School of Public Health BNI-ART Institute.
  • Celebrated its 15th Anniversary of serving patients at BMC in 2009 in which guest speaker, Michael Botticelli, the former Director of Massachusetts Bureau of Substance Abuse Services, commended the program’s success.