title: Using the chronic care model to address tobacco in health care delivery organizations: a pilot experience in Washington state.
abstract: This article describes a Washington State-based Systems Change Pilot Project in which the chronic care model and the model for improvement were used as tools to promote tobacco cessation-related changes within a health care system. Three diverse sites participated in the pilot. Site teams tailored plan-do-study-act tests to site circumstances, addressing current resources and barriers to implementing change. Teams tested system changes that incorporated tobacco use documentation into the routine health services provided. Findings from this pilot suggest that (a) even simple changes with minimal disruption of services can make a difference in improving documentation of tobacco use status; (b) changes to routine practices of health organizations may not be sustainable if ongoing quality assurance mechanisms are not developed; and (c) systems implemented for other disease states within the same organization or patient population are not instinctively applied to tobacco, because of a multitude of factors.
authors.affiliation: Free & Clear, Inc., 999 Third Ave., Seattle, WA 98104, USA. Beatriz.Carlini@freeclear.com
authors.forename: Beatriz H
authors.initials: BH
authors.lastname: Carlini
authors.forename: Gillian
authors.initials: G
authors.lastname: Schauer
authors.forename: Susan
authors.initials: S
authors.lastname: Zbikowski
authors.forename: Juliet
authors.initials: J
authors.lastname: Thompson
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D007256:Information Systems / Q000458:organization & administration; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008962:Models, Theoretical; D010865:Pilot Projects; D016540:Smoking Cessation / Q000379:methods*; D018511:Systems Integration; D014861:Washington