MCC/ MOQC Lead TeamAnna Notier, MSWGrayce Galiyas, RN, BA, NDJane Severson, RN, MSN, MHSAJoan Schmidt, RN, MSNKaren Brown, MPAMara Minasian, BA

BackgroundThere are many risks associated with

continuing to smoke after a cancer diagnosis:◦Treatments less likely to be successful◦More side effects from surgery, chemotherapy, and

radiation therapy◦ Increased chance of the cancer returning◦ Increased risk of other serious illnesses, such as

heart and lung diseases or getting a second cancer

BackgroundOncologists play a vital role in tobacco

cessation by providing the recommendation and education to patients to help them quit

Many offices do not have the resources available to assist patients with quitting nor are they aware of the free tobacco cessation counseling services available to all cancer patients in Michigan

QOPI® Tobacco Cessation Measures

MOQC Current Situation

QOPI Data

Quality Gap

QOPI Data

QOPI Data

QOPI DataGap Widens

QOPI Data

MOQC Data

Quality Gap

Root Cause AnalysisLow referral rate to tobacco cessation counseling services for cancer patients who use tobacco:

A. Staff and providers not educated on effects of tobacco use in cancer patients and implications for treatment

B. No standard workflow or resources in clinic to ensure patients are asked if they use tobacco, advised to quit, and referred to tobacco cessation counseling

C. Staff and providers not aware of MCC Michigan Tobacco Quitline and free services for cancer patients

Overview

MOQC/MCC Tobacco Cessation Demonstration Project

Project Goals

To change clinical culture and practice patterns to ensure that every patient being treated for cancer who uses tobacco is identified, advised to quit, and offered scientifically sound treatments

To build practice leadership capacity in quality improvement and change management

19 Participating Sites1 Bronson Medical Group Oncology 2 Center for Cancer Care & Blood Disorders - Lansing3 Center for Cancer Care & Blood Disorders - Owosso4 IHA Hematology Oncology 5 Karmanos Cancer Center6 Lacks Cancer Center Surgical Oncology Practices7 Oaklawn Oncology8 Oakwood Hem/Onc - Dearborn9 Oakwood Hem/Onc - Downriver10 Singh & Arora Hem/Onc11 Southwest Oncology Associates12 Sparrow Cancer Center13 St. John Health Partners - Grosse Pointe14 St. John Health Partners - Macomb15 St. John Health Partners - Warren16 Toledo Clinic Cancer Center - Adrian 17 Toledo Clinic Cancer Center - Monroe18 University of Michigan Cancer Center19 West Michigan Cancer Center

Changing the Culture About Tobacco Cessation for Cancer Patients

Tobacco Cessation Demonstration Project Organizational Structure

Participating Sites

MOQC

Project Team

Advisory TeamIncludes Quality & Content

Subject Matter Experts

MCC

National Jewish Health (QuitLine)

Measures of Success

Percent of target population with tobacco use STATUS DOCUMENTED in the medical record; TARGET: 100%

Percent of tobacco users with REFERRALS to Michigan Tobacco Quitline (or other program) DOCUMENTED in the medical record; TARGET: 90%

Measures of Success

Improvement in QOPI performance > 90 % for Demonstration Project participating practices:

Smoking / tobacco use cessation counseling recommended to smokers/ tobacco users in the past year

Future State: Change Packet

Pre-Printed Fax Referral Forms for Data Tracking

MOQC Tobacco Cessation Toolkit

Performance Tracking Tool

Preliminary Results

• Number of Sites Participating: 19

• Number of Referrals Faxed(May 1 – June 13, 2013): 91

• % of Referred Patients Engaged in Quitline Program: 43%

Next Steps

Collaborative Meeting #2 and #3Site visits at the end of JuneSpread to other populations and

practices (2 hour new practice enrollment)

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