Abstract
Purpose
The goal of the Stanford Tobacco Treatment Initiative was to improve referrals from primary care clinics to a specialty tobacco addiction treatment clinic.
Methods
Lean A3 problem solving was used to map current state, perform a cause and effect analysis, develop key drivers for program referrals, and ideate tests of change. We discarded ideas that put any additional burden on on-the-ground providers, favouring automated and sustainable processes. After prioritizing for feasibility and impact, plan-do-study-act (PDSA) cycles were performed on the following interventions: education and outreach, referral champions, and automated referrals.
Results
Following implementation, referrals to the specialty tobacco treatment clinic increased by 600% and had no impact on clinic provider workflow.
Conclusion
The new process spread through all of Stanford Primary Care clinics, has sustained over time, and could serve as a model for other institutions seeking to enhance capacity for tobacco treatment in their health care system using process improvement methodology.
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Acknowledgements
The authors would like to thank the Clinical Effectiveness and Leadership Training program at Stanford Health Care, Stanford Primary Care, and the Stanford Department of Psychiatry and Behavioral Sciences for sponsoring this quality improvement initiative.
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Kendra, M.S., Dang, J., Artandi, M. et al. Connecting tobacco users in the primary care setting to comprehensive tobacco treatment: a quality improvement initiative. J Public Health (Berl.) 30, 1213–1218 (2022). https://doi.org/10.1007/s10389-020-01401-0
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DOI: https://doi.org/10.1007/s10389-020-01401-0