Bella Bella’s R.W. Large Memorial Hospital 3rd VCH site to implement SBIRT protocol

Since launching in 2014 at VGH and then GF Strong, Bella Bella’s R.W. Large Memorial Hospital is now the third VCH site to implement the Screening, Brief Intervention, and Referral to Treatment initiative, or SBIRT.

SBIRT is about starting a conversation with a patient about their drinking habits – even if they are not dependent on alcohol, they can still be at risk of an alcohol-related injury. Hospital emergency departments and trauma centres – even in remote communities such as Bella Bella – provide opportunities for early intervention with at-risk substance users before more severe consequences occur.

Hospital, local health centre work together

Sian Carter, Patient Care Coordinator/Educator at the Central Coast hospital, was key to bringing the evidence-based SBIRT initiative to Bella Bella.

“Implementing SBIRT in Bella Bella was challenging at first – being a unique, rural community comes with many implications such as providing culturally sensitive care,” says Sian. “We are fortunate to have worked collaboratively with the local Community Health Centre and have successfully implemented SBIRT for our acute care client population. We have only had two successful referrals so far, but if we can make a difference in even one life then this initiative is a success.”

Goal is to identify high-risk clients

Zahra Hussein, the Injury Prevention Program Lead for Trauma Services at VGH who worked with Bella Bella staff to implement SBIRT, says the goal is to identify high-risk clients and prevent an injury related to alcohol or a more severe injury if they’ve already come in with an alcohol-related injury.

“We do a really good job of intervening with patients who are alcohol dependent and now we can say that we also do a good job of intervening with patients who drink at amounts greater than those suggested by the Canadian Centre on Substance Abuse (CCSA) National Low Risk Drinking Guidelines,” says Zahra.

In Bella Bella it is not uncommon for a client to screen positively with the SBIRT tool; most clients will not see their drinking habits as problematic and that is not anyone’s decision to make for them, explains Sian.

“We offer the intervention and allow the client to make an informed decision in their own health care,” says Sian. “The intervention consists of referral to community counselling services with potential for further referral to a treatment centre if indicated.”

Evidence-based protocol

SBIRT is an evidence-based, comprehensive, integrated approach to the delivery of early intervention and treatment services for people with substance use disorders and people who are at risk of developing these disorders.

Zahra noted that there is a lots of evidence from around the world to support the effectiveness of alcohol screening and brief interventions.

“It is a standard of care in trauma centres in the U.S., as well as, in many other countries,” says Zahra.

For Sian and the Bella Bella team, any opportunity to improve a person’s life is worthwhile.

“By screening every client, regardless of their presenting concern, we can potentially improve health related outcomes by addressing issues not previously recognized,” says Sian. “Evidence-informed practice is part of our commitment to providing high quality care for our community members.”

The hope of the Regional Trauma Program is that SBIRT be addressed with all trauma patients across the VCH as alcohol is such a significant risk factor for injury and SBIRT has been shown to decrease recidivism rates.