Working to Create Comprehensive Tobacco-Related Policies at Hospitals in New York City and Boston

Marie P. Bresnahan, MPH1; Jenna Mandel-Ricci, MPA, MPH1; Susan Kansagra, MD, MBA1; Elizabeth Kilgore, MA1; Margaret Reid, RN, BA2; Sophia Finfer, BA2;

1Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene (DOHMH)2 Community Initiatives Bureau, Boston Public Health Commission

Creating Comprehensive Policies in Both Cities

Overall GoalSupport the development of comprehensive tobacco-free policies and employee and patient cessation services at hospitals in New York City and Boston.

RationaleAddressing tobacco use among employees: Employees who smoke account for billions in health care and

lost productivity costs; Smoke-free policies are associated with reductions in amount

smoked and an uptake in cessation services by employees; and Promoting tobacco cessation results in improved employee

health and productivity.Addressing tobacco use among patients: Promoting tobacco cessation results in improved health and

supports higher levels of patient satisfaction; Patients report that clinician’s advice to quit is an important

motivator to stopping smoking; Federal health care reform is pushing for increased preventive

health care services; and Hospitals can be reimbursed for outpatient cessation services.

American Public Health Association Annual MeetingSan Francisco, CA * October 2012

EXPECTED OUTCOMES

Strengthened policies will reduce exposure to environmental tobacco smoke in or near healthcare

settings.

Reduced employer health care costs and increased employee productivity and wellness.

Increased compliance with Joint Commission Tobacco Measures Set and alignment with federal

Meaningful Use requirements through patient screening and treatment.

Promotion and sharing of best practices among hospitals and recognition of hospital achievements.

Strengthened partnerships between healthcare facilities and health departments.

For more information, please contact: Marie P. Bresnahan, MPH; Senior Administrator, Bureau of Chronic Disease Prevention and Tobacco Control

NYC Department of Health and Mental Hygienembresnahan@health.nyc.gov

Made possible with funding from the Centers for Disease Control and Prevention

New York City Tobacco-Free Hospitals Campaign

In 2010, the NYC Health Department (DOHMH) launched the Tobacco-Free Hospitals Campaign with the of goal supporting the review and upgrade of tobacco policies and services at hospitals throughout the city.

Campaign members receive a license to a nationally recognized web-based tool, developed by NC Prevention Partners (NCPP), to assess their current tobacco policies and practices. Members also receive access to tailored reports and toolkits to guide them upgrading policies and protocols for systematically identifying and treating tobacco users.

Additionally, DOHMH is providing:

Technical assistance; Meetings with national experts; and Access to NCPP webinars, planning tools, case studies, and

sample policy language.

Results and Next Steps

New York CityHospitals are recognized for achieving standards of excellence related to policies and systems in one (Bronze Star Status), two (Silver) or three (Gold) areas: a) environment/employee, b) inpatient and, c) outpatient policies and services. Currently, 13 hospitals have joined the campaign and 6 have demonstrated excellence in Environmental and Employee policies and services.

The NYC Department of Health and Mental Hygiene will continue to recruit campaign members and support continued improvement of tobacco policies in hospitals throughout New York City.

BostonAt the start of the effort, 6 of the 10 participating hospitals allowed smoking on their campuses. Four completed the transition to smoke free. One is convening a hospital working group to initiate the process.

Two pediatric hospitals introduced tobacco screening and referral into their EHR, to identify and refer parents and guardians who smoke and BPHC is educating the hospital regarding model cessation benefits for employees.

Boston Tobacco-Free Hospitals Initiative

In 2012, the Boston Public Health Commission (BPHC) convened 10 hospitals in the Boston Tobacco Free Hospitals Initiative. Hospitals met monthly for 12 months and BPHC provided:

A pre and post organizational assessment tool, completed by each hospital to guide priorities for action and measure success;

A forum for peer to peer learning and mentorships; Access to presentations and trainings, technical assistance;

planning tools and policy language; Free nicotine replacement therapy for hospital employees; and Recognition for hospitals including extensive media coverage.

A paid facilitator convened monthly meetings, developed agendas and kept detailed notes. The facilitator maintained regular contact with each hospital to identify and address barriers to progress and to ensure that training and technical assistance was relevant to participants needs.