measuring smokefree success beyond the hospital walls measuring smokefree success beyond the...
TRANSCRIPT
MEASURING SMOKEFREE SUCCESS BEYOND THE HOSPITAL WALLSMEASURING SMOKEFREE SUCCESS BEYOND THE HOSPITAL WALLS
Penny ThompsonSmokefree Liaison NurseTotally Smokefree ProjectHawke’s Bay DHB
Project Team
Carleine Receveur Project Manager
Kate O’Brien Train the Trainer
Suzanne Marshall Coordinator for Maternal,
Child and Youth Workstream
Rebecca Missen Coordinator for Mental Health
and Addiction Workstream
Rangi Barcham Cessation Support
David Mitchell Cessation Support
Overview
• Background of HBDHB Totally Smokefree project
• DHB Policy
• Project Approach
• Health targets
• Moving outside the hospital walls
• What we found outside the hospital walls
Where we were just over 3 years ago
• Dedicated Smoking rooms
• Policy that focused on where not to smoke
• No dedicated team to support clinical practice
Burden of Tobacco in HB
Smoking prevalence (%) by single year of age- all gender New Zealand v Hawke's Bay
0%5%
10%15%20%25%30%35%40%45%
15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 +
Age
%
New Zealand Hawke's Bay DHB
Increasing Smokefree Understanding
Policy - Purpose
“To describe the HBDHB smokefree
strategy and systems to encourage and
support smokefree lifestyles for all”.
Policy Principles
HBDHB recognises:
- Level of harm of tobacco use- Leadership- Funder and provider- Best practice- Health promotion and protection
Policy Statements
100% of patients/clients will have their smokefree status identified.
100% of patients/clients identified as smoke exposed will have appropriate smokefree interventions.
Smokefree Best Practice: ABC Smokefree Best Practice: ABC
AA is for is for askask
BB is for is for brief advicebrief advice
CC is for is for cessation cessation supportsupport
ApproachSystems First: model of organisational change
Evidence Policy Systems
Education
Patient
Roles
Intervention
ApproachSystems First: model of organisational change
• Acknowledgement harm
• Impact harm
• Evidence of Treatment
Evidence
ApproachSystems First: model of organisational change
Describes• Purpose / Vision• Principles• Scope• Strategies / policy
statements• Roles and
responsibilities• Link to other
organisation policies
Policy
ApproachSystems First: model of organisational change
• Links policy to action
• Framework for accountability
• Guides interventions and strategies
• Provides shape to work
Systems
ApproachSystems First: model of organisational change
• Clarity
• Match education to specialty
• Confidence and competence in clinical practice
Education
ApproachSystems First: model of organisational change
Roles and Responsibilities
• Supportive role for everyone identified
• Roles align to purpose
• Establishes accountability for delivering clinical best practice
Role
ApproachSystems First: model of organisational change
• Clinical best practice becomes a reality
• The ABC’s A = AskB = Brief
AdviceC = Cessation Support
Intervention
ApproachSystems First: model of organisational change
• 100% of patients/clients will have their smokefree status identified.
• 100% of patients/clients identified as smoke exposed will have appropriate smokefree interventions.
Patient
ApproachSystems First: model of organisational change
Evidence Policy Systems
Education
Patient
Roles
Intervention
Data
• Data is the “currency” of systems
• Data has two primary purposes 1. To monitor performance
2. To inform understanding and future planning
• Types of Data1. Process data
2. Outcome data
Ministry of Health Target
By June 2010 80% By June 2010 80%
By June 2011 90% By June 2011 90%
By June 2012 95% By June 2012 95%
Hospitalised smokers will be provided with advice and
help to quit
Measuring Outside the Hospital Walls
Activities outside the hospital walls
• Mental Health and Addiction
Community services
• Public health nurses
• Dental Therapists
• Diabetes Clinics
• District Nurses
HBDHB and HBPHO
Auditing Framework
Audit Process–Executive Summary–Terms of Reference
Aims and ObjectivesScope
Audit Approach–Significant Findings
Risks
–Recommendations–Table of Corrective
Actions
Findings
- Transferability
- Service Specific
- Systems Approach
- Cessation Support Services
- Performance Feedback
- Measuring Success
Acknowledgements
• David Smith and Stephanie Cowan “Systems First” framework
• Hawkes Bay PHO
Sue Taaffe and Wendy Jacques
• Hawke’s Bay District Health Board
Totally Smokefree Project Team
References • Hodge P & Binnie V. Smoking cessation and periodontal health – a
missed opportunity? Evidence-Based Dentistry (2009) 10, 18–19
• Johnson NW, Bain CA. Tobacco and oral disease. British Dental Journal Vol. 189, no. 4, pp. 200-206. 26 Aug 2000
• Ellison J, Mansell C, Hoika L, MacDougall W, Gansky S, Walsh M. Characteristics of adolescent smoking in high school students in California. Journal of Dental Hygiene, Spring, 2006
• Micheal Fiore. Chair of the US Public Health Services 2000 Smoking Cessation Clinical Practice Guidelines Panel. Author of: Treating Tobacco Use and Dependence. August, 2003
