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Project Team

MEASURING SMOKEFREE SUCCESS BEYOND THE HOSPITAL WALLS Penny Thompson Smokefree Liaison Nurse Totally Smokefree Project Hawke’s Bay DHB. Project Team. Carleine Receveur Project Manager Kate O’Brien Train the Trainer Suzanne Marshall Coordinator for Maternal, Child and Youth Workstream

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Project Team

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  1. MEASURING SMOKEFREE SUCCESS BEYOND THE HOSPITAL WALLSPenny ThompsonSmokefree Liaison NurseTotally Smokefree ProjectHawke’s Bay DHB

  2. Project Team Carleine Receveur Project Manager Kate O’Brien Train the Trainer Suzanne Marshall Coordinator for Maternal, Child and Youth Workstream Rebecca Missen Coordinator for Mental Health and Addiction Workstream Rangi Barcham Cessation Support David Mitchell Cessation Support

  3. Overview • Background of HBDHB Totally Smokefree project • DHB Policy • Project Approach • Health targets • Moving outside the hospital walls • What we found outside the hospital walls

  4. Where we were just over 3 years ago • Dedicated Smoking rooms • Policy that focused on where not to smoke • No dedicated team to support clinical practice

  5. Burden of Tobacco in HB

  6. Increasing Smokefree Understanding

  7. Policy - Purpose “To describe the HBDHB smokefree strategy and systems to encourage and support smokefree lifestyles for all”.

  8. Policy Principles HBDHB recognises: • Level of harm of tobacco use • Leadership • Funder and provider • Best practice • Health promotion and protection

  9. Policy Statements 100% of patients/clients will have their smokefree status identified. 100% of patients/clients identified as smoke exposed will have appropriate smokefree interventions.

  10. Smokefree Best Practice: ABC A is for ask B is for brief advice C is for cessation support

  11. ApproachSystems First: model of organisational change Education Policy Systems Evidence Patient Intervention Roles

  12. ApproachSystems First: model of organisational change • Acknowledgement harm • Impact harm • Evidence of Treatment Evidence

  13. ApproachSystems First: model of organisational change Describes • Purpose / Vision • Principles • Scope • Strategies / policy statements • Roles and responsibilities • Link to other organisation policies Policy

  14. ApproachSystems First: model of organisational change • Links policy to action • Framework for accountability • Guides interventions and strategies • Provides shape to work Systems

  15. ApproachSystems First: model of organisational change • Clarity • Match education to specialty • Confidence and competence in clinical practice Education

  16. ApproachSystems First: model of organisational change Roles and Responsibilities • Supportive role for everyone identified • Roles align to purpose • Establishes accountability for delivering clinical best practice Role

  17. ApproachSystems First: model of organisational change • Clinical best practice becomes a reality • The ABC’s A = Ask B = Brief Advice C = Cessation Support Intervention

  18. ApproachSystems First: model of organisational change • 100% of patients/clients will have their smokefree status identified. • 100% of patients/clients identified as smoke exposed will have appropriate smokefree interventions. Patient

  19. ApproachSystems First: model of organisational change Education Policy Systems Evidence Patient Intervention Roles

  20. Data • Data is the “currency” of systems • Data has two primary purposes 1. To monitor performance 2. To inform understanding and future planning • Types of Data • Process data • Outcome data

  21. Ministry of Health Target • By June 2010 80% • By June 2011 90% • By June 2012 95% Hospitalised smokers will be provided with advice and help to quit

  22. Measuring Outside the Hospital Walls

  23. Activities outside the hospital walls Mental Health and Addiction Community services Public health nurses Dental Therapists Diabetes Clinics District Nurses

  24. HBDHB and HBPHO

  25. Auditing Framework Audit Process Executive Summary Terms of Reference Aims and Objectives Scope Audit Approach Significant Findings Risks Recommendations Table of Corrective Actions

  26. Findings Transferability Service Specific Systems Approach Cessation Support Services Performance Feedback Measuring Success

  27. Acknowledgements • David Smith and Stephanie Cowan “Systems First” framework • Hawkes Bay PHO Sue Taaffe and Wendy Jacques • Hawke’s Bay District Health Board Totally Smokefree Project Team

  28. References • Hodge P & Binnie V. Smoking cessation and periodontal health – a missed opportunity? Evidence-Based Dentistry (2009) 10, 18–19 • Johnson NW, Bain CA. Tobacco and oral disease. British Dental Journal Vol. 189, no. 4, pp. 200-206. 26 Aug 2000 • Ellison J, Mansell C, Hoika L, MacDougall W, Gansky S, Walsh M. Characteristics of adolescent smoking in high school students in California. Journal of Dental Hygiene, Spring, 2006 • Micheal Fiore. Chair of the US Public Health Services 2000 Smoking Cessation Clinical Practice Guidelines Panel. Author of: Treating Tobacco Use and Dependence. August, 2003

  29. Questions Penny Thompson Smokefree Liaison Nurse Hawke’s Bay District Health Board penny.thompson@hawkesbaydhb.govt.nz

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