Electronic Health Record-Enabled Evidence-Based Smoking Cessation Quality Improvement Implementation Program

Study Overview
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Brief Summary
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The goal of this quality improvement program is to implement, evaluate, and sustain an evidence-based smoking cessation treatment program with a population-based approach so that all patients at the Siteman Cancer Center, Washington University, Barnes-Jewish Hospital, BJC Healthcare, and satellite locations receive assessment of smoking and all smokers receive treatment support.

Official Title
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Electronic Health Record-Enabled Evidence-based Smoking Cessation Quality Improvement Program

Conditions
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Smoking Cessation

Intervention / Treatment
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* Behavioral: ELEVATE enhancement to electronic health record (EHR) to improve cessation counseling offer
* Behavioral: ELEVATE enhancement to electronic health record (EHR) to improve smoking cessation medication offer
* Behavioral: Data Driven Feedback reports


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: -Patients seen at Siteman Cancer Center, Washington University, Barnes-Jewish Hospital, BJC Healthcare, or any of the satellite locations Exclusion Criteria: -None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Smoking Cessation<br>Patients enter the program through clinic appointments or community outreach programs. Patients will be given brief advice to quit smoking and referral options to receive evidence-based treatment through Missouri/Illinois Quitlines, Smokefree.TXT, or smokefree.gov dependent on the patient's preference for counseling Patient can also be prescribed smoking cessation pharmacotherapy | Behavioral: ELEVATE enhancement to electronic health record (EHR) to improve cessation counseling offer<br>* Brief advise to quit smoking Referral to Missouri/Illinois Quitlines, Smokefree.TXT, or smokefree.gov<br>Behavioral: ELEVATE enhancement to electronic health record (EHR) to improve smoking cessation medication offer<br>* -Nicotine replacement therapy, varenicline, bupropion, or combination therapy (not provided by study)<br>Behavioral: Data Driven Feedback reports<br>* -Feedback reports will be based on data<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinic level percentage of patients receiving brief counseling |  | From 6 months pre-intervention through 6 months post-intervention | 
| Clinic level percentage of smokers offered referral to additional counseling |  | From 6 months pre-intervention through 6 months post-intervention | 
| Clinic level percentage of smokers offered medication |  | From 6 months pre-intervention through 6 months post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinic level percentage of patients receiving brief counseling |  | Estimated to be 12 months pre-intervention and 12, 24, 36, and 48 months post-intervention | 
| Clinic level percentage of smokers offered referral to additional counseling |  | Estimated to be 12 months pre-intervention and 12, 24, 36, and 48 months post-intervention | 
| Clinic level percentage of smokers offered medication |  | Estimated to be 12 months pre-intervention and 12, 24, 36, and 48 months post-intervention | 
| Clinic level percentage of smokers receiving smoking assessment |  | Estimated to be 12 months pre-intervention and 12, 24, 36, and 48 months post-intervention | 
| Clinic level percentage of smokers receiving cessation medication |  | Estimated to be 12 months pre-intervention and 12, 24, 36, and 48 months post-intervention | 
| Number of patients who have abstained from smoking |  | Estimated to be 6 months post-intervention |