Executive-Level Support a Big Key to Wheaton Franciscan’s Tobacco Treatment

Some tobacco-treatment champions struggle to get a meeting with upper management on how to better help patients quit tobacco use. Not Megan Anderson, an exercise physiologist and the team leader of the Smoking Cessation Task Force at Wheaton Franciscan Healthcare -- All Saints, which includes two hospitals and several medical group physician offices in Racine.

“Physician support has been unreal,” Anderson said.

That includes Chief of Staff Dr. Nicholas Omdahl, a pulmonologist who’s a physician advocate for the task force. “I think tobacco treatment is critical,” Dr. Omdahl said, “because of the large number of patients I see with end-organ effects—emphysema, lung cancer and asthma.”

Dr. Omdahl has helped bring in speakers on tobacco. Concerned physicians, including the medical director of the Wheaton Franciscan Healthcare – All Saints Cardiovascular Institute, have proactively contacted Anderson about bolstering the stop-smoking program.

Wheaton Franciscan Healthcare – All Saints Chief of Staff Dr. Nicholas Omdahl and Exercise Physiologist Megan Anderson serve on the hospital’s tobacco cessation task force. They get assistance from Jennifer Youngblood of the UW Center for Tobacco Research and Intervention.

All that support, combined with reinforcement from standards set by The Joint Commission, has helped All Saints to make tobacco treatment a core performance measure that’s tied to employee compensation.

How They Treat Tobacco Use
Every patient is asked about tobacco use at admission at all of the All Saints’ hospitals and physician offices. If the patient smokes, he or she gets a special packet and coaching on how to quit. All inpatients get an educational sheet regardless of his or her smoking status. “Everyone knows somebody who smokes,” Anderson said.

Patients interested in quitting are also referred to the Wisconsin Tobacco Quit Line at 1-800-QUIT-NOW. The hospital is piloting the Fax to Quit program in some departments; this allows patients to sign up for a future call from the Quit Line. Soon they plan to expand Fax to Quit hospital-wide. All Saints also offers a free quit-smoking class every-other month.

Inpatients are offered the nicotine patch and gum as well as coaching on how to quit, and outpatients are offered prescriptions for other medications—such as Chantix or Zyban—if medically appropriate. They also have a standing order set for smoking cessation to prompt physicians and make treatment faster and easier.

Anderson said nurses are in charge of ensuring each patient is asked about tobacco use, and that smokers and chewers are counseled to quit. But it’s everyone’s responsibility in every department to reinforce that counseling. She said patients have said that surgeons asked them to quit smoking before the surgery so they can heal afterwards.

Wheaton Franciscan Healthcare – All Saints has had a campus that is 100 percent smoke free for about two years. Associates who smoke off-campus and return smelling like smoke violate the dress code. Guests of the ICU who smoke can access free nicotine-replacement medication.

The hospital is moving toward electronic health records and Anderson said they’ll definitely have a component for tobacco treatment. Orientation for new associates and continuing education courses also discuss tobacco treatment.

Taking it to the System
Wheaton Franciscan hospitals and clinics serve thousands of patients in the Milwaukee area and beyond. The Wheaton system is standardizing its tobacco-treatment process, including a uniform quit-tobacco educational packet for patients. It’s all based on the 
U.S. Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence.

Tips on Tobacco Treatment
Anderson said the key to building a strong program is to have a diverse task force. “We have all key areas represented—a physician advocate, a nurse educator, a pharmacist who offers the medication perspective and a librarian.”

Next, she said, is to educate yourself on tobacco addiction and treatment on an ongoing basis. “Often, it’s not taught in college,” she said. Then use that knowledge when helping patients understand why and how to quit.

Finally, Anderson advises working with tobacco experts from the UW Center for Tobacco Research and Intervention (UW-CTRI). “Contact your local UW-CTRI rep,” she said. “They have resources you might not know about, such as trainings, updates on medications and new materials.” To contact your local UW-CTRI outreach professional, click here.
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