As part of Medicare’s National Acute Myocardial Infarction (AMI) project, the NC state Peer Review Organization partnered with acute care hospitals and the state pharmacy association to increase smoking cessation rates among heart attack patients. AMI remains a major cause of morbidity and mortality among NC Medicare beneficiaries, accounting for > 13,000 hospitalizations in 1998. Smoking cessation counseling is one of seven quality indicators targeted to improve among heart attack patients. Despite the fact that the majority of smokers want to quit, statewide baseline measurements revealed only 35% of heart attack patients who smoke were counseled to quit. Because the target audience and setting provide ideal conditions to begin tobacco use treatment, a training program for health care professionals was developed to assist hospitals in improving their rates. A multifaceted approach to ensure all patients are assisted in cessation efforts was emphasized. The 2000 Public Health Service Practice Guidelines guided the program and behavioral, pharmacological and systems-level approaches to tobacco treatment were encouraged. Physician and institutional barriers were also addressed. Health education and quality improvement theories were used in project development. Interventions included a comprehensive inpatient toolkit for hospital staff, a training program on the guidelines, patient and provider education materials and the provision of self-monitoring tools. Educational materials included reminder systems, prompts for physicians to discuss cessation, documentation labels and pre-packaged patient education kits. Post-test evaluations (N=38) measured individual and system-level changes among participating hospitals. The session will focus on program planning, intervention tools, lessons learned and evaluation data.
Learning Objectives: 1. Identify recommended strategies for improving the delivery of inpatient smoking cessation counseling. 2. Describe the planning process, partnership strategies and lessons learned from a statewide healthcare quality improvement project aimed at improving tobacco use treatment.
Keywords: Hospitals, Health Care Quality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.