Healthy Lungs Initative (HLI): A program for tobacco cessation and asthma/COPD education in a safety net hospital system

Healthcare systems oftentimes miss opportunities to integrate health education and promotion into routine patient care. Healthy Lungs Initiative (HLI) is an evidenced-based, multi-year program developed at the Cook County Health and Hospitals System (CCHHS) to provide smoking cessation counseling and asthma/COPD education in the large Cook County health system, where the impact of tobacco-related disease and asthma severity are high. A 2006 Cook County tobacco tax surplus provided funding for HLI, a collaboration with Respiratory Health Association. Since 2008, trained Lung Health Educators have provided multi-lingual smoking cessation counseling (quit plans and telephone follow-up support) and asthma/COPD self-management instruction (medication use and action plans, inhaler device training, and trigger reduction) to adult and pediatric patients in two CCHHS hospitals, associated primary care and subspecialty clinics, and in several Federally Qualified Health Centers and substance abuse facilities contributing to the safety net. Key elements of the program include: standardized educator training; defined educator areas of expertise; integration of services throughout the health system; and the use of a unique, web-based database integrated with the CCHHS electronic medical record system that supports the management and improvement of the program. To date, HLI has had over 67,000 one-on-one or group tobacco contacts with smokers and 13,000 asthma/COPD patient contacts. Staff and educator narratives provide insight into the challenges of establishing a new education-based service in a complex health system, while data show high patient-educator satisfaction and a beneficial impact on tobacco use in using this health system as a locus for health promotion.