Unhealthy alcohol use and the joint commission
An impetus for a standardized approach to SBIRT for unhealthy alcohol use, is the recent inclusion by JCAHO of SBIRT as a quality care measure for hospitalized patients [5], and these recommendations have been summarized [6]. In brief, JCAHO has recommended screening for unhealthy use in all patients, brief intervention for patients with unhealthy use, in-hospital treatment or referral for alcohol use disorders, and consideration of medications for alcohol dependence treatment. Performance of these tasks would be measured by self-reported outcomes through phone contact within 2 weeks of discharge. This JCAHO initiative is grounded in the recognition that unhealthy alcohol use and other drug use is a major determinant of health in hospitalized patients, but has been criticized due to insufficient evidence on the overall effectiveness of SBIRT among general hospital inpatients [6]. In that regard, the JCAHO quality initiative extends beyond the evidence, but represents an attempt to integrate research findings into medical care. This intent must be applauded, and should be used as a springboard to further develop methods that will improve patient outcomes following an index hospitalization. The more severe nature of unhealthy alcohol use in the hospital, the process of SBIRT, and the intended outcomes should drive the research agenda. Some thoughts in this regard are listed in Table 7, which is not meant to be exhaustive. Research efforts must be geared toward generic processes of care and quality assessment, as the intent will be to improve patient outcomes in settings where personnel with unique interests in this field are not always present.
คณะกรรมาธิการร่วมและสุราไม่แข็งแรง An impetus for a standardized approach to SBIRT for unhealthy alcohol use, is the recent inclusion by JCAHO of SBIRT as a quality care measure for hospitalized patients [5], and these recommendations have been summarized [6]. In brief, JCAHO has recommended screening for unhealthy use in all patients, brief intervention for patients with unhealthy use, in-hospital treatment or referral for alcohol use disorders, and consideration of medications for alcohol dependence treatment. Performance of these tasks would be measured by self-reported outcomes through phone contact within 2 weeks of discharge. This JCAHO initiative is grounded in the recognition that unhealthy alcohol use and other drug use is a major determinant of health in hospitalized patients, but has been criticized due to insufficient evidence on the overall effectiveness of SBIRT among general hospital inpatients [6]. In that regard, the JCAHO quality initiative extends beyond the evidence, but represents an attempt to integrate research findings into medical care. This intent must be applauded, and should be used as a springboard to further develop methods that will improve patient outcomes following an index hospitalization. The more severe nature of unhealthy alcohol use in the hospital, the process of SBIRT, and the intended outcomes should drive the research agenda. Some thoughts in this regard are listed in Table 7, which is not meant to be exhaustive. Research efforts must be geared toward generic processes of care and quality assessment, as the intent will be to improve patient outcomes in settings where personnel with unique interests in this field are not always present.
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