**Kettering Medical Center**

**Program Description**

This is a program sponsored by Substance Abuse and Mental Health Service Administration (SAMHSA) via SBIRT (Screening, Brief Intervention, Referral and Treatment) Medical Residency Program. This program will teach 160 area residents in the Screening, Brief Intervention, Referral and Treatment modalities for patients who present with substance abuse issues. This instruction will originally be housed in a University affiliated Community Hospital. We expect to see that broaden to surrounding communities as we proceed across the continuum of this program. 

We are unique in that we have an addictive medicine consultation and liaison services. The Department of Medical Education at Kettering Medical Center began this program in 1985. By 1998, the Internal Medicine Residency program made the rotation in Addictive Medicine a requirement. It was an elective rotation for psychiatry, family medicine, emergency medicine, and transition year. 

In addition to training residents in SBIRT, we intend to teach, and present SBIRT preventative concepts to non-residents. Our hospital owns Kettering College of Medical Arts where we provide degrees (AS and BS) in Nursing as well as in Physician Assistants. We also have an accredited program for Clinical Pastoral Education. SBIRT training will be provided to the nurses, physician assistants and clergy. 

Kettering Medical Center (KMC) is a part of Kettering Health Network (KHN). We will be able to serve patients at all KHN facilities: Kettering Medical Center, Kettering Medical Center at Sycamore, Grand View Medical Center, South View Medical Center, Greene Memorial Hospital, Kettering Behavioral Medicine Center, Vic Cassano Primary Care Center, and Sycamore Primary Care Center. 

We will serve patients in five surrounding counties: Montgomery, Greene, Warren, Miami, and Butler. We are affiliated with Dayton Area Graduate Medical Education Consortium and Crisis Care of Montgomery County, and the Community Network of Greene County. These affiliations will enable us to take SBIRT possibilities into many area medical residency programs: Good Samaritan Hospital, Miami Valley Hospital, Daytons Veterans Affairs Medical Center, Wright-Patterson Medical Center, and the Boonshoft School of Medicine at Wright State University. 

We also work in collaboration with surrounding universities: University of Dayton, Wright State University, Kettering College of Medical Arts, and Sinclair Community College. 

Our screening target is to see an increase in the numbers of screening and brief interventions, referrals, or treatments. The goal for year one is a 50% increase, which will eventually rise to a 90% increase from our baseline screening numbers obtained prior to the start of this program. 

**Program Model**

Currently our curriculum is a combination of paper and electronic. Our goal is to transform all paper curriculum into electronic. We eventually would like to provide our residents with their own addictive medicine flash drive that they can easily carry and refer to as they care for their patients. We also may create a "quick reference" card for their lab coat pocket for SBIRT references. 

Our curriculum currently consists of 11 Seminars.

· Seminar 1: Orientation, Attitudes Survey, NIAAA's Project MATCH, Stages of Change, Relapse Prevention 

· Seminar 2: Motivational Interviewing, Miller's DVD Series, Core Features, Brief Intervention 

· Seminar 3: Theories of Etiology, Psychological theories, Sociocultural theories, Biological theories, The Disease Model, Genetic Factors 

· Seminar 4: Classification, Drug Effects, SMS-IVR, Common Terminology, Assessment, Blocks to Diagnosis and Treatment, Screening Procedures, Questionnaires, Physical Examination, Biochemical Markers, Drug Screens, Interview Format, Drug Class Specific, Additional Background Information, Adult vs Adolescent, The Drug Seeker 

· Seminar 5: Alcohol Withdrawal, Characteristics, Management, Predicting, Potential, Methodology 

· Seminar 6: Drug Abuse and the Brain, How Drugs Work, Anatomic Correlates, Neurotransmitter Systems, GABA Receptor Complex 

· Seminar 7: Barbiturate, Benzodiazepine Withdrawal, Characteristics, Predicting Potential, Management 

· Seminar 8: Cocaine, Actions, Related Medical Problems, Presentations, Management, Treatment 

· Seminar 9: Opioid Withdrawal, Characteristics, Management, Opioid Substitution, Chronic Pain 

· Seminar 10: Nicotine Withdrawal, Characteristics, Management, Nicotine Replacement 

· Seminar 11: Treatment, Addiction Medicine, Resources, In Patient vs Out Patient, ASAM Patient Placement Criteria, Adjunctive Drugs, Anti-Alcohol Drugs, Others, Comprehensive Care

At the start of the SBIRT program, our residents will be trained for in patient services. Our plan is to continue to develop these services to our ambulatory care settings as we work with the physicians at Vic Cassano Primary Care Center, and Sycamore Primary Care Center.

As the SBIRT program advances, we plan to provide continuing medical education opportunities to faculty and medical residents at Ohio Medical Schools; Case Western Reserve University, University of Toledo, Northeastern Ohio University, Ohio State University, University of Cincinnati, Ohio University.

**Service Features**

We plan to develop a Research Protocol to further obtain and analyze data. This will enable us to capture additional data points not required to be collected by GPRA. Information gleamed from this research will be presented to SAMHSA. It will consist of number of screening at baseline of study for substance abuse, what substance the patient is struggling with, and the screening techniques utilized and what response was chosen for the brief intervention, referral or treatment. Further data will be obtained as to the financial impact of non intervention, verses intervention. 

**Contact Info**

Kettering Medical Center3535 Southern BlvdKettering, OH 45429

Project Director Douglas Teller, MDKettering Medical Center3535 Southern BlvdKettering, OH 45429Phone: 937-298-3399 ext 55975doug.teller@khnetwork.org 

Project MonitorRobert T. Smith, MD, FACPKettering Medical Center3535 Southern BlvdKettering, OH 45429Phone: 937-395-5505Robert.smith@khnetwork.org 

Project Manager: Faye E. Hager, BSN, RNKettering Medical Center3535 Southern BlvdKettering, OH 45429Phone: 937-395-8367faye.hager@khnetwork.org