APPENDIX A Sample clinic implementation checklist Below is a table showing a sample clinic implementation checklist. This checklist is designed to lay the general foundation for tasks to be completed to get SBIRT implemented in your clinic. Implementation Steps Topics Key Leaders to Include Meet with clinic management staff to determine how SBIRT might fit clinic flow SBIRT overview Evidence based prevention practices Health care reform WASBIRT-PCI Clinic Administrator Medical Director Meet with clinic staff to assess implementing SBIRT overview Comfort with discussion alcohol and drug use WASBIRT-PCI (if working with DSHS) Clinic Managers MDs MAs Nurses Front Desk Staff Conduct follow up meetings with all clinic to begin defining SBIRT implementation Overview of SBIRT Review planning documents Begin discussions about implementation plan Strategies for phased in implementation Clinic model Clinic flow Hiring & Training Contracting Modifying the clinic electronic health record (EHR) Sustainability DSHS specific topics: WASBIRT-PCI overview Business Associate Agreements and Data Sharing Government Performance and Results Act reporting data Clinic Administrator Clinic Managers MDs MAs Nurses Front Desk Staff Other staff? Schedule SBIRT Implementation Team 1 hour orientation Weekly (15-20 minutes) 2-4 weeks prior to implementation SBIRT overview Clinic buy in Develop flow QA / QI process Implementation plan Data collection Change Management Clinic administrator MD IT Billing MA BHI Medical records Human Resources
Join the WASBIRT-PCI Clinical Implementation Workgroup Discuss clinical issues as they arise Provide feedback and suggestions for systems improvements Discuss barriers and successes to implementation Conference held every two weeks Process Evaluation Requirements Schedule a time for team to conduct in clinic surveys (1-3 months into implementation; 9-11 months into implementation; 6 months post funding period) Complete the Clinic Information Form (attached) within 3 months of implementation; Form reviewed at 9-11 months) Brief 10 minute survey to be completed by all staff in clinic implementing SBIRT Clinic Information Form collects data on the size of the clinic, demographics of patients, SBIRT clinic model, etc. Persons Implementing BI (SBIRT supervisors welcome as well) Attend Learning Collaborate Continued MI training Education on alcohol and substance use/abuse Co-occurring disorders Anxiety and Depression Topics as requested Monthly Meetings Clinic Preparation Process This form is intended to track when general implementation items related to SBIRT are completed. Although procedures, polices, staff, etc. may change over the course of the grant, we would like to capture when the initial processes happen. In some cases you may only be able to identify a month year which is acceptable. Redefining/restructuring Date Completed Writing the organization’s vision, policies and procedures to implement SBIRT Written policies/procedures Financial support Dedicated program staff/personnel Involving to develop an implementation plan and clinic flow Training/education offered EHR adaptations to include Providing ongoing monitoring and quality improvement