consumer experiences of the canberra hospital smoke free … · 2018-09-30 · hcca report july...

Health Care Consumers’ Association ACT INC 114 Maitland Street, HACKETT ACT 2602 Phone: 02 6230 7800 Fax: 02 6230 7833 Email: [email protected] ABN: 59 698 548 902 hcca.org.au | hcca-act.blogspot.com | facebook.com/HCCA.ACT | @HealthCanberra

Consumer Experiences of The Canberra Hospital Smoke Free Environment

Submitted 10 July 2015

Contact

Darlene Cox

Executive Director

[email protected]

02 6230 7800

Author

Yelin Hung

Multicultural Liaison Officer

[email protected]

mailto:[email protected]

http://www.hcca.org.au/

http://hcca-act.blogspot.com/

http://www.facebook.com/HCCA.ACT

http://twitter.com/healthcanberra



HCCA Report July 2015 Consumer Experiences of The Canberra Hospital

Smoke Free Environment

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Acknowledgements

HCCA would like to thank the people who participated in this survey. We greatly appreciate

the generous donation of their time to contribute to this survey.



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Background and Introduction

The Health Care Consumers’ Association (HCCA) of the ACT the peak consumer

advocacy organisation in the Canberra region. HCCA provides a voice for consumers on local

health issues and now provides opportunities for health care consumers to participate in all

levels of health service planning, policy development and decision making.

HCCA involves consumers through:

consumer representation

consumer and community consultations

training in health rights and navigating the health system

community forums

information sessions about health services

advocating for issues of concern to consumers

works for the improvement of quality and safety of health services

In September 2014 the Canberra Hospital campus became a completely smoke free

environment. This means that the Hospital does not have any designated smoking areas on

the hospital campus. The primary aim of this initiative was to foster a healthy environment

that promotes a healthy lifestyle for patients, visitors, staff and contractors. An outcome of

the initiative was to support people who smoke to manage their nicotine use and if willing, be

supported to quit.

ACT Health is evaluating the initiative to gain further consumer feedback. In light of this,

HCCA carried out a consumer survey looking for feedback and experiences from recent visits

to the Canberra Hospital campus since the implementation of the free smoke environment

policy.

In this survey, 63 responses were received. The results of the survey show a snapshot of

consumer perspective and experiences with different aspects of the smoke free initiative.

This data can be used to look specifically at how to ensure staff, consumers and carers are

supported while this policy is in place.

Analysis seen in this report captures the main issues as raised by participants in the survey,

however further examination of the quotes included would be valuable when looking to

evaluate the effectiveness of the Smoke Free initiative. This information should policy makers

in shaping future draft policy around smoking on ACT Health Campuses and supporting the

ACT community when implementing these changes.



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Key findings

The consumer experience of the Canberra Hospital Smoke Free implementation

project shows consumers have a broad range of views on this policy

A great number of people are seen smoking around Canberra Hospital

Most people are seen smoking at the entrance to the Emergency Department and

near Yamba Drive.

Communication about the policy has reach almost all consumers surveyed.

There is little awareness about support available to impatients such as nicotine

replacement therapy.

There was broad support for the reintroduction of a designated smoking area

Many consumers advocated for an exemption for mental health patients.

Many consumers felt staff were a poor example for the policy particularly when

smoking in their uniforms.

Data analysis

Q1: Did you see signs at the Canberra Hospital about it being smoke free?

96% of responses have seen smoke free signage at the Canberra hospital.



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Q2: Where were these signs and information located at the Canberra Hospital?

Q3: How helpful was the smoke free campus information?

It was interesting to see that 84% of the respondents have seen signs on pathways while only 8% saw a card on their meal tray. One participant commented that they saw the policy advertised on video that was played in a reception area at the Canberra Hospital.

The weighted average or mean for this questions was a rating of 3.2. This indicates that mean rating was that the information was somewhat helpful on a scale from 1 to 5. Few responses indicated a two or lower.



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Q4: Did you know that if people who are smokers are admitted to the Canberra Hospital they

have the option to receive Nicotine Replacement Therapy?

Q6: Did you receive advice on how to access Nicotine Replacement Therapy as an inpatient?

This graph shows that 54% of participants were not aware of the option to receive Nicotine Replacement Therapy. Just under half of those surveyed (46%) indicated they were aware of this form of support.

The majority of people who completed the survey did not have recent experience as an inpatient at the Canberra Hospital (90%) The 10 % who indicated they had recent experience as an inpatient specified that 100% of them did not received the information about the option to receive Nicotine Replacement Therapy to support them while on the smoke free campus..



