MCC/ MOQC Lead Team

2. MCC/ MOQC Lead Team • Anna Notier, MSW • Grayce Galiyas, RN, BA, ND • Jane Severson, RN, MSN, MHSA • Joan Schmidt, RN, MSN • Karen Brown, MPA • Mara Minasian, BA

3. Background • There are many risks associated with continuing to smoke after a cancer diagnosis: • Treatments less likely to be successful • More side effects from surgery, chemotherapy, and radiation therapy • Increased chance of the cancer returning • Increased risk of other serious illnesses, such as heart and lung diseases or getting a second cancer

4. Background • Oncologists play a vital role in tobacco cessation by providing the recommendation and education to patients to help them quit • Many offices do not have the resources available to assist patients with quitting nor are they aware of the free tobacco cessation counseling services available to all cancer patients in Michigan

5. QOPI® Tobacco Cessation Measures MOQC Current Situation

6. QOPI Data

7. Quality Gap QOPI Data QOPI Data

8. Gap Widens Quality Gap QOPI Data QOPI Data MOQC Data

9. Root Cause Analysis Low referral rate to tobacco cessation counseling services for cancer patients who use tobacco: • Staff and providers not educated on effects of tobacco use in cancer patients and implications for treatment • No standard workflow or resources in clinic to ensure patients are asked if they use tobacco, advised to quit, and referred to tobacco cessation counseling • Staff and providers not aware of MCC Michigan Tobacco Quitline and free services for cancer patients

10. Overview MOQC/MCC Tobacco Cessation Demonstration Project

11. Project Goals • To change clinical culture and practice patterns to ensure that every patient being treated for cancer who uses tobacco is identified, advised to quit, and offered scientifically sound treatments • To build practice leadership capacity in quality improvement and change management

12. 19 Participating Sites

13. Changing the Culture About Tobacco Cessation for Cancer Patients

14. Tobacco Cessation Demonstration Project Organizational Structure MCC MOQC National Jewish Health (QuitLine) Project Team Advisory Team Includes Quality & Content Subject Matter Experts Participating Sites

16. Measures of Success • Percent of target population with tobacco use STATUS DOCUMENTED in the medical record; TARGET: 100% • Percent of tobacco users with REFERRALS to Michigan Tobacco Quitline (or other program) DOCUMENTED in the medical record; TARGET: 90%

17. Measures of Success Improvement in QOPI performance > 90 % for Demonstration Project participating practices: Smoking / tobacco use cessation counseling recommended to smokers/ tobacco users in the past year

18. Future State: Change Packet

19. Pre-Printed Fax Referral Forms for Data Tracking

20. MOQC Tobacco Cessation Toolkit

22. Performance Tracking Tool

23. Preliminary Results • Number of Sites Participating: 19 • Number of Referrals Faxed(May 1 – June 13, 2013): 91 • % of Referred Patients Engaged in Quitline Program: 43%

24. Next Steps • Collaborative Meeting #2 and #3 • Site visits at the end of June • Spread to other populations and practices (2 hour new practice enrollment)

25. ASK ADVISE REFER