Staff Training

MOQC/MCC Tobacco Cessation Patient Education Video:

Why Cancer Patients Should Quit Tobacco

Agenda1. Background2. Future State3. Change Packet4. MOQC Resources5. Next Steps

1. Background

Background• There is growing evidence that using tobacco:– Compromises the effectiveness of cancer treatments

(e.g., chemotherapy, surgery)– Reduces treatment tolerance– Increases the risk of complications and the risk for a

secondary primary cancer • Stopping tobacco use immediately after being

diagnosed with cancer gives patients the best chance for their cancer treatment to work

Background• Oncologists play a vital role in tobacco cessation by

providing the recommendation and education to patients to help them quit

• Clinicians can make a difference with even a minimal intervention (less than 2 minutes)

• Barriers to referring patients to tobacco cessation counseling include:– Physician attitudes and behaviors – Financial burden for patient– Scarce resources at the practice level

Goal and Approach• Goal: To change clinical culture and practice patterns to

ensure that every patient being treated for cancer who uses tobacco is identified, advised to quit, and offered scientifically sound treatments

• Approach: MOQC is collaborating with the Michigan Cancer Consortium and Michigan Department Community Health to implement a standard process within participating oncology practices to automatically refer cancer patients who smoke to the free Michigan Tobacco Quitline

Measure of Success• Percent of target population with tobacco use STATUS

DOCUMENTED in the medical record TARGET: 100%• Percent of tobacco users with REFERRALS to Michigan

Tobacco Quitline (or other program) DOCUMENTED in the medical record

TARGET: 90%

Results to Date – Pilot Group

Data Source: Michigan Tobacco Quitline

2. Future State

Future State

Michigan Tobacco Quitline Services• Program is free and confidential for the patient• Open 7 days per week, 7am-1am ET• All Quitline coaches are highly trained in Motivational

Interviewing and Behavior Modification• Provides:

- Referrals to local programs- Counseling- Unlimited reactive calls for one year- Self-help materials- Text messaging- Online program

Michigan Tobacco Quitline Eligibility

Michigan Tobacco Quitline ProcessTiming Action

Day one (initiated by participant)

• Participants call or are referred to the MI Tobacco Quitline• Tobacco cessation specialist will likely conduct intake and first

of four coaching sessions

Within 5 days of enrolling

• Participant receives welcome letter and self-help workbook• If participant completes first coaching call, 1st shipment of

Nicotine Replacement Therapy (NRT) is sent out at this time

Over next 6 to 8 weeks

• Tobacco cessation specialist conducts three remaining coaching sessions as outbound calls to participant

At any time • Participants call Michigan Tobacco Quitline for support

Program completion

• Participant receives completion certificate after 4 coaching calls• Participants will receive a follow up call at 3/6/12 months after

intake to determine their quit status

• Use only the pre-populated form provided by MOQC to ensure proper data tracking

• Provider signature NOT required unless patient has one of three listed conditions

• Patient signature and initials NOT required

• Instruct patient to expect a call from the Quitline: 1-800-QUIT-NOW (784-8669)

Quitline Fax Referral Process

Quitline Fax Referral Process• Patient should expect call from the Quitline:

1-800-QUIT-NOW (784-8669)• Patient is called within 24 hours of receipt or based on

the preferred times indicated by the participant• 3 attempts to reach the patient based on the preferred

times indicated on the fax referral form• If no preferred times are indicated, patient is called at

24 hours, 3 days, and 10 days

Quitline Process: Office Follow Up• Providers will receive fax back updates on patient’s

progress with the Quitline:1. Fax Received (within 48 hours)2. Enrolled3. NRT Ordered4. Program Complete5. Declined to Enroll6. Unreachable

Updates dependent on complete information on fax referral form

BEST PRACTICE: Update medical record in standard location or image Quitline status faxes into record so staff can provide appropriate patient support at return visit

3. Change Packet

4. MOQC Resources

Resource Tool Kit

5. Next Steps

Go Live Date

Our practice will go live on:

____________________

Accountability is defined by role Buttons worn; brochures visible Auto Referral (Opt Out) Process: All patients in

target population who use tobacco will be referred to the Michigan Tobacco Quitline (patients have to actively opt out)

Staff show empathy & support – personal triumphs shared with patients

Staff engage families in the quit process

Tips for Success!

Tobacco Cessation Demonstration Project: Voice of the Customer

ASK ADVISE REFER

CC-MOQC-TEAM@med.umich.edu

www.moqc.org

MOQC is a Blue Cross Blue Shield of Michigan funded quality initiative

Thank You!