Tom: There are five key steps doctors can take
to make screening and counseling routine.
First, establish a system, a systematic way
to screen/counsel patients because unless you
have a plan you're not going to be able to follow it.
Second, involve the entire healthcare team.
Doctors are busy, and it doesn't have to be the physician
who provides the counseling.
Other individuals on the healthcare team can do it
and the screening can be done through electronic tools,
through medical histories, through lots of other ways.
It doesn't have to take the doctors time.
Third, make sure that the screening is done routinely
on all adult patients.
Fourth, make sure that patients who do screen positive
Brief intervention is simple but it's structured
and there needs to be a way to make sure that it gets
applied and done regularly and effectively with
each patient who screens positive.
And fifth, make sure that you're testing,
assessing and evaluating how that program is going.
Pilot it, see how it's working,
see how you can tweak it to make it work better.
You know that's really the bottom line for all
of medical practice.
Whatever we start to do we need to assess whether it's working.
We need to not be afraid to rigorously evaluate
are we actually screening well.
Are we providing that intervention effectively?
Can we get a feedback loop so that we
can assess how it's going and improve it.
No project anyone has ever done
has been perfect forever.
So, unless we have a good feedback loop,
unless we have data systems to assess and improve,
we won't be able to stay on track.
Those are the five key steps.
First, establish a systematic plan.
Second, involve the entire team.
Third, make sure all patients get screened.
Fourth, make sure those who screen positive
get effectively counseled,
and fifth and finally make sure you have a data system
in place to assess and improve over time.
With those five steps you can help really hundreds
of your patients to not only assess their alcohol use
but improve it, and that will improve not only
their alcohol related disorders but all of their health.
Director of the U.S. Centers for Disease Control and Prevention