Tobacco Treatment Program Planning Tool – Resources
What do you need to design, launch, and sustain your tobacco treatment program?
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EHR modification prioritization
Engaging IT specialists early in the program planning process will enhance program design and allow time for approval and prioritization processes that often take months. Strong leadership support can expedite prioritization. See Engaging Stakeholders for more.
Approval to deliver proactive treatment on an opt-out basis
Share with leaders the ethical case for treating tobacco like other chronic diseases for which beginning treatment is the default and how this approach may enhance health equity. See this article on using an opt-out approach in outpatient oncology and this one on inpatient care to learn about programs that have successfully implemented opt-out tobacco treatment.
Access to clinic teams to provide training and feedback (initially and as turnover occurs)
Work with your system and clinical leadership to obtain their buy-in and get on clinic team meeting schedules to provide training on the referral process or on delivering tobacco treatment. See resources forengaging staff for more information.
Quality Improvement team involvement in training and feedback activities
Talking with your quality improvement (QI) teams about how to align tobacco program activities with metrics that key stakeholders value is a great way to secure buy-in for your program. The QI team can also help you monitor and adapt the program to enhance its impact and sustainability. See data and measurement resources for more.
Funding is essential for tobacco treatment programs. Some ways funds are used include hiring staff, providing medications at no cost to patients, sending staff to Tobacco Treatment Specialist training, and paying for IT and analyst staff time to make EHR modifications and run reports.
Programs secure funding for tobacco treatment in varied ways, including:
Securing commitments from central administration. Gaining administration support may be enhanced by designing programs so that they support accreditation efforts or garner public recognition.
Generating revenue to cover at least some program costs (see guidance on billing for tobacco treatment)
Making use of publicly-funded external referral resources such quitlines and integrating referral into existing workflows with minimal costs
Hosting annual fundraising campaigns to sustain the program
Whichever method you choose, obtaining buy-in and identifying champions will facilitate efforts to fund the program.
Securing space for tobacco treatment specialists to work is a common challenge. Designing your program so that tobacco treatment can be provided by existing staff at the point of care or remotely (via internal or external specialists) may help if space is limited.
Human Resource (HR) support
Involving HR in job classification, descriptions, postings, and planning for training and supervision can be very helpful. It can also help to involve your IT team in early discussions regarding what kinds of EHR security, permissions, and templates will be needed in any new positions you create. Tobacco treatment specialists may be medical assistants, nurses, or others with health profession training but may come from other training backgrounds (e.g., community health, health education, psychology, etc.).
Business analyst time to design program metrics
It is never too early to start thinking about how you will assess the program’s impact, equity, and efficiency. Talking with leaders about key metrics that will inform their decisions about program support, expansion, and sustainment can enhance your measurement approach. Will you need automated dashboards, periodic reports, and in-depth program reviews during implementation? Talking with teams who design reports for QI initiatives can inform your data capture and analysis plans. See the section on data and measurement for details.
Protected time for program leaders, champions, and project team meetings
Coordinating efforts to implement a tobacco treatment program is a big job but one that can accelerate progress toward goals identified by the health system (e.g., enhancing clinical care, enhancing equity, better addressing social determinants of health, improving medical education, reducing readmission). Aligning the program with such objectives may help make the case to protect the time of key champions for this effort and to secure dedicated resources.
Endorsement of the program by key leaders to facilitate buy-in across levels
Several C3I participants noted that obtaining buy-in from influential leaders facilitated many aspects of program implementation, including securing funding, space, and IT resources and prioritization, and getting time on clinic team schedules for training. See resources to help secure buy-in from such leaders.
Educational and outreach materials for care teams and patients
Many excellent education materials for patients and care teams already exist. You may adapt them to your population, program, and context.
Support from coders if billing for tobacco cessation counseling
See guidance regarding billing for tobacco treatment.