(1112) Impact of a Statewide Quality Collaborative on Screening and Referral for Perinatal Substance Use Disorders

To evaluate the effectiveness of a statewide quality improvement (QI) collaborative for increasing the adoption of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in pregnant persons with substance use disorder (SUD).

Study Design:

We evaluated the impact of a statewide perinatal collaborative aimed at increasing the adoption of SBIRT through implementation of the Alliance for Innovation in Maternal Health (AIM) patient safety bundle on caring for pregnant and postpartum people with substance use disorder (SUD). We evaluated changes in average rates of SBIRT and bundle implementation through hospital-level chart reviews, aggregate data submission, structure measure surveys, and engagement metrics over a 2-year period from January 2022 to December 2023. QI metrics for the collaborative, including process, outcome and structure measures were defined in alignment with the AIM bundle. Hospitals with data from the initial (Jan 1 - Mar 31, 2022) and final (Oct 1 – Dec 31, 2023) phase of the project were included. All study variables were coded as nominal data and analyzed using Chi-square tests; statistical significance was set at p<span style="mso-bidi-font-family: 'Times New Roman';">≤.05.

Results:

Ten hospitals met criteria for inclusion in this QI initiative review and were evaluated for SBIRT adoption before and after implementation of the patient safety bundle. There were no significant differences among sites with regards to geographic location or obstetric bed size. Evaluation of screening patterns demonstrated a significant increase in rates of SUD screening (59.4% to 90.1%, p< .001) after bundle implementation (Figures 1 and 2). Rates of referral for SUD treatment (77.8% to 83.8%, p =.21) and counseling about medications for opioid use disorder (MOUD) (84.5% to 89%, p=.31) were also noted to increase over the 2-year implementation period, however – this did not reach statistical significance (Figure 1).

Conclusion:

Adoption of a structured patient safety bundle implemented through a statewide quality collaborative has the potential to increase screening and timely referrals for enhancing care delivery in patients with perinatal SUD.