Implementation Barriers to and Facilitators of Screening, Brief Intervention, Referral, and Treatment (SBIRT) in Federally Qualified Health Centers (FQHCs). Inner Setting


The structural, political, and cultural contexts through which the implementation process will proceed.

  • Organizational development consultation may result in the better fit of SBI into FQHC workflows than adding SBI-specific staff: Assisting health centers to infuse substance use screening and treatment into their existing patient flows, EHRs, and accountability structures may increase uptake and sustainability.

  • Behavioral health clinicians working in FQHCs need substance use training and skills: Behavioral health specialists should be skilled in assessing and managing the wide range of behavioral health issues of primary care patients, including their unhealthy use of alcohol and other drugs.

  • Substance use records should be integrated into all EHR systems: EHRs should always include fields for substance use risk assessment, diagnosis, and treatment.

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