aafp office champions leading tobacco cessation in fqhcs with theresa jacob, md, faafp and niambi...
DESCRIPTION
From the the first Annual National Conference on Tobacco and Behavioral Health, which occurred May 19-20, 2014 in Bethesda, MD and was hosted by the Central East Addiction Technology Transfer Center, a program of The Danya Institute. You can see videos from the conference on our website www.ceattc.org (go to “Tobacco and Behavioral Health Resources” under “Special Topics”). PRESENTERS: Theresa Jacob, MD, FAAFP, Family Medicine Physician, Family Health Centers of Georgia Niambi Lavender-Coleman, MA, National Certified Medical Assistant, Family Health Centers of Georgia This workshop will share practical tips on empowering clinic staff to take a leadership role in making systems changes to support tobacco cessation in Federally Qualified Health Centers. The presenters will explain the success of the American Academy of Family Physicians (AAFP) Office Champions FQHC Tobacco Cessation project overall, and specifically at the Family Health Centers of Georgia. This workshop will provide information on how to support a tobacco-free culture with the Office Champions model by integrating changes into the clinical system thus increasing positive health outcomes by utilizing AAFP resources/patient education materials. Participants will be able to: - Define a Federally Qualified Health Center - Describe the American Academy of Family Physicians (AAFP) Office Champions Tobacco Cessation project - Discuss the link between tobacco cessation and behavioral health in patient care - Describe the role of the Office Champion and Physician Champion in tobacco cessation - Identify the steps on how to apply the AAFP Office Champions model in any practice - Describe the health outcomes and successes of Family Health Centers of GeorgiaTRANSCRIPT
![Page 1: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/1.jpg)
AAFP Office Champions Leading Tobacco
Cessation in FQHCsFamily Health Centers of Georgia, Inc.
Theresa Jacobs, M.D. , FAAFPNiambi Lavender, Medical Assistant
5/19/14
![Page 2: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/2.jpg)
2
Disclosure
• The American Academy of Family Physicians (AAFP) Office Champions Tobacco Cessation Federally Qualified Health Center (FQHC) Project was funded by Pfizer Inc, in collaboration with the Smoking Cessation Leadership Center (SCLC)
![Page 3: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/3.jpg)
3
AAFP Office Champions Tobacco Cessation Project
• AAFP recruited FQHCs to participate in the Office Champions Tobacco Cessation Project. An FQHC is a non-profit private or public entity that serves medically underserved populations and/or areas
![Page 4: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/4.jpg)
4
What is Office Champions?
A team-focused quality improvement model that incorporates practical, proven strategies:• Develop an implementation plan • Provide training and improve staff
collaboration• Initiate systems changes• Increase patient engagement• Evaluate results (chart reviews and surveys)
![Page 5: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/5.jpg)
5
AAFP Tobacco Cessation Resources
http://www.aafp.org/patient-care/public-health/tobacco-cessation/ask-act.html
![Page 6: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/6.jpg)
6
Burden of Tobacco Use
The annual burden of smoking-attributable mortality in the U.S. is currently estimated to be 480,000. Millions more are living with smoking-related diseases
![Page 7: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/7.jpg)
7
National Uniform Data System & Office Champions
Outcomes
National UDS 2011
National UDS 2012
Office Champions
2013
0
20
40
60
80
100
120
79.585.6
96.1
52.757.6
74.5
% Tobacco Use Screen-ing% Tobacco Intervention
![Page 8: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/8.jpg)
8
Who We Are
• Family Health Centers of Georgia, Inc. (FHCGA) began providing comprehensive preventive healthcare in 1976.There are eight locations in Fulton and Cobb counties. Healthcare services include medical, behavioral health, and dental care
![Page 9: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/9.jpg)
9
Behavioral Health Services
• FHCGA has a licensed clinical social worker on staff that counsels patients, as needed. All patients 13 and older are screened for depression and referred to behavioral health for in-house counseling
![Page 10: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/10.jpg)
10
Behavioral Health & Tobacco Cessation
• More that 1 in 3 adults (36%) with a mental illness smoke cigarettes, compared with about 1 in 5 adults (21%) with no mental illness
