Using a statewide collaborative approach to improve tobacco cessation referral rates for cancer patients.

Abstract

74 Background: Tobacco use by cancer patients decreases the effectiveness of cancer treatment, increases treatment toxicity, increases the risk of developing a second primary cancer, and increases mortality. Stopping tobacco use may reduce many of these adverse effects in cancer patients. Methods: The Michigan Oncology Quality Consortium (MOQC) collaborated with the Michigan Cancer Consortium (MCC) to implement the Tobacco Cessation Demonstration Project. This entailed designing a standard workflow and other lean tools to assist oncology practices in referring all cancer patients who use tobacco to the free Michigan Tobacco QuitLine or other cessation services. 19 practices participated in three learning sessions during which the following were provided: education by subject matter experts, use of data management and lean tools, and the sharing of barriers and successes. Results: Examination of baseline MOQC Quality Oncology Practice Initiative (QOPI) data demonstrated that < 47% of patients who use tobacco were advised to quit or referred for tobacco cessation (n = 574 charts/44 sites), which was equivalent to the national QOPI mean in Fall 2012. Root cause analysis of this lack of action in tobacco cessation identified limited knowledge to the risks of continued smoking and the lack of available resources as barriers to adopting necessary change. Implementation of the MOQC/MCC Tobacco Cessation Demonstration Project increased total statewide referrals to the QuitLine by 30.9% over the first 2 months with an increasing proportion of patients (41%) being cancer patients referred by MOQC participating sites. Conclusions: Supplying scientific evidence, collaboration, and the use of lean tools improved the referral rate to a tobacco cessation program for oncology patients. [Table: see text]