Following up on screening result, brief intervention conversation, or referral to treatment is crucial to on-going whole health management with each patient. Brief intervention or referral to treatment conversations need to include a discussion with the patients about the need to be follow up, for what, and by whom.
The S·BI·RT process needs to include the mechanisms necessary to flag patients who require follow up but have not yet had it (perhaps they no-showed). Include a check in at their next visit. Track internal and external behavioral health referrals and seek progress reports.
Follow up is essential to your relationship with your patient and your establishment of alcohol and drug use information as a meaningful part of your healthcare relationship. You have had a conversation that a young person may have never had with anyone before about their alcohol and drug use, to not ask about it the next time you are with them is to minimize its importance, to not schedule a time to be with them to discuss it further is to minimize its importance – failure to follow up will undermine the effort of the brief intervention.
For more information, please view this Follow Up presentation put together by the NH Youth SBIRT Initiative.
Confidentiality of your brief intervention conversation with young patients may make scheduling follow up more complex – how will you code the reason for follow up visit and explain it to the parent of the youth? Telephonic follow up by behavioral health or case management staff may be an option at your site.
The follow up can be as simple as – Last time we talked you told me you were drinking with friends on the weekends. Would you mind if I asked you some follow up questions? Can you tell me about your drug and alcohol use since then?