• The most common behavioral health issues linked to nicotine dependence at FHCGA is stress, depression, and anxiety
![Page 11: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/11.jpg)
11
Clinical Environment
• More than 40% of FQHC patients use tobacco, double the national prevalence rate
• Health disparities that impact the FHCGA community are: race, low socioeconomic status, lack of insurance, low education levels, and unemployment
![Page 12: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/12.jpg)
12
Office Champion & Physician Champion Role
Office Champion• Provide health
education to patients• Help develop
cessation plans based on health risks
• Monitored patient progress
Physician Champion • Identify cessation
modality• Refer patient to
behavioral health counseling
• Provide patients with treatment options
![Page 13: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/13.jpg)
13
Team Approach
In order for Office Champions to be successful, the practice team must collaborate to meet the common goal of achieving a tobacco-free culture • Effective communication• Staff buy-in• Office & Physician Champions
sharing a leadership role
![Page 14: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/14.jpg)
14
Systems Changes
• The AAFP Office Champions FQHC project was instrumental in improving clinical practice patterns at FHCGA. The goal was to incorporate cessation into routine workflow and reduce smoking prevalence by 10-20%
![Page 15: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/15.jpg)
15
1) Implementation Plan: Referrals
• Patients were referred to behavioral health counselors, case managers, social workers, health educators, and quitlines as needed. In addition, the head pharmacist is a tobacco cessation treatment specialist
![Page 16: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/16.jpg)
16
2) Implementation Plan: Staff
Communication/Education• Several health education classes were
made available to patients. Workshops offered included the Office Champion as a speaker and offered a table to display with AAFP’s Ask and Act patient education materials and resources to promote tobacco cessation
![Page 17: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/17.jpg)
17
3) Implementation Plan: Marketing
• AAFP’s Ask and Act resources including patient education materials, flyers, posters, lapel pins, newsletters, etc. helped to encourage a culture of tobacco cessation
![Page 18: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/18.jpg)
18
Tobacco Cessation 2013 rates at FHCGA
• 1,133 patients were enrolled in the tobacco cessation program, 30% of the patients enrolled have reduced cigarettes intake to less than 5 per day, 20% of patients no longer smoke
![Page 19: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/19.jpg)
19
Challenges
The barriers that were identified while implementing the changes:• Finding affordable medication for the
patients on an individual basis• Working on prior authorization from the
insurance companies to use approved medications
• Patients that have relapse due to life changes
![Page 20: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/20.jpg)
20
Successes!
• FHCGA has initiated a comprehensive tobacco cessation program because tobacco use screening and intervention is extremely effective in both cost and health outcomes
![Page 21: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/21.jpg)
21
Patient Centered Medical Home
• FHCGA, whose framework is based on the Patient Centered Medical Home (PCMH), has incorporated tobacco cessation into the workflow
• The changes made are sustainable, and now are part of the system to support a tobacco-free culture
![Page 22: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/22.jpg)
22
Achieving Goals
• By participating in AAFP’s Office Champions project, FHCGA achieved its goal to incorporate cessation into routine workflow and reduced smokers by 10-20%.
For more information on Ask and Act and final report results visit:
www.aafp.org/askandact/officechampions
http://www.aafp.org/dam/AAFP/documents/patient_care/tobacco/office-champions-final-report-2013.pdf
![Page 23: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/23.jpg)
23
![Page 24: AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA](https://reader033.vdocuments.site/reader033/viewer/2022061217/54b564404a7959d74b8b45e2/html5/thumbnails/24.jpg)
24
Thank You! Questions ?
Theresa Jacobs, M.D., FAAFP
Niambi Lavender, Medical Assistant
Christy Alexander, MPH
American Academy of Family Physicians
Project Specialist
913-906-6000 x 3140