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Q7: Do you see people smoking around the Canberra Hospital?

A staggering 88% of respondents said they have seen people smoking around the hospital grounds.



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Q8: If yes, were they

When asked who the participants saw smoking on campus the highest proportion identified were hospital staff (73%) followed by patients (69%) and vistors (65%). Fewer people saw contractors smoking on campus (46%). 23% of the time people were not able to identify who the person smoking was.



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Q10: Where do you see people smoking around Canberra Hospital?

The most common area people were smoking was Yamba Drive (75%) followed by at the bus stops (48%) the car park (39%) and the area near the primary school (33%). Respondents who indicated they had seen people smoking elsewhere (28%), 53% indicated they had seen people smoking outside of the emergency department. Roughly 18% saw people smoking on Palmer Street near National Capital Private Hospital and the remaining 17% of people who indicated other saw people in varied places across the campus like pathways, courtyards, carparks and the back of building seven.



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Q11: If you are a smoker, where do you go to smoke when you visit the Canberra Hospital

campus?

The majority of those surveyed were not active smokers (80%). Of the remaining 20% of participants who indicated they smoked, 8% responded that they smoke in the car park, 4% will wait until they leave hospital grounds, 4% of people smoked on Yamba Drive, and 2% near the bus stop. The 2% of people who indicated included one result for Yamba drive, one person who smokes in their car and someone who said they smoked anywhere they could.



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Q12: Have you been or have you seen anyone at the Canberra Hospital being approached by

security officers because you or someone else were smoking at the hospital?

Interestingly 85% of participants have not seen anyone at the Canberra Hospital being approached by security officers because of smoking at the hospital. Only 15% had seen a security guard approach someone who was smoking.



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Q13: If yes, please select your experience from these options (tick as many as applicable)

Key Issues

There were various issues concerning consumers in regards to the implementation of the

Smoke Free Environment Project. Several issues can be identified when looking at the

open/ended questions of the survey such as Are there any other issues you would like to

raise about the Canberra Hospital being smoke free? And; How could ACT Health support

consumers to maintain a smoke free environment into the future?. These include: Mental

Health, Policy/ Enforcement, Stress, Communication/Education, Staff Training, and

Designated Smoking Area. We will discuss each area below and provide brief analysis. A

number of quotes are provided as a means of capturing and exploring prevalent views

expressed, and allowing for further analysis by those accessing this summary report.

Predominantly 50% people stated that they saw security provide information about the Canberra Hospital being smoke free;38% of participants felt that security officers were friendly, 13% stated that security officers made people feel uncomfortable. 13% of people also indicated that they were informed of Nicotine replacement therapy. 13 % of people said they were informed of the consequences of smoking on campus.



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Mental Health

According to participants’, many felt that mental illness can be exacerbated by the pressure

of withdrawal from smoking particularly people seeking ongoing care at the Adult Mental

Health Unit. Below are comments from consumers around this impact of the new policy:

“It is hard enough to have a mental breakdown and try to recover without the added

pressure of withdrawal from cigarettes in this process. AMHU has sufficient outside space

which is away from the general public. I am a MH worker and its hard enough for these

people without added stress.”

“The mental health unit MUST BE EXEMPT! People on treatment orders are not offered

NRT and are gold they can't have a cigarette (or escorted to a smoking area) because they

are on a treatment order! This is dangerous to staff and patients!”

“I think the rule should not apply to people in the adult mental health unit”.

“I support the smoke free initiative, however I also support exemptions for in-patient MH

and AOD consumers.”

“As a support worker for clients with mental health concerns, I cannot endorse the ban on

smoking in the adult mental health unit. It is counter productive to effective engagement and

treatment, regardless of the longer term health concerns. I do support a broader ban on the

campus however.”

This suggests a need to provide an exception to mental health consumers and provide

adequate outdoor areas for those who do smoke.

Policy/Enforcement

A number of comments suggesting that this new implementation of smoke free policy

should be welcomed at the Canberra Hospital. But it is important that measures are

implemented in order to improve the health of all members of our community. There were

several comments about the need to further enforce the ban through higher fines and

involving the community in a passive surveillance policy to help enforce this policy. Others

discussed they help to was impossible to inforce or not right to given that smoking is legal.

“I think it's great”.

“difficult to police and enforce”

“I think it's an excellent initiative but could remain hard to enforce”

“I don't think it is being enforced as well as it should be. There are people smoking

everywhere and it’s disgusting! I saw mean and women smoking outside the women and

children hospital. With newborns in tow!!! I recon if you’re going to ban smoking BAN it!

zero tolerance! don't just do it half arsed. $500 a pop that'll get the message through!”

