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. 2008 Aug;23(8):1214-7.
doi: 10.1007/s11606-008-0610-4. Epub 2008 May 9.

A computerized aid to support smoking cessation treatment for hospital patients

Kate E Koplan  1 , Susan Regan, Robert C Goldszer, Louise I Schneider, Nancy A Rigotti
Affiliations

A computerized aid to support smoking cessation treatment for hospital patients

Kate E Koplan et al. J Gen Intern Med. 2008 Aug.

Abstract

Background: Hospital-based interventions promote smoking cessation after discharge. Strategies to deliver these interventions are needed, especially now that providing smoking cessation advice or treatment, or both, to inpatient smokers is a publicly reported quality-of-care measure for US hospitals.

Objective: To assess the effect of adding a tobacco order set to an existing computerized order-entry system used to admit Medicine patients to 1 hospital.

Design: Pre-post study.

Measurements and main results: Proportion of admitted patients who had smoking status identified, a smoking counselor consulted, or nicotine replacement therapy (NRT) ordered during 4 months before and after the change. In 4 months after implementation, the order set was used with 76% of Medicine admissions, and a known smoking status was recorded for 81% of these patients. The intervention increased the proportion of admitted patients who were referred for smoking counseling (0.8 to 2.1%) and had NRT ordered (1.6 to 2.5%) (p < .0001 for both). Concomitantly, the hospital's performance on the smoking cessation quality measure improved.

Conclusions: Adding a brief tobacco order set to an existing computerized order-entry system increased a hospital's provision of evidence-based tobacco treatment and helped to improve its performance on a publicly reported quality measure. It provides a model for US hospitals seeking to improve their quality of care for inpatients.

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Figures

Figure 1
Figure 1
The tobacco order template added to the clinician order entry system.
Figure 2
Figure 2
Orders for nicotine replacement therapy and smoking counseling consultations,4 months before and after implementation of the tobacco template.
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