2nd Annual Partners Tobacco Cessation SkillsTraining Retreat

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2nd AnnualPartners Tobacco Cessation
Skills-Training Retreat

• September 7th, 2006

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Goals for Today

• Meet and reconnect with colleagues
• Celebrate our accomplishments of FY06
• Identify and plan to meet challenges for FY07
• Learn something new
• Community, state resources
• Integrating tobacco treatment into electronic
  systems
• Counseling skills motivational interviewing,
  stress mgmt

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WELCOMETobacco cessation in context of
Signature Initiatives

• Elizabeth Mort, MD
• Team Leader Signature Initiative III
• Uniform High Quality

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Thanks for your contributions

• You have made the case for promoting tobacco
  cessation programs
• You have successfully advocated for resources
• You have brought the thought leaders together
• You have designed cutting edge tools and
  resources
• You have collaborated with academic researchers
  to support the advancement of the science and
  health service delivery

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National Hospital Quality Measures (JCAHO /
Medicare Core Measures )

• Among patients who
• Smoked in past 12 months AND
• Diagnosis MI or CHF or pneumonia
• Does chart document that smoking cessation
  advice, counseling or medication was offered
  during hospital stay?

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Scores are not really moving
8/13 (62) of Q106 smoking scores are red
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Performance on P4P Measures
Draft Q106 data shown target misses on many
smoking metrics
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High Reliability Design
Tier 1 Standardization Prevent initial failure
using intent and standardization. (10-1 and
10-2 concepts) Gets the process to 80 success
rate Tier 2 Redundancy function Identify
failure and mitigate (10-2 concepts) Used when
something slips through the cracks (the other
20) Gets the process to 95 success rate Tier
3 Critical failure mode Identify critical
failures and redesign Used when a failure happens
even with Tier 1 and Tier 2 in place (the last 5)
2 in 10 failures
Set Up
Definitions 10-1 80 or 90 success rate (1 or
2 failures in 10) This level is when no shared,
articulated process exists. For example, if you
ask 5 front line people to describe the process
they will not provide the same answer. 10-2 95
success rate (5 or fewer failures in 100) At
this level there is generally a shared common
process
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FY07 Tobacco Treatment Goalsfrom the Signature
Initiative III leadership

• Achieve 90th -ile performance on Smoking
  Cessation National Hospital Quality Measures
• Achieve P4P targets
• Develop a population-based strategy to improving
  treatment of tobacco use across Partners system
  (inpatient and outpatient)