Project Team
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Transcript of Project Team
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MEASURING SMOKEFREE SUCCESS BEYOND THE HOSPITAL WALLSMEASURING SMOKEFREE SUCCESS BEYOND THE HOSPITAL WALLS
Penny ThompsonSmokefree Liaison NurseTotally Smokefree ProjectHawke’s Bay DHB
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Project Team
Carleine Receveur Project Manager
Kate O’Brien Train the Trainer
Suzanne Marshall Coordinator for Maternal,
Child and Youth Workstream
Rebecca Missen Coordinator for Mental Health
and Addiction Workstream
Rangi Barcham Cessation Support
David Mitchell Cessation Support
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Overview
• Background of HBDHB Totally Smokefree project
• DHB Policy
• Project Approach
• Health targets
• Moving outside the hospital walls
• What we found outside the hospital walls
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Where we were just over 3 years ago
• Dedicated Smoking rooms
• Policy that focused on where not to smoke
• No dedicated team to support clinical practice
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Burden of Tobacco in HB
Smoking prevalence (%) by single year of age- all gender New Zealand v Hawke's Bay
0%5%
10%15%20%25%30%35%40%45%
15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 +
Age
%
New Zealand Hawke's Bay DHB
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Increasing Smokefree Understanding
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Policy - Purpose
“To describe the HBDHB smokefree
strategy and systems to encourage and
support smokefree lifestyles for all”.
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Policy Principles
HBDHB recognises:
- Level of harm of tobacco use- Leadership- Funder and provider- Best practice- Health promotion and protection
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Policy Statements
100% of patients/clients will have their smokefree status identified.
100% of patients/clients identified as smoke exposed will have appropriate smokefree interventions.
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Smokefree Best Practice: ABC Smokefree Best Practice: ABC
AA is for is for askask
BB is for is for brief advicebrief advice
CC is for is for cessation cessation supportsupport
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ApproachSystems First: model of organisational change
Evidence Policy Systems
Education
Patient
Roles
Intervention
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ApproachSystems First: model of organisational change
• Acknowledgement harm
• Impact harm
• Evidence of Treatment
Evidence
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ApproachSystems First: model of organisational change
Describes• Purpose / Vision• Principles• Scope• Strategies / policy
statements• Roles and
responsibilities• Link to other
organisation policies
Policy
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ApproachSystems First: model of organisational change
• Links policy to action
• Framework for accountability
• Guides interventions and strategies
• Provides shape to work
Systems
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ApproachSystems First: model of organisational change
• Clarity
• Match education to specialty
• Confidence and competence in clinical practice
Education
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ApproachSystems First: model of organisational change
Roles and Responsibilities
• Supportive role for everyone identified
• Roles align to purpose
• Establishes accountability for delivering clinical best practice
Role
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ApproachSystems First: model of organisational change
• Clinical best practice becomes a reality
• The ABC’s A = AskB = Brief
AdviceC = Cessation Support
Intervention
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ApproachSystems First: model of organisational change
• 100% of patients/clients will have their smokefree status identified.
• 100% of patients/clients identified as smoke exposed will have appropriate smokefree interventions.
Patient
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ApproachSystems First: model of organisational change
Evidence Policy Systems
Education
Patient
Roles
Intervention
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Data
• Data is the “currency” of systems
• Data has two primary purposes 1. To monitor performance
2. To inform understanding and future planning
• Types of Data1. Process data
2. Outcome data
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Ministry of Health Target
By June 2010 80% By June 2010 80%
By June 2011 90% By June 2011 90%
By June 2012 95% By June 2012 95%
Hospitalised smokers will be provided with advice and
help to quit
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Measuring Outside the Hospital Walls
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Activities outside the hospital walls
• Mental Health and Addiction
Community services
• Public health nurses
• Dental Therapists
• Diabetes Clinics
• District Nurses
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HBDHB and HBPHO
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Auditing Framework
Audit Process–Executive Summary–Terms of Reference
Aims and ObjectivesScope
Audit Approach–Significant Findings
Risks
–Recommendations–Table of Corrective
Actions
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Findings
- Transferability
- Service Specific
- Systems Approach
- Cessation Support Services
- Performance Feedback
- Measuring Success
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Acknowledgements
• David Smith and Stephanie Cowan “Systems First” framework
• Hawkes Bay PHO
Sue Taaffe and Wendy Jacques
• Hawke’s Bay District Health Board
Totally Smokefree Project Team
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References • Hodge P & Binnie V. Smoking cessation and periodontal health – a
missed opportunity? Evidence-Based Dentistry (2009) 10, 18–19
• Johnson NW, Bain CA. Tobacco and oral disease. British Dental Journal Vol. 189, no. 4, pp. 200-206. 26 Aug 2000
• Ellison J, Mansell C, Hoika L, MacDougall W, Gansky S, Walsh M. Characteristics of adolescent smoking in high school students in California. Journal of Dental Hygiene, Spring, 2006
• Micheal Fiore. Chair of the US Public Health Services 2000 Smoking Cessation Clinical Practice Guidelines Panel. Author of: Treating Tobacco Use and Dependence. August, 2003