Objective:

To evaluate a coordinated quality improvement initiative aimed at identifying and offering treatment to patients with unhealthy alcohol use in a hospital setting.

Approach:

• Screening Method: All patients admitted to one hospital between September 2022 and 2024 were screened for unhealthy alcohol use using the AUDIT-PC questionnaire.
• Intervention Strategy: Patients were stratified based on risk level to receive scaled interventions, including behavioral counseling and medication for AUD.
• Implementation Team: A multidisciplinary program involving nurses, substance use navigators, and medical professionals was developed to facilitate screening and treatment.

Key Findings:

• Of nearly 28,000 admitted patients, 18,146 were screened for unhealthy alcohol use, with 489 (2%) identified as high-risk.
• Among high-risk patients, 231 (47%) were initiated on medication for AUD prior to discharge.
• Screening was conducted for all admitted patients, not limited to those with alcohol-related complications.

Interpretation:

The study highlights practical challenges in implementing widespread screening and treatment programs for unhealthy alcohol use in hospital settings.

Limitations:

• Screening all inpatients may not be practical at scale due to competing priorities in acute care.
• The study was not designed to evaluate patient outcomes, and follow-up data were limited, leading to potential attrition bias.

Conclusion:

The study highlights the importance of systematic screening and treatment for unhealthy alcohol use in hospitals.