Alcohol Misuse Screening: Enhancing Rates by Integrating Information Technology Solutions in a Quality Improvement Project

BACKGROUND: Alcohol misuse among teenagers poses serious public health risks. The screening, brief intervention, and referral to treatment approach aims to prevent, discourage, and treat substance use issues. Despite recommendations to screen all trauma admissions of patients older than 12 years, implementation at trauma centers is often inconsistent and inefficient. OBJECTIVE: This study aims to assess the impact of integrating targeted information technology (IT) solutions into electronic health record (EHR) systems on improving the consistency and effectiveness of alcohol misuse screening in admitted patients over the age of 12 years. METHODS: This study is a single-center, pre-post intervention quality improvement project carried out at an urban academic Level I pediatric trauma center in the Southeastern United States. Data were retrospectively gathered from April 2022 to September 2025. The intervention involved surveying peer centers, mandating EHR-based alcohol screening, integrating blood ethanol testing, automating alerts for social workers on positive screens, and providing staff education with real-time feedback. RESULTS: A total of 1126 pediatric injured patients met the inclusion criteria. The preintervention group consisted of 600 patients spanning from April 2022 to February 2024, while the postintervention group comprised 526 patients from March 2024 to September 2025. The rate of alcohol misuse screenings increased from 65.67% preintervention to 89.54% postintervention. CONCLUSION: Adopting a multicomponent interventional strategy, along with integrated order selections for specific admission sets, can establish a consistent workflow that sustained compliance over a 19-month period. However, extended follow-up across various institutions will be necessary to verify its long-term sustainability.