The Christ Hospital Health Network, Cincinnati, OH
Smoking Cessation Project

Background: Our aims were to design a smoking cessation program and to standardize the documentation of smoking status with the goal of improving the health of a subset of underserved patients in the internal medicine clinic.

Methods: We educated residents and nursing staff in how to review and record smoking status in the patient’s chart during each visit, created an algorithm that residents and nurses could follow when educating patients on smoking cessation, and implemented follow-up phone calls by a nurse after the patient agreed to stop smoking. We collected data from 2010–2015 of all the patients in the medical residency clinic and assessed their smoking status. After the implementation of the smoking cessation program, we looked at the data from February 2016 to February 2017 to assess improvement of smoking documentation.

Results: Comparing the preintervention and postintervention data showed improved smoking status documentation. From preintervention to postintervention, the number of documented current smokers decreased from 1,684 to 584, the number of patients documented as former smokers decreased from 1,173 to 634, the number of patients who had never been assessed decreased from 227 to 1, and the number of patients documented as never having smoked decreased from 1,621 to 769. Creating a follow-up program called the “Don’t Do It” protocol helped to support patients in their efforts to quit smoking. This intervention included close nursing follow-up with phone calls to monitor progress and to document any medication side effects.

Conclusion: Patients benefit from improved documentation and follow-up in their smoking cessation efforts. The smoking cessation project increased smoking status documentation and smoking cessation counseling. A long-term goal is to screen patients for lung cancer with low-dose CT scans who should qualify for screening with correct smoking history documentation. This project will be continued as a quality improvement project by future residents with the goal of decreasing the number of smokers.