Focusing management in implementing a smoking ban in a university hospital in Sweden.
To explore the impact of various steps when introducing a smoking ban at the Karolinska Hospital (1000 beds; 6000 employees) in Stockholm, Sweden, a multiple evaluation strategy was performed over 5 years. All heads of clinical departments (N = 41) and a random sample of employees (n = 517) and a convenience sample of hospital labour managers (n = 17) were separately addressed through questionnaire surveys at different time intervals after the introduction of the ban in 1992. An observational and interview study completed the follow-up. The implementation process was supplemented by a comprehensive information strategy over 5 years. The two most important steps during implementation were management support and focus on environmental tobacco. The ban was well known at introduction. Heads of clinical departments reported a third of staff to be satisfied with the restrictions. In contrast, the staff survey revealed 62% to be positive. A shift in favour of a radical tobacco-free hospital was perceived during follow-up. Co-operation between hospital board, heads of clinical departments and local labour managers proved successful. The consecutive evaluations served as tools in labour management and contributed to staff compliance. A total ban, including the selling of tobacco and smoking in the hospital grounds is still to be achieved.
Ullén
H
H
Department of Cancer Prevention, Karolinska Institute, Karolinska Hospital, S 171 76 Stockholm, Sweden. henrik.ullen@smd.sll.se
Höijer
Y
Y
Ainetdin
T
T
Tillgren
P
P
D006291:Health Policy / Q000331:legislation & jurisprudence*; D006785:Hospitals, University / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006801:Humans; D008505:Medical Staff, Hospital / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D016134:Organizational Policy; D012907:Smoking / Q000331:legislation & jurisprudence*; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors