Best Practices Practice Select all that apply Comments Tobacco use queried and documented for all Never Where documented? admissions/visits. Sometimes All of the time Training for tobacco dependence treatment Never What is offered? offered to healthcare providers. Sometimes Workshops All of the time In-services New Staff Orientation Designated responsible for smoking Yes No Title of position? cessation program. (e.g., Program Coordinator, Smoking Cessation Counsellor/Educator). Tobacco dependence treatment included on Admission/Registration Which forms include Smoking Cessation? clinical management tools and/or in Clinical Assessment (e.g., Clinical Pathways, Care Maps, Electronic Medical Records (). Discharge/Referral Kardex, Vital Sign Stamp, Nursing History) Patient self-help materials readily available. Never Which self-help materials are available? Sometimes Where are self-help materials available? All of the time Links to community resources readily Never Which community resources are available? available. Sometimes Where are community resources All of the time available? Quit Smoking Medications available to Patch Bupropion Which processes are in place? patients. Gum Varenicline Standing/Pre-printed Orders Inhaler Medical Directives Lozenge Pre-Printed Prescriptions Spray Other: Processes in place to follow up with tobacco Yes No Which processes are in place? users for at least one month after initial Automated Telephone Follow-up consultation. Smokers’ Helpline Manual Follow-up Other: Processes in place to evaluate the degree to Yes No Which processes are in place? which healthcare providers are identifying, (e.g., Auditing Patient Charts/EMR/ documenting, and treating patients who use Program Database) tobacco (quality control). Processes in place to provide feedback to Yes No Which processes are in place? healthcare providers about performance and program effectiveness.
Best Practices Practice Select all that apply Comments Tobacco use queried and documented for all admissions/visits. Never Sometimes All of the time Where documented? Training for tobacco dependence treatment offered to healthcare providers. Never Sometimes All of the time What is offered? Workshops In-services New Staff Orientation Designated responsible for smoking cessation program. Yes No Title of position? (e.g., Program Coordinator, Smoking Cessation Counsellor/Educator). Tobacco dependence treatment included on clinical management tools and/or in Electronic Medical Records (). Admission/Registration Clinical Assessment Discharge/Referral Which forms include Smoking Cessation? (e.g., Clinical Pathways, Care Maps, Kardex, Vital Sign Stamp, Nursing History) Patient self-help materials readily available. Never Sometimes All of the time Which self-help materials are available? Where are self-help materials available? Links to community resources readily available. Never Sometimes All of the time Which community resources are available? Where are community resources available? Quit Smoking Medications available to patients. Patch Gum Inhaler Lozenge Spray Bupropion Varenicline Which processes are in place? Standing/Pre-printed Orders Medical Directives Pre-Printed Prescriptions Other: Processes in place to follow up with tobacco users for at least one month after initial consultation. Yes No Which processes are in place? Automated Telephone Follow-up Smokers’ Helpline Manual Follow-up Other: Processes in place to evaluate the degree to which healthcare providers are identifying, documenting, and treating patients who use tobacco (quality control). Yes No Which processes are in place? (e.g., Auditing Patient Charts/EMR/ Program Database) Processes in place to provide feedback to healthcare providers about performance and program effectiveness. Yes No Which processes are in place?
app_a_rfa_needs_assessment_and_best_practice_080416.docx