Tobacco Treatment at Partners Health Care: An Update

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Tobacco Treatment at Partners Health Care An
Update

• Nancy Rigotti, MD

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PARTNERS TOBACCO TREATMENT TASKFORCE
Established February 2005 Sponsors Signature
III/CNO Jeanette Ives Erickson RN, Liz Mort,
MD Co-chairs Nancy Rigotti MD, Pat Reid Ponte
RN, DNSc Members
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The VISION An Ideal Tobacco Treatment System

• Every patient coming to PHS hospital or office
  has smoking status reliably identified and
  captured in an electronic information system.
• Every smoker seen at a PHS hospital or office is
  routinely given advice to quit, offered
  cost-effective assistance, and linked to
  appropriate community resources.
• Public private payers reimburse for counseling
  meds
• Outcomes are routinely monitored and improved.
• Care is offered proactively to the population
  (DTS)

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The Immediate CHALLENGEFix a Problem
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PARTNERS INPATIENT MODEL

• Step 1 Routine smoking status ID at admit
• in an electronic database
• Step 2 Brief care from floor staff (RN / MD)
• Provide brief advice to quit booklet DOCUMENT
• Step 3 Counseling (dedicated counselor)
• Counsel, offer medication, arrange care after d/c
• DOCUMENT
• Step 4 Post-discharge care
• Enroll in local or community counseling resource
  such as QuitWorks

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TASK FORCE RECOMMENDATIONS TO PHS HOSPITALS for
FY06

• People
• Fund existing required additional smoking
  cessation counseling positions and resources
• Systems
• Adopt a required smoking status field in an
  electronic format for inpatients and outpatients
• Establish reliable (ideally automated) systems to
  implement the inpatient model and document action

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FY06 TOBACCO TREATMENT TASKFORCE
ACCOMPLISHMENTSPeople

• NEW Smoking Counselors
• 3.3 new counselors added in FY06 (NSMC, MGH)
• 1.5 new counselors requested in FY07 (BWH)
• NEW TTS Training Annual Retreat

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FY06 TOBACCO TREATMENT TASKFORCE ACCOMPLISHMENTS
Systems

• IMPROVED Electronic Systems to ID Smokers
• NEW Partners-wide Handout for Inpatients
• NEW Tobacco Treatment Website
• NEW LMR Tobacco Module for Outpatients

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HOW ARE WE DOING?
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FY07 Tobacco Treatment Goals from 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)

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Proposed Strategy to Reach FY07 Goals

• Inpatient
• People are in place
• Focus on adapting electronic systems to reliably
  identify smokers and document actions
• e.g., redundant systems (admission AND
  discharge)
• In the short-term, use a few bandaids
• What can the Task Force do?
• Advocate for a Partners standard of smoking
  status identification in electronic systems
• Provide coordination, technical assistance to
  each hospitals tobacco team

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Proposed Strategy to reach FY07 Goals

• Outpatient
• Implement and test LMR Tobacco Module
• New
• Begin to build a registry of smokers at PHS/PCHI
• Pilot test a system to measure outcomes (quit
  rates)