Encompasses the steps taken to introduce and sustain the innovation.
Planning SBI implementation to avoid disrupting patient flows and workflows and to minimize interference with classes or school operations is essential in school-based health SBI. Projects that prepare concise, specific guides for clinicians and workbooks for youth and that conduct focus groups to test the usefulness of manuals and processes see improved uptake and sustainability. Simple metrics for monitoring clinicians' delivery of SBI, feedback, and clinical supervision have been found useful. As with adult SBI implementation, practice management systems and electronic medical record systems that prompt providers to screen and manage adolescents' substance use and that automate billing facilitate SBI programs.319, 320