Provider Focused Process Improvement Project to Enhance Patient Participation in a Tobacco Smoking Cessation Program

Open Access

Abstract

United States soldiers face the most heinous dangers on a daily basis while serving our country. Despite knowing the risks, they are courageous and willing warriors. They are equipped with training, knowledge, and equipment to combat these dangers. However, despite all the training, despite the equipment, and despite their courage, there is a danger that lurks beyond those associated with military service and it is tobacco smoking. Tobacco smoking is associated with life threatening and life limiting disease. The effects of tobacco smoking may take years to present which can provide a false sense of invincibility to the Veteran. Tobacco smoking has declined among the general population. However, the same is not true among the military Veteran population. Reported estimates suggest that smoking is 40% higher among Veterans compared to the general population. The literature also suggests that smoking-related illnesses have been higher among patients in the Veterans Health Administration compared to the general population. Smoking tobacco presents a major risk factor for heart disease as well as chronic obstructive pulmonary disease. Smoking cessation is associated with reduction in prevalence of these diseases, decreased exacerbations, and reduced mortality. This capstone report presents an evidenced based intervention that is focused on providers in a Primary Care setting. With the inclusion of the Transtheoretical Model as a framework for understanding patient readiness, providers were provided with education related to strategies of brief motivational interviewing. The goal of this process improvement was to increase the confidence and skill level of providers to work with ambivalent patients relative to tobacco smoking habits.