| Tools to improve documentation of smoking status. Continuous quality improvement and electronic medical records. | |
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MedLine Citation:
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PMID: 9932067 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite the deleterious effects of smoking on the nation's health and evidence that smoking cessation advice by family practice physicians is cost-effective, self-sustaining office systems to identify smokers in primary care clinics have been difficult to establish. We worked on a continuous quality improvement project group, aided by an electronic medical record, to design a system to document and periodically update smoking status in a consistent place in the medical record. INTERVENTION: Using the continuous quality improvement plan-do-study-act cycle, a 7-member group worked with nursing staff to define roles, routines and responsibilities for medical assistants to screen for and document 1 of 4 categories of smoking status in the major problem list of the electronic medical record for at least 80% of patient appointments. Screening rate was tracked monthly by means of the electronic medical record and feedback was given to staff. RESULTS: The screening rate rose from 18.4% to 80.3% within 2 weeks after the system was implemented and was maintained for 19 months. An additional benefit was an increased rate of smoking cessation counseling documented by providers, from a baseline rate of 17.1% to 48.3%. CONCLUSIONS: A continuous quality improvement group process aided by an electronic medical record is useful to develop a self-sustaining office system to screen, document, and periodically update smoking status in a consistent place in the medical record. Although screening for and documenting smoking status are only the first step toward helping patients stop smoking, it is an important one. |
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Authors:
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E Spencer; T Swanson; W J Hueston; D L Edberg |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Archives of family medicine Volume: 8 ISSN: 1063-3987 ISO Abbreviation: Arch Fam Med Publication Date: 1999 Jan-Feb |
Date Detail:
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Created Date: 1999-02-18 Completed Date: 1999-02-18 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9300357 Medline TA: Arch Fam Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 18-22 Citation Subset: IM |
Affiliation:
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Eau Claire Family Practice Residency Program, Department of Family Medicine, University of Wisconsin-Madison, USA. lspencer@eauclair.fammed.wisc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Family Practice
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standards* Humans Mass Screening / statistics & numerical data* Medical Audit Medical Records Systems, Computerized* Outcome and Process Assessment (Health Care) / methods* Smoking* Total Quality Management* Wisconsin |
| Grant Support | |
ID/Acronym/Agency:
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1-D15-PE-15323/PE/BHP HRSA HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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