A computerized aid to support smoking cessation treatment for hospital patients.
BACKGROUND
Hospital-based interventions promote smoking cessation after discharge. Strategies to deliver these interventions are needed, especially now that providing smoking cessation advice or treatment, or both, to inpatient smokers is a publicly reported quality-of-care measure for US hospitals.


OBJECTIVE
To assess the effect of adding a tobacco order set to an existing computerized order-entry system used to admit Medicine patients to 1 hospital.


METHODS
Pre-post study.


RESULTS
Proportion of admitted patients who had smoking status identified, a smoking counselor consulted, or nicotine replacement therapy (NRT) ordered during 4 months before and after the change. In 4 months after implementation, the order set was used with 76% of Medicine admissions, and a known smoking status was recorded for 81% of these patients. The intervention increased the proportion of admitted patients who were referred for smoking counseling (0.8 to 2.1%) and had NRT ordered (1.6 to 2.5%) (p < .0001 for both). Concomitantly, the hospital's performance on the smoking cessation quality measure improved.


CONCLUSIONS
Adding a brief tobacco order set to an existing computerized order-entry system increased a hospital's provision of evidence-based tobacco treatment and helped to improve its performance on a publicly reported quality measure. It provides a model for US hospitals seeking to improve their quality of care for inpatients.
Koplan
Kate E
KE
Harvard Medical School, Boston, MA, USA. kkoplan@partners.org
Regan
Susan
S
Goldszer
Robert C
RC
Schneider
Louise I
LI
Rigotti
Nancy A
NA
D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D050316:Medical Order Entry Systems; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome; D014584:User-Computer Interface