Gundersen Health System Rachael Garbers, BSCHE; Andy Wagner, RN BSN; Ann Lang, RN MS; Andrew J. Borgert, PhD; Mason Fisher, MD FACS

 American College of Surgeons-Verified Level II Trauma Center  Trauma Services, La Crosse, Wisconsin  325-bed teaching hospital  >9% patients identified with at-risk consumption  SBIRT implemented in 2009

 Completed by RN on unit  Patients ages 12 years and up  365 days/year  GHS maintains 90.8% screening capture rate

 Brief Intervention (BI)  Wellness Specialist ◦ Motivational Interviewing  Clinician ◦ Traditional Methods

 Motivational Interviewing method: ◦ Patient-centered ◦ Elicit positive lifestyle change talk ◦ Collaborative ◦ Emphasize Autonomy ◦ Open-ended, affirmation, reflect, summarize (OARS)

 Measure Audit-C  Timeframe ◦ One week ◦ One month ◦ Six months ◦ One year

 Motivational Interviewing Intervention ◦ Consulted 509 patients ◦ 264 (52%) agreed to follow-up  Traditional Intervention ◦ Consulted 426 patients ◦ 90 (21%) agreed to follow-up

 Multiple Staff  Smaller facility  Population with little ethnic diversity  no test of interrater reliability  Retrospective study

 Review of techniques  MI has higher success rate  Non-directive, patient-centered approach ◦ Reduces resistance ◦ Promotes behavior change

 Bertholet, N., Palfai, T., Gaume, J., Daeppen, J. B., & Saitz, R. (2014). Do brief alcohol motivational interventions work like we think they do? Alcohol: Clinical and Experimental Research, 38(3),  Field, C., Walters, S., Marti, N., Jun, J., Foreman, M., & Brown, C. (2014). A multisite randomized controlled trial of brief intervention to reduce drinking in the trauma care setting. Annals of Surgery, 259(5),