Tools to Improve Documentation of Smoking Status: Continuous Quality Improvement and Electronic Medical Records

Spencer, Elizabeth; Swanson, Todd A.; Hueston, William J.; Edberg, Debora L.

doi:10.1001/archfami.8.1.18

Cited by 40 publications

(31 citation statements)

References 10 publications

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“…Traditional methods to change provider practice, such as continuing medical education conferences, have met with sobering results. More promising methods include academic detailing or office-based educational outreach (Soumerai & Avorn, 1990), peer-comparison data feedback (Keller, Griffin, Schneiter, Wennberg, & Russell, 2000;Keller, Wennberg, & Soule, 1997), use of reminder systems or computerized tools (Spencer, Swanson, Hueston, & Edberg, 1999), and enhancing office systems for quality improvement (Dietrich et al, 1992;Hollis, Lichtenstein, Vogt, Stevens, & Biglan, 1993). Studies using either academic detailing or data feedback have been shown to decrease unnecessary medication prescribing and laboratory testing for some conditions (Kroenke & Pinholt, 1990;McConnell et al, 1982;Ramoska, 1998); studies using either method to increase the provision of preventive services have had inconsistent findings (Goldberg et al, 1998;Tierney, Hui, & McDonald, 1986;Williams, Eckert, Epstein, Mourad, & Helmick, 1994).…”

Section: Introductionmentioning

confidence: 99%

Academic profiling of tobacco-related performance measures in primary care

Swartz¹,

Cowan²,

DePue

et al. 2002

CNTR

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Academic detailing and data feedback are two methods that have been used to change provider behavior. Academic profiling is proposed as an intervention that combines provider educational outreach and peer-comparison feedback of data generated from chart reviews and health plans. This project assessed the feasibility of academic profiling, using baseline measures to assess provider performance in identifying and treating patients who smoke. The pilot study was undertaken with four primary care practices in Maine. Two health plans shared administrative claims data on adult patients of participating providers. Two educational sessions were conducted: one including feedback of tobacco-related chart documentation and claims for nicotine replacement and bupropion (Zyban), and the other, coding for tobacco use (ICD-9 305.1) in adults enrolled in two health plans during 1998. A mailed survey assessed provider attitudes following the intervention. Among 24 providers, 80% attended the first session and 70% attended the second session. Provider documentation of tobacco status in the medical records varied from 68% to 100%. The frequency of tobacco pharmacotherapy claims for adult health plan enrollees having a provider visit in 1998 varied from 0% to 4.6% (mean 1.5%) by provider. The frequency of tobacco use diagnosis claims (ICD-9 305.1) varied from 0% to 19.8% by provider. More than 90% of the providers who reviewed the profiling graphs found the data were understandable, and 66% reported that the sessions helped them improve the ways they interact with patients who smoke. Practices vary in tobacco-related documentation, the prescribing of tobacco pharmacotherapy, and the coding for tobacco use. Providers are willing to participate in educational outreach using peer-comparison feedback, presenting opportunities to improve performance in the treatment of tobacco dependence.

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Section: Introductionmentioning

confidence: 99%

Academic profiling of tobacco-related performance measures in primary care

Swartz¹,

Cowan²,

DePue

et al. 2002

CNTR

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“…Screening the records for smoking status also led to increased smoking cessation counselling for a selected group of smokers in another study [14]. In the intervention centres, 21% (50/241) of the smokers accepted the offer of cessation treatment; 40% (19/47) of these patients reported that they were non-smokers after one year.…”

Section: Discussionmentioning

confidence: 99%

Smoking cessation in patients with diabetes mellitus: Results from a controlled study of an intervention programme in primary healthcare in Sweden

Persson

Hjalmarson

2006

Scandinavian Journal of Primary Health Care

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“…These efforts include the growth of practice-based research networks in primary care 37 and the ongoing expansion of continuous quality improvement in health-care settings. 38 …”

Section: Assess the Intervention In Diverse Clinical Practice Settingsmentioning

confidence: 99%

Translational Behavioral Research in Respiratory Medicine

Bender

Aloia

Rankin

et al. 2011

Chest

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Human behavior can prevent or invite disease and is a major determinant of the success of any planned treatment. Indeed, 40% of premature deaths in the United States are caused by human behaviors, including smoking, obesity, and alcohol use, with smoking accounting for the most premature deaths, killing 435,000 people in the United States each year. 1 An additional 2.3 million Americans were living with smoking-induced respiratory or cardiovascular disease in 2006. 2 Other behaviors that contribute to poorly controlled respiratory disease include an unwillingness to seek medical attention when symptoms are present, poor adherence to treatment, poor diet, and physical inactivity.Debate over health-care reform has increased awareness of the importance of changing behavior to improve population health and reduce health-care costs. 3 The need for behavioral interventions that can improve health and illness self-management is now well recognized and has produced many research initiatives. Translational research aims to facilitate more effective dissemination and uptake of scientifi c advances so that evidence-based strategies for prevention and treatment reach patients in all care settings. 4 Use of the translational research model to guide behavioral health research has been at best inconsistent. We believe that health behavior research can follow the translational research model and contribute signifi cantly to accomplishing the national objectives of translational research (http://nihroadmap. nih.gov). This article discusses the fi ve steps that can guide behavioral translational research to promote respiratory health (Fig 1 ).Human behavior can prevent or invite disease and is a major determinant of treatment success. Consequently, many efforts have been directed toward developing interventions to promote behaviors essential to managing or preventing respiratory disease. The process of developing, testing, and disseminating health behavior interventions should closely follow the translational research paradigm. However, most behavioral investigators have failed to adequately apply the translational research paradigm to behavioral research. The fi nal stage of translation, consisting of testing the effectiveness of interventions in broad clinical settings after effi cacy has been demonstrated in randomized controlled trials, is too often omitted. Additionally, the important task of understanding why any given health behavior intervention succeeds with some people but fails to change behavior in others is inconsistently pursued and seldom used to develop the robust theories of behavior change needed to improve respiratory health. Bringing health behavior research through the full translational process has the potential to signifi cantly enhance respiratory health with specifi c behavioral targets, including smoking cessation, obesity prevention, TB control, and adherence to a multitude of respiratory treatments. CHEST 2011; 139(6):1279-1284Abbreviations: CER 5 comparative effectiveness research; PCT 5 pragmatic cli...

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Tools to Improve Documentation of Smoking Status: Continuous Quality Improvement and Electronic Medical Records

Cited by 40 publications

References 10 publications

Academic profiling of tobacco-related performance measures in primary care

Academic profiling of tobacco-related performance measures in primary care

Smoking cessation in patients with diabetes mellitus: Results from a controlled study of an intervention programme in primary healthcare in Sweden

Translational Behavioral Research in Respiratory Medicine

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