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Keywords:

  • alcohol problems;
  • brief interventions;
  • motivational enhancement

Abstract

Objectives: 1) To develop and teach a brief intervention (BI) for “hazardous and harmful” (HH) drinkers in the emergency department (ED); 2) to determine whether emergency practitioners (EPs) (faculty, residents, and physician associates) can demonstrate proficiency in the intervention; and 3) to determine whether it is feasible for EPs to perform the BI during routine clinical care. Methods: The Brief Negotiation Interview (BNI) was developed for a population of HH drinkers. EPs working in an urban, teaching hospital were trained during two-hour skills-based sessions. They were then tested for adherence to and competence with the BNI protocol using standardized patient scenarios and a checklist of critical components of the BNI. Finally, the EPs performed the BNI as part of routine ED clinical care in the context of a randomized controlled trial to test the efficacy of BI on patient outcomes. Results: The BNI was developed, modified, and finalized in a manual, based on pilot testing. Eleven training sessions with 58 EPs were conducted from March 2002 to August 2003. Ninety-one percent (53/58) of the trained EPs passed the proficiency examination; 96% passed after remediation. Two EPs left prior to remediation. Subsequently, 247 BNIs were performed by 47 EPs. The mean (± standard deviation) number of BNIs per EP was 5.28 (± 4.91; range 0–28). The mean duration of the BNI was 7.75 minutes (± 3.18; range 4–24). Conclusions: A BNI for HH drinkers can be successfully developed for EPs. EPs can demonstrate proficiency in performing the BNI in routine ED clinical practice.