“You can't make people stop. The effect of the ban has made smokers congregate on

Yamba drive, and presumably other areas on the boundaries of the campus. It's a terrible



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look when driving past / to the hospital - if people are smoking that heavily on the edges,

makes you wonder what's happening at the front doors.”

“It may be smoke free but people are certainly paying no attention to this”

“Who enforces this policy?”

“I have encountered people smoking at the TCH and often there's not a security person

around to inform. As a non smoker I find cigarette smoke causes breathing problems. While

the smoke free initiative is a very good start more enforcement is required”

“A good initiative but very difficult to 'police'. Will take time and need to rely on consumers,

community to enforce as well as security.”

Stress

Several consumers mentioned the high levels of stress being a patient or a carer at the

hospital is and the feeling that banning smoking adds to this stress. Many felt the complete

ban was inappropriate given that smoking is legal and many smoke more during stressful

times.

“It doesn't work. Stressful situations happen at the hospital and in some cases people turn

to smoking to de-stress.”

“It is still a concern about the areas people can go to smoke, families and friends have to

deal with great stress and there is no direction on where to go.”

“show us where people can smoke. I think it's important to be a smoke free campus, but

people who have an addiction to smoking should not be so ostracised.”

Communication/Education/Staff Training

Participants stressed that the communication plan fails to deliver important information

about support that is available to the community. Other discussed the need for better

education and training for staff to happen in order help enforce and implement the policy.

Staff setting an example was also mentioned a number of times particularly around staff in

uniforms on Yamba Drive smoking..

‘Either the smoking ban is enforceable in some way, with (a) information, (b) incentives, and

(c) sanction/penalty, or there's no point having it. Staff role modelling would be an important

contribution. TCH staff find ways and places to smoke, and if staff are doing it then why

shouldn't consumers’

“Maybe staff could be educated as to how to approach smokers. Sometimes they can be

intimidating”

“Please continue to be smoke free and assist health care staff who smoke to stop smoking

and be an example.”

“Encourage NOT coerce! Educate NOT reprimand!”



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‘Providing better information to consumers, visitors and patients. There is a lack of

information and support.’

‘It doesn't look very good when you are driving on Yamba Drive and see all of the staff (in

unifrom) sitting on milk crates on the footpath smoking. Perhaps a smal smoking area could

be created off-campus that is not in view of the public.’

‘It is a very poor look to have the main access to the Canberra Hospital being occupied by

people smoking, especially when they are in staff uniforms. And the milk crates are

unsightly. Something needs to be done about this. If it is smoke free then there needs to be

some enforcement.’

Designated Smoking Area

Most of the participants advocated for the urgent need for a designated smoking area to be

provided. Whilst many supported a broad ban on most smoking on campus, many felt that a

small area, out of view should be provided.

“I feel that there needs to be a small designated area for staff, visitors and patients - away

from heavily populated areas where they can smoke.”

“As a smoker, I'd be happy to have a designated area away from pathways that I could light

up”.

“I think it is awful that people need to smoke on Yamba drive outside a health facility. There

needs to be a dedicated smoking area that is not visible to the general public......smoking is

not illegal even if it is bad for your health!!”

“You can't make people stop. The effect of the ban has made smokers congregate on

Yamba drive, and presumably other areas on the boundaries of the campus. It's a terrible

look when driving past / to the hospital - if people are smoking that heavily on the edges,

makes you wonder what's happening at the front doors.”

“There really needs to be designated smoking areas away from public thoroughfares and

spread across the hospital. People won't stop smoking unless there's consequences, such

as a fine. I've asked people to please move away from the front entrance so I can go

through without getting smoke in my already diseased lungs but they get aggressive.

Friends who are smokers tell me the patches can take several days to come from

pharmacy and then enough aren't sent.”



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Recommendations

Support to staff, consumers and inpatients with Nicotine Replacement Therapy

Allow for a smoking zone/room

Better information/education to staff, consumers, visitors and patients

Help ensure staff are an example for the smoke free zones.

Stronger enforcement approaches to maintain a smoke free environment

Increase signage and support to quit

Encourage staff not to smoke in their uniforms or when wearing their work ID.

It would be strongly recommended that a larger scale survey should be undertaken

to understand staff and community attitudes.

consumer experiences of the canberra hospital smoke free … · 2018-09-30 · hcca report july...

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