Below are common SBIRT workflows implemented in primary care settings and emergency departments. These workflows can be tailored to best suit the needs of clinics and hospitals.

Select a patient category:

receptionist nurse clinician
  • Given at least once a year, during any visit.
  • Identifies patients who warrant a full screen.
  • Primary care: paper or electronic form completed in  waiting area, or via patient portal online.
  • Emergency department: administered through verbal interview by nurse during triage.
  • One question screens for unhealthy alcohol use and one question screens for recreational or drug use.
  • Given to patients who answer positive on the brief screen.
  • Primary care: given by the medical assistant via paper form or verbal interview in the exam room, or completed electronically in the waiting area or patient portal.
  • Emergency department: administered by the behavioral health professional via paper form or verbal interview, before discharge.
  • The AUDIT is a full screen that assesses severity of alcohol use; the DAST is a full screen that assesses severity of recreational drug use.
  • The medical provider or behavioral health specialist scores the full screen in the exam room, or before discharge in the emergency department.
  • Brief interventions that employ principles of motivational interviewing are delivered to patients with unhealthy alcohol or drug use.
  • Referrals to specialized treatment are facilitated with  patients likely experiencing a substance use disorder and ready to accept treatment.

nurse clinician
  • The CRAFFT or S2BI are full screening tools given to patients ages 12-17 at least once a year, during any type of patient visit.
  • Primary care: given by the medical assistant via paper form, tablet, or verbal interview in the exam room, when the patient is alone.
  • Emergency department: given by the behavioral health specialist before discharge, when the patient is alone.
  • The CRAFFT and S2BI ask about frequency and consequences related to substance use, which can indicate a possible  substance use disorder.
  • The medical provider or behavioral health specialist scores the full screen in the exam room, or before discharge in the emergency department.
  • Brief interventions that employ principles of motivational interviewing are delivered to patients with unhealthy alcohol or drug use.
  • Referrals to specialized treatment are facilitated with  patients likely experiencing a substance use disorder and ready to accept treatment.

nurse clinician
  • The 5Ps screening tool is given to patients at least once during pregnancy.
  • Primary care: verbal interview administered in the exam room when the patient is alone.
  • Emergency department: verbal interview administered by a behavioral health specialist before discharge when the patient is alone.
  • The 5Ps tool screens for likely substance use during pregnancy, as well as intimate partner violence and depression.
  • The medical provider or behavioral health specialist scores the 5Ps in the exam room, or before discharge in the emergency department.
  • Brief interventions that employ principles of motivational interviewing are delivered to patients with alcohol or drug use.
  • Referrals to specialized treatment are facilitated with  patients likely experiencing a substance use disorder and ready to accept treatment.