How will you ensure your team is ready to treat tobacco use?
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Hire staff who are already Certified Tobacco Treatment Specialists (CTTS)
Many people from diverse health professions have already completed training and gained expertise and experience in treating tobacco. See the Council for Tobacco Treatment Training Programs website for more information about accredited training programs for CTTS. You could hire new staff who are already certified. You will need to decide what kind of position to advertise (e.g., health educator, social worker, psychologist, nurse, nurse practitioner, physician assistant, physician) and what kind of template to create for these specialists.
Keep in mind that advanced practice providers, such as nurse practitioners or physician assistants, can bill for counseling services and prescribe medications. Non-prescribing advanced practice providers such as psychologists can also bill for tobacco cessation counseling.
When deciding who to hire, you may want to consider whether this person’s role will be exclusively focused on tobacco treatment, or whether tobacco treatment will be part of a larger scope of responsibilities.
Setting up a new role often entails working with human resources and IT to define requirements and electronic health record security permissions. Review job postings for tobacco treatment specialists at other institutions and similar positions such as nurse, social worker, or health educator roles in your system to create a posting for your desired hire.
Train existing staff to become Certified Tobacco Treatment Specialists (CTTS)
You can train team members playing diverse roles to become Certified Tobacco Treatment Specialists and provide tobacco treatment counseling, medication management, and care coordination. See the Council for Tobacco Treatment Training Programs website for information about accredited training programs that you sponsor for your existing team members.
When selecting personnel to train as CTTS, you may want to consider that advanced practice providers, such as nurse practitioners or physician assistants, can bill for counseling services and prescribe medications. Non-prescribing advanced practice providers such as psychologists can also bill for tobacco cessation counseling. Generating revenue in the tobacco treatment program may enhance its sustainability (see Case Studies H and M for examples). However, one C3I program stopped billing for services due to a related decline in engagement (see Case Study E).
You may also want to work with your IT team to determine whether modifications to existing role-based EHR security templates need to be updated for staff becoming CTTS to facilitate their work in this new role.
Train clinical care teams
Addressing tobacco use is a shared responsibility and educating stakeholders and care team members can promote a broader cultural shift and collective commitment to tobacco treatment as a standard of care. Many strong tobacco treatment programs offer coordinated care comprising both point-of-care treatment approaches and referrals to tobacco treatment specialists (see Case Studies for examples).
Even if Tobacco Treatment Specialists deliver most tobacco treatment, tobacco screening activities will likely be conducted by a broader team. Every clinical team member can also support the tobacco treatment program by advising patients to use available treatment resources, as well, even if referrals are placed automatically.
When designing your team trainings, consider the frequency and modality of these training sessions. Options include:
- Intensive workshops and communities of practice, such as the Memorial Sloan Kettering Assessment and Treatment of Tobacco Dependence in Cancer Care Training
- Dynamic internal trainings such as Grand Rounds, clinic meetings, nurse huddles, and retreats
- Asynchronous educational modules including recorded presentations and sessions
- Resource libraries of educational materials for staff such as fact sheets, guides, brochures, and toolkits
Diverse patient experiences with clinician interactions regarding smoking, cancer, and tobacco cessation
Offering multiple training modalities regularly may help you build and sustain tobacco cessation expertise in your care teams.
