The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72151

Amy Conway, MPH, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612, (510) 987-2653, Amy.Conway@ncal.kaiperm.org

Kaiser Permanente in Northern California is an integrated health maintenance organization, which serves 3.2 million health plan members at 37 medical facilities. The Kaiser Permanente Tobacco Dependence Program has demonstrated increasing success in integrating tobacco dependence treatment into routine outpatient clinical care. As a result of our Smoking As A Vital Sign program (SVS), rates of physician advice to quit smoking have improved substantially in Northern California. In the fourth quarter of 2001, 49.5% of smokers received advice to quit at their last visit. This number increased to 55% in the fourth quarter of 2002.

The success of this program is a result of several factors. Smoking status is a routine part of the medical record. Smoking status is assessed and the health care provider is prompted to give advice to quit and referrals to smokers. Kaiser Permanente offers several smoking cessation programs to choose from. Clinic staff receive training on how to identify smokers, give advice to quit, and refer patients to smoking cessation programs.

In 2001, the Board of Directors named SVS as an organizational Quality Goal. To measure progress, the existing patient satisfaction survey was modified to ask patients if they received advice to quit. This data provides performance feedback to all medical departments. Performance is linked to funding for each medical center and physician compensation.

The long-term goal for advising smokers to quit is 65%. As we continue integrating SVS into all departments, we anticipate that advice will continue increasing and smoking prevalence will decrease.

Learning Objectives:

At the conclusion of the session, participants will be able to:
• List 5 characteristics of a successful Smoking As A Vital sign program.
• Explain how performance feedback and incentive pay can be used to motivate health care providers to advise their patients to quit smoking.
• Describe the importance of having both upper management support and grass roots support in order to increase advice to quit smoking rates.

Keywords: Smoking Cessation, Screening

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Kaiser Permanente
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.