Project ASSERT: Description, Goals and Accomplishments

Project ASSERT is an ED program at Boston Medical Center, originally funded in 1993 as a federal demonstration grant. Six Health Promotion Advocates (HPAs), hired from the community, work collaboratively with ED professionals to screen, intervene, and facilitate access to primary care, preventive services and substance abuse treatment. In 1998, Project ASSERT became a hospital budget line item, providing services daily from 8:30am-midnight, in several languages.

The objective of Project ASSERT has been to use the ED encounter to improve the quality of care for patients who use alcohol, tobacco, and substances, and for patients with difficulties in accessing primary and preventative healthcare. By using community health workers the opportunity of the ED encounter is maximized while recognizing the time constraints of ED healthcare practitioners, overcrowding, and general resource limitations.

Since 1994 over 50,000 patients have received services. From 1999-2005, Project ASSERT provided services to 27,101 patients: 32% female; 46% Black, 16% Hispanic; 27% without primary care, 28% unable to afford medications, 61% smoked, 24% always used a seat belt, 31% with an alcohol- or drug-related injury, and 20% mildly or moderately depressed. Among the 15,786 who drank in excess of National Institute of Alcohol Abuse and Alcoholism guidelines (NIAAA, 2005) or used drugs within 30 days, 44% were placed in detox, 9% in outpatient programs, and 42% referred to NA/AA.

Moreover, 11,315 patients who screened negative for substance abuse were referred for primary care, and 42% received an array of other mental health and preventive referrals.

Since 1993 Project ASSERT has trained more than 2000 health care professionals across the nation in this model as part of the BU SPH BNI-ART Institute (Brief Negotiation & Active Referral to Treatment). Currently, the Massachusetts Department of Public Health, Bureau of Substance Abuse has funded the BNI-ART Institute to disseminate the Project ASSERT model and train providers in six ED’s throughout the state.

Here's a video about a patient whose life was turned around by contact with Project ASSERT and the ED staff: