This work was performed at the hospital, Portland, Oregon, and supported by OHSU Hospital and the OHSU Division of Pulmonary and Critical Care Medicine.
The Joint Commission Journal on Quality and Patient Safety
Background: Postdischarge follow-up is a critical step for increasing effectiveness of hospital smoking cessation treatment. A quality improvement project was undertaken at an academic medical center tobacco cessation consult service to evaluate whether a tailored message (TM) linking immediate risks of continued smoking—particularly carbon monoxide exposure— to hospital recovery would stimulate more patient interest in the hospital’s cessation treatment, including agreement to postdischarge follow-up, compared to patients receiving the usual treatment protocol with a standard message (SM) regarding more general health benefits of abstinence. Methods: Data from 697 smokers ordered/referred for smoking cessation treatment in 2013 who received either the SM (January–April; n = 323) or the TM (April–November; n = 374) were analyzed. Results: Multivariate regression analysis showed that the TM was associated with significantly greater agreement for follow- up (odds ratio [OR] = 10.83, 95% confidence interval [CI] = 3.66–32.04, p < 0.0001) than the SM. Those patients who received the TM were more willing to try to remain abstinent postdischarge (willingness score = 10, p = 0.0052) and engaged in longer consults (consult time > 10 minutes, p = 0.0075) than SM patients. TM patients also self-reported a higher continuous abstinence rate (OR = 2.07, 95% CI = 1.17–3.66, p = 0.0130] at follow-up than SM. Conclusion: Linking risks of continued smoking, particularly carbon monoxide exposure, to hospital patients’ immediate recovery following discharge in a treatment protocol resulted in longer consult times and increased agreement to follow-up compared to the usual protocol message. The TM was integrated into the hospital tobacco cessation intervention as standard of care.
Locate the Document
Gonzales, D., Bjornson, W. G., Markin, C. J., Coleman, T. M., Favela, F., Clemons, N., ... & Lapidus, J. A. (2020). Improving Smoking Cessation Outcomes Through Tailored-Risk Patient Messages at a University Hospital Tobacco Cessation Service. The Joint Commission Journal on Quality and Patient Safety.