Hello, I’m Dr. Brenna VanFrank from CDC’s Office on Smoking and Health.
Tobacco use is the number one cause of preventable death and disease in the United States.
Cigarette smoking alone kills nearly half a million U.S. adults every year and harms nearly every organ system in the body.
More than 49 million U.S. adults currently use tobacco products, including 34 million who currently smoke cigarettes.
We know what works to help people quit smoking, but treatment is underutilized.
Fewer than one in three U.S. adults who smoke report using evidence-based treatments to try to quit.
Health care professionals can help provide patients treatment and integrating treatment into routine care can make it
easier to provide patients treatment.
To help health systems and healthcare professionals expand and improve their delivery of tobacco cessation interventions,
CDC and Million Hearts have developed the Tobacco Cessation Change Package.
The change package is a clinical quality improvement tool built to provide you with a menu of evidence- and practice-based changes that can drive improvement in clinical care.
that can drive improvement in clinical care.
It contains high-value resources gathered from experts in the field that you can adapt and use
as you work to engage all patients in tobacco cessation treatment.
With over 160 tools from more than 50 organizations, you’re sure to find something that will help you.
The change package is organized into five key focus areas:
Key Foundations focuses on taking stock of current practices, preparing to make changes,
and creating supportive environments for cessation.
Equipping Care Teams focuses on approaches and tools to prepare and motivate care teams to consistently address tobacco use;
and Screening; Treatment; and Referral and Follow Up provide tools and resources that promote consistent tobacco use screening,
treatment delivery, and follow up, including population management strategies to identify and reach patients.
Now, each of these five focus areas is further divided into three key elements:
Change Concepts, which are broad ideas that are useful in the development of specific ideas that lead to improvement.
Change Ideas, which are actionable, specific ideas or changing a process; and then,
Tools and Resources, which can be used to help guide your work, so you don’t have to re-invent the wheel.
The tools and resources are further categorized by outpatient, inpatient, and behavioral health clinical settings
to help you navigate to what will be most useful to you in your practice.
Now, let me walk you through an example of how this works.
Let’s say your team has decided to work on improving your tobacco-related clinical quality measures
by enhancing some systems processes.
So, you do an assessment and find that your clinic could probably do a better job screening patients for tobacco use.
So, you open the Change Package and you flip to the Screening section.
There, you’ll find one overarching change concept: Make Tobacco Use a Vital Sign.
But now what? How do you actually get that done?
Well, that’s where the change ideas come in.
For this change concept, there are four – adopting protocols, establishing workflows and determining roles,
embedding status prompts, and leveraging decision support scripts.
Now you need to pick - which of these four best fills your care gap?
There are a lot of questions to consider when making your choice.
What will result in the most change? What will have the best staff buy-in?
If more than one change needed, which needs to happen first?
So, let’s say your assessment indicated that you have a pretty clear workflow and staff know what they’re supposed to do and when,
but they keep forgetting to ask the screening questions and the documentation is burdensome.
So, you decide to work on building and embedding a status prompt and making it easy for staff to quickly document.
This is where the robustness of the change package comes in.
You do not have to invent the status prompt.
There are 13 here to choose from, including screen shots from electronic health records.
And, if you don’t find exactly what you want,
you can decide what elements you do want to include from the examples provided and work from there.
The last thing to know about the Change Package is that it is part of a suite of tobacco cessation-related materials
available to help you in your work.
The Change Package is intended to help healthcare professionals integrate treatment into clinical care.
The other two resources, the Tobacco Treatment Protocol and the Clinician Action Guide,
are intended to guide you on how to treat tobacco use and dependence.
Used together, these resources can help guide you in advancing the reach and effectiveness of your tobacco cessation interventions
to help make tobacco cessation a part of standard care for all patients.
We wish you great success as you embark on this important journey to help foster improvements in clinical care.