| What
Are the Policy Guidelines for Health Care Systems? |
The
Utah Tobacco Policy Guidelines for Health Care Systems
was developed to assist health care facility managers
and providers in developing and maintaining top quality
services for their patients who use tobacco. The Guidelines
are based on the Public Health Service Clinical Practice
Guideline for Treating Tobacco Use and Dependence. Throughout
System recommendations you will see a referral to the
"5 A's." The "5A's" are a specific
set of clinical interventions designed for tobacco using
patients. They can be viewed at: View
the 5As
The major Health Care System Guidelines are comprised
of the following categories and recommendations:
(Please
note: The Guidelines are also available in a pdf format)
|
| Accessibility
of Cessation Resources |
|
Identify
and assign staff or clinician(s) to implement each of
the 5 A’s. (Different persons may be responsible
for different parts of the intervention.) |
|
Include
tobacco dependence intervention in written protocol or
job descriptions and in the performance evaluations of
salaried clinicians and specialists. |
|
Ask
pregnant women about tobacco use status using multiple-choice
format.
|
| Delegation
of Responsibilities |
|
Identify
and assign staff or clinician(s) to implement each of
the 5 A’s. (Different persons may be responsible
for different parts of the intervention.) |
|
Include
tobacco dependence intervention in written protocol or
job descriptions and in the performance evaluations of
salaried clinicians and specialists.
|
| Staff
and Clinician Education |
|
Provide training to clinicians and staff
to implement the 5 A's. On a regular basis, offer lectures/seminars/
in-services with continuing medical education (CME) and/or
other credit for tobacco dependence treatment.
|
| Evaluation |
|
Evaluate fidelity to 5 A model and effectiveness
of clinician and staff efforts. Drawing on data from chart
audits, electronic medical records, and computerized patient
databases, evaluate the degree to which clinicians are
identifying, documenting, and treating patients who use
tobacco. Provide feedback to clinicians about their performance.
|
| Accessibility
of Cessation Resources |
|
Health
care systems provide tobacco cessation materials for tobacco-using
patients. |
|
Hospitals
make group or individual tobacco cessation counseling
available to all hospitalized tobacco-using patients. |
|
Pharmacy
formularies include FDA-approved tobacco dependence pharmacotherapies.
|
| Reimbursement |
|
Reimburse clinicians for tobacco dependence
consultation services; Pay physicians for treatment of
tobacco-use disorder (ICD9 code 305.1, ADA code 1320) |
|
Inform
clinicians and specialists that they will be reimbursed
for using effective tobacco dependence treatments. |
|
Insurance formularies include FDA-approved
tobacco dependence pharmacotherapies, including both Nicotine
Replacement Therapy (NRT) and Zyban. |
|
Insurers and managed care organizations
(MCO's) cover group or individual counseling for members.
Group or individual counseling should last 90-300 minutes
and involve at least 4 sessions. |
|
Health plans inform subscribers of the availability
of covered tobacco dependence treatments (both counseling
and pharmacotherapy) and encourage patients to use these
services. |
|
Employers and other health care purchasers
purchase health plans that include cessation benefits.
|
| Smoke-Free
Environment |
|
Ensure
compliance with JCAHO regulations mandating that all sections
of the hospital be entirely smoke-free. |
|
Ensure
compliance to the Utah
Clean Indoor Air Act, including:
|
| |
1.
|
Smoking
prohibited in all indoor areas of public access and throughout
all public buildings. |
| |
2.
|
Outside
smoking designated areas for employees and visitors not
allowed within 25 feet of building entrances, exits, air
intakes, or windows. |
| |
3
|
.Smoking
and nonsmoking areas are designated with signs. |
