Routine screening and related interventions significantly improve the effectiveness of emergency department detection and management of alcohol withdrawal syndrome

ObjectiveTo evaluate the effectiveness of a routine screening and triage tool for alcohol withdrawal syndrome (AWS) in improving clinical care delivery in an ED setting. MethodsIn a regional ED in Australia, a screening and triage tool for AWS was introduced to routine ED assessment for a 13 week period. Subjects were all presentations to ED aged 16 and above with relevant presenting problems during the pre-intervention phase (1 January 2015-31 December 2016) and the post-intervention phase (8 August 2016-4 November 2016). Key clinical care delivery elements related to AWS in patients presenting to ED were compared pre- and post-intervention, namely proportion of presentations: (i) meeting criteria for AWS; (ii) receiving appropriate management for AWS; and (iii) with alcohol documentation in patient notes. ResultsA total of 5.8% of total ED presentations in the post-intervention phase and 4.5% in the pre-intervention 1 year phase had relevant presenting problems. Compared to the 1 year pre-intervention phase, post-intervention showed: (i) a significant decrease in the number of presentations meeting criteria for AWS ((2) = 6.56, P = 0.01); (ii) a significant increase in appropriate management of AWS ((2) = 17.09, P < 0.001); and (iii) a significant increase in alcohol documentation in notes (chi(2) = 13.29, P < 0.001). ConclusionsDetection and appropriate management of AWS and documentation of alcohol use can be improved significantly through adoption of a brief screening and triage tool, and related interventions to increase awareness of alcohol-related problems.