Below are common SBIRT workflows carried out 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:

receptionistnurseclinician
  • The Brief screen is given to all adult patients age 18 or older, at least once a year.
  • Identifies adult patients who warrant a Full screen.
  • Primary care: administered by receptionist via paper form, tablet, or kiosk in the waiting area.
  • Emergency department: administered through verbal interview by nurse during triage.
  • One question screens for unhealthy alcohol use and one question screens for recreational or illicit drug use.
  • The Full screen is administered to adult patients who answer positive on the brief screen.
  • Primary care: administered by the medical assistant via paper form or verbal interview in the exam room, as part of the rooming process.
  • 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, and the DAST is a Full screen that assesses severity of non-medical drug use. Other Full screening tools approved for use by the Oregon Health Authority  are listed here.
  • The clinician or behavioral health specialist scores the Full screen in the exam room (primary care) or before discharge (emergency department).
  • Brief advice/education is given to adult patients with low-risk substance use.
  • Brief interventions employ principles of motivational interviewing, and are delivered to patients likely experiencing risky use, or a mild or moderate substance use disorder.
  • Referrals to specialized treatment are recommended to patients likely experiencing a moderate or severe substance use disorder.

nurse clinician
  • The S2BI screening tool is given to adolescent patients ages 12-17 at least once a year, during any type of patient visit.
  • Primary care: administered via paper form, tablet, or interview in the exam room when the patient is alone.
  • Emergency department: administered via interview during triage, when the patient is alone. Supplemental questions may be administered by a behavioral health professional before discharge.
  • Measures frequency of substance use in the past year, which can identify a possible mild, moderate, or severe substance use disorder.
  • Other screening tools approved by the Oregon Health Authority for use are listed here.
  • The clinician or behavioral health specialist (primary care) or triage nurse (emergency department) gives brief education and advice to adolescent patients who do not use substances or have infrequent use.
  • The clinician or behavioral health specialist delivers brief interventions to adolescent patients likely experiencing a mild or moderate substance use disorder. Brief interventions employ principles of motivational interviewing to explore a patients readiness to change.
  • Referrals to specialized treatment are delivered by the clinician or behavioral health specialist to patients likely experiencing a moderate or severe substance use disorder. Parents or trusted adults may be involved with the patient’s permission.

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 from a family member or
    partner.
  • Emergency department: verbal interview administered by a behavioral health specialist before discharge when the patient is alone from family member or partner.
  • Assesses substance use to indicate if a brief intervention or referral to specialized treatment is indicated.
  • Other screening tools approved by the Oregon Health Authority for use are listed here.
  • Primary care: delivered by the clinician or behavioral health specialist in the exam room when the patient is alone from a family member or partner.
  • Emergency department: delivered by a behavioral health specialist before discharge, when the patient is alone from a family member or partner.
  • Brief interventions are delivered when indicated on the 5Ps screening tool.
  • Referrals to specialized treatment are delivered to patients when indicated on the 5Ps screening tool. Referrals to specialized treatment are conveyed through a brief intervention.