Photo courtesy of Teresa Conklin
Seton Hall University’s Department of Health Services has been given the 2015 Bernard A. Kushner Innovations in Quality Improvement Award by the Accreditation Association of Ambulatory Health Care Institute for its work in alcohol abuse education and prevention and its commitment to improving students’ lives.
SOUTH ORANGE, NJ — Seton Hall University’s Department of Health Services has been recognized with the 2015 Bernard A. Kushner Innovations in Quality Improvement Award for its work in alcohol abuse education and prevention and its commitment to improving students’ lives.
The award, given by the Accreditation Association of Ambulatory Health Care Institute, is named after Bernard A. Kershner, a leader in ambulatory health care and a past chairman of the Accreditation Association of Ambulatory Health Care Institute Board of Trustees.
Organizations were asked to submit descriptions of completed quality improvement studies and their resulting interventions, which led to positive outcomes. Two winners were chosen among the submissions to be honored for their excellent quality improvement studies.
Seton Hall University Health Services, the primary care winner, was recognized for implementing a comprehensive improvement study to refine current alcohol screening methods and interventions in collegiate health centers.
In an email, Naomi Kuznets, vice president and senior director of the AAAHC Institute for Quality Improvement, told the News-Record about the criteria for the award, describing what stood out about Seton Hall’s submission.
“An expert panel composed of health care professionals and performance measurement experts reviews the goal of the applicant’s initiative, interventions, the data collected to show progress toward that goal and the overall outcomes from the initiative,” Kuznets said. “Our panel also looks for innovation, the teamwork involved and whether the program can be used as a model for other organizations.”
Seton Hall’s submission focused on alcohol abuse and education in the college setting, a demographic that is surprisingly unaware of both the short- and long-term effects alcohol can have.
“Seton Hall University Student Health Services developed a program that addressed an important public health problem, alcohol misuse on a college campus, did an excellent job implementing activities to increase detection and decrease misuse, and then demonstrated with ‘hard’ data that the program was successful,” Kuznets continued. “The Seton Hall program could serve as a model for universities across the country.”
The Seton Hall study featured two components: extensive staff training on alcohol education and the inclusion of a screening tool into the routine health questionnaire students completed when visiting Health Services.
First, Health Services staff underwent extensive training on alcohol misuse among students. This taught clinicians
to adequately provide information to
students who were at risk for hazardous drinking behaviors in order to raise awareness and offer beneficiary strategies for reducing alcohol misuse. This training program was a collaborative effort with the Counseling and Psychological Services.
Secondly, Health Services staff integrated alcohol screenings into electronic health records to identify and provide support to students. Each student was asked to fill out an electronic form at a private kiosk before their appointment.
The surveys consisted of visual references of standard drinks, and emphasized confidentiality to enhance the honesty and accuracy of answers. With the students’ permission, Health Services staff then offered feedback to “at risk” students about the student’s drinking patterns in relation to healthy living. Counseling and Psychological Services then offered brief interventions that combined motivational interviewing and personalized normative feedback.
Teresa Conklin, a Health Services nurse, spoke about the department’s focus on alcohol abuse as the subject for their study in a recent phone interview with the News-Record.
“Seton Hall’s Health Services is accredited by the AAAHC and part of the program is meeting four standards and being surveyed every three years where possible risks are reviewed and we can see if there are any areas that we can improve and deliver better health care,” Conklin said. “Health care is constantly changing and they recommend that alcohol training be integrated into primary care, and we realized that we didn’t have a formal tool for that.”
So the Health Services Department set out to change that, adding a three-question screening tool to the health screening that each student filled out, electronically and privately, at a kiosk inside the Health Services Center.
If results indicated that a student screened positive for alcohol abuse concerns, the staff at the Health Services Center would ask if the student were open to more education about alcohol abuse and, when necessary, provide a referral for additional counseling services.
“I think a lot of people don’t know what heavy or moderate drinking is and this allows us to have a conversation with them,” Conklin said. “We can educate about what is healthy and what isn’t. We realize that they aren’t going to abstain, but at least they have the knowledge.”
Dr. Jude Uy, formerly of Seton Hall’s Counseling and Psychological Services, echoed the same sentiment about the need to educate students and also provide them information about resources that exist right on Seton Hall’s campus.
“Oftentimes, there is a belief that drinking is normal and expected, but the truth is that majority of students do not drink excessively,” Uy said in a recent phone interview with the News-Record. “For my part with the study, we talked a lot about the intervention that we would have afterward, particularly motivational interviewing.”
As with any life-changing intervention, a willingness to learn and take steps to change is the most important factor in the process, and per Uy, college students learning about the effects alcohol can have on them is no different.
“The motivational interviewing serves to help move them from precontemplation to understanding effects of alcohol on their bodies and their academic performance,” he said. “But you don’t enter into discussions if the patient/student isn’t interested and we have to ask if it’s OK to share information. The goal was to plant the seed for people to get an idea and think about it and revisit it later on. We’re not forcing information on anyone and we also gave a referral if they wanted counseling.”
The results of the study showed a significant improvement in the way alcohol education was received and delivered on campus. The screening rate for alcohol misuse increased to 75 percent at Seton Hall University Health Services after the program was administered. Within two weeks of implementation, 55 students were categorized as “binge drinkers” and 50 students were proposed a brief intervention.
A student survey revealed that 43 percent of students reported decreased alcohol use and 29 percent reported that the program influenced their decision about alcohol. In addition, at the conclusion of this program, informational materials related to alcohol consumption were made readily accessible to students through both community and campus resources.
From a quality-improvement perspective, Conklin also noted the new screening tool will help Health Services better gauge what meets the needs of students.
“This gave us a chance to do something psychometrically and gave us a sound formal tool that we can use,” she said. “It also helps us to document more accurately, because the screening is embedded in the electronic health record.”
The need for performance measures to gauge the success of programs such as the one being implemented at Seton Hall are also important for showing strengths and weaknesses in service delivery.
“Performance measures gauge how effective and efficient we are at accomplishing the best health care outcomes for the patient and where we have opportunities to improve health care,” Kuznets said. “Taking advantage of these opportunities — continuing to find ways to improve health care for patients — is a goal of all health care providers. The aim is always to provide the best care to help people live healthier, happier lives.”