Mile Bluff Helps Patients Quit Smoking and Chewing Tobacco
Mile Bluff Medical Center uses a systematic approach to help patients quit tobacco use. The medical center in rural Mauston is the flagship for a healthcare system that includes Hess Memorial Hospital—the only hospital in Juneau County—and five clinics in nearby communities.
Back in 2001, Mile Bluff was already a pioneer in tobacco treatment. Health Promotion Director Sue Fabian, RN, and Dr. June Lewandoski organized a committee to discuss how best to treat the leading cause of preventable death.
“We got a lot of help from UW-CTRI,” Fabian said. “And having a physician champion like Dr. Lewandoski helps. We had people from PR and QI involved, too.”
Former UW-CTRI Outreach Specialist Tricia Brein (right) provided training and technical assistance to Sue Fabian and the health-promotion staff at Mile Bluff Medical Center in Mauston.
The committee created a state-of-the-science system where nurses and medical assistants at all facilities ask each patient about tobacco use, advise smokers to quit and document it as a vital sign. Doctors, physician assistants and nurse practitioners reaffirm the importance of quitting smoking and relate it to the patient’s medical status.
If the patient is ready to quit within a month, he or she is given a packet of materials--including information on the Wisconsin Tobacco Quit Line, medications and quit tips. Then nurses and MAs refer the patient to the Mile Bluff Health Promotion Department. The health-promotion team calls each patient once a week to provide telephone coaching based on the Clinical Practice Guideline.
“Our key ingredient is that we show them we care,” Fabian said. “We are supported 100 percent by the medical staff—they don’t have much time and they’re very appreciative. I think it’s excellent.” She said nurses and medical assistants are busy, too, but they can certainly run through the 5 A’s—Ask, Advise, Assess, Assist and Arrange—then refer to the health promotion department for follow-up. Staff members also offer the Fax to Quit Program for patients who prefer to have the Wisconsin Tobacco Quit Line initiate the first phone call.
“What has really helped is finding the people who really want to quit,” Fabian said. While some providers prescribe medications to help patients quit smoking, more often it’s Fabian who connects interested patients with pharmacotherapies. “They don’t need to have another visit for that.”
The system’s outpatient clinics are the primary referral source to the Health Promotion Department. But Fabian said they also get patients from other sources like the hospital, childbirth-education program and self-referrals. The Mile Bluff telephone coaching program is free to the entire community--patients and non-patients. Mile Bluff also offers group classes for people trying to quit tobacco use for $25.
Fabian has found it takes tenacity to reach smokers by phone, and many can only be reached at night after work. But she said it’s well worth it.
“We know our program makes a difference.”