Stimulating healthcare organizational improvement through public reporting of smoking cessation advice rates

Healthcare;Quality Improvement;Joint Commission on Accreditation of Healthcare Organizations (JCAHO);Smoking Cessation

Das, Smita

关键词: Healthcare;    Quality Improvement;    Joint Commission on Accreditation of Healthcare Organizations (JCAHO);    Smoking Cessation;   

Others  :  https://www.ideals.illinois.edu/bitstream/handle/2142/16056/1_Das_Smita.pdf?sequence=3&isAllowed=y

美国|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

The purpose of this study was to evaluate a novel method of instituting quality improvement among hospitals in the area of smoking cessation through publicizing poor performance. Smoking cessation was used as an indicator due to its impact on the health of our population, evidence base and also because of availability of data. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) specified “smoking cessation advice and counseling” as a process measure of the quality of care for acute myocardial infarction, congestive heart failure, and pneumonia in 2004. This measure includes patients who are given any sort of advice about stopping smoking while they are in the hospital. Nationally in 2005 few hospitals reached a goal of 100% compliance to the JCAHO smoking cessation measures. Failure of hospitals to comply with evidence based medicine is problematic and reflects poorly upon their image. With this in mind, in an effort to improve those rates, we proposed a novel study in which we randomized and informed California hospitals of their smoking cessation performance and offered to help them improve their advice rates. We also let the treatment hospitals know that we would publicize their performance in a year in local print media as incentive for the hospitals to improve. This component of the study is based on a broader application of protection motivation theory, emerging research on how the threat of public health quality reporting can stimulate improvement and the push-pull-capacity model of improvement. Over one year the control sites had a significantly higher increase in smoking cessation advice rates. The end adherence rate was 94% overall (compared to an initial rate of 88%). This study demonstrates a secular trend of improvement and the impact collection of JCAHO data has on hospital performance in all areas of care, likely via financial incentives.