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Comprehensive Tobacco Control Initiative for Disease Management

Implement and evaluate evidence-based cessation services in HCSD hospitals to improve disease outcomes. Key factors: Population-based perspective, evidence-driven approach, physician advice, media success, increased cost restrictions on smoking. Implementation planning includes conducting needs assessment, setting goals, developing evaluation plans, and identifying training needs. Program indicators aim to increase patient referrals for cessation treatment and follow-up contacts for quit attempts. Improvement strategies involve increasing attendance rates, physician support, and patient engagement. Future directions include hiring and training field staff, establishing a standardized database, and creating a formal indicator system to enhance tobacco control efforts.

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Comprehensive Tobacco Control Initiative for Disease Management

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  1. TOBACCO CONTROL INITIATIVE HCSD Disease Management Program Quarterly Meeting April 26, 2005 Sarah Moody Thomas, PhD Statewide Clinical Lead

  2. Goal: to implement and evaluate evidence-based cessation services in HCSD hospitals.

  3. HCSD Disease Management Program Coordination of resources across the healthcare delivery system to improve disease outcomes.

  4. Three Critical Factors for Tobacco Control Program Success • Use a population-based perspective and data • Recognize tobacco use as key health indicator • Know needs of population • Be evidence-driven • Focus on needs of population • Be evidence-driven

  5. Population Based Smoking Cessation 2 Increased CostRestrictions on SmokingPharmacological Therapy Comprehensive Tobacco-Control Program 1 Physician AdviceMedia Successful Cessation Smoker Quit Contemplation Relapse Prevention Telephone Hotlines 3

  6. Three Critical Factors for Tobacco Control Program Success • Obtain broad organizational support • Seek support at all levels of organization • Set high goals and interim objectives • Provide support for clinical activity • Remove financial and organizational barriers to effective tobacco treatment • Rigorously evaluate • Integrate tobacco control program into • Quality Improvement • Disease Management • Guideline projects

  7. IMPLEMENTATION PLANNINGTHE 12 STEPS Healthcare Effectiveness Meeting, 4/03

  8. Implementation Planning - 12 Steps  Conduct Needs Assessment - Shared  Identify IT needs - Shared  Develop goals and objectives - Shared  Identify target population – Facility specific

  9. Implementation Planning - 12 Steps  Design program evaluation - Shared • Develop marketing and communication plan – Shared & Facility-specific  Assess pharmacy options – Facility specific  Program roll-out – Facility specific

  10. Implementation Planning – 12 Steps  Determine staff and operational needs – Shared & Facility specific  Identify training needs – Facility specific  Establish timeline – Shared & Facility specific  Identify pilot sites – Facility specific

  11. INDICATORS

  12. Program Indicators • Increase to 75%, the proportion of clinics (physicians) that refer patients to evidence-based cessation treatment. • Increase to 100%, the proportion of patients who are asked about tobacco use status and documented at every visit.

  13. Program Indicators • Increase to 90%, the proportion of patients who are advised to quit. • Increase to 75%, the proportion of patients using tobacco and willing to make a quit attempt who are assisted (i.e. behavioral counseling and pharmacotherapy).

  14. Program Indicators • Increase to 50%, the proportion of patients using tobacco who attempt to quit (i.e. receive an appointment for cessation classes), for whom follow-up contact is arranged. • Increase to 10%* annually the number of smokers who are trying to quit, who stay abstinent for a full year or longer. *National quit rate is 6 %

  15. Breakout SessionFacility Representation • Bogalusa Medical Center • Chabert Medical Center • Earl K. Long Medical Center • Huey P. Long Medical Center • Lallie Kemp Regional Medical Center • Medical Center of Louisiana • University Medical Center • W. O. Moss Medical Center

  16. Improvement StrategiesBreakout Session Feedback • Increase attendance rates • Consider alternate scheduling processes • Offer multiple times • Increase physician support/compliance • Engage nursing staff (nurse-friendly strategies) • Continue/increase TCI Staff presence • Prompts • Posters • Chart indicators identifying tobacco users • Provide patient-related feedback (cessation updates)

  17. Improvement StrategiesBreakout Session Feedback • Increase the proportion of patients advised to quit by their provider • Exit surveys • Peer review • Marketing • Hospital Newsletters • Program Awareness • Available classes • Staff/Clinic recognition • Special events • Examine hospital policies • Market employee cessation

  18. Future Directions2005 Objectives • Complete hiring and training of field staff • Establish standardized database • Create a formal indicator system • Standardize data sources • Resource Scheduling • Abstraction Sources • Clinic forms revision • Establish HCSD website presence

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