J Clin Outcomes Manage
Smoking cessation counseling in U.S. hospitals: a comparison of high and low performers
Williams SC, Morton DJ, Jay KN, Koss RG, Schroeder SA, Loeb JM
Abstract Objective: To identify differences between hospitals that consistently provide smoking cessation counseling to their patients and those organizations that do not with respect to counseling practices, perceived organizational barriers, and perceptions of hospital leadership. Design: Quantitative survey research. Setting and participants: 113 acute care hospitals selected as high or low performers based on smoking cessation counseling performance measure data submitted for inpatients admitted with acute myocardial infarction, heart failure, or pneumonia between 1 July 2002 and 31 March 2004. Methods: A 30-item, 2-part survey was developed to evaluate smoking cessation counseling practices in acute care hospitals. The first part of the survey was completed by the hospitalís chief executive officer and included 3 items addressing perceptions related to smoking cessation counseling. The second part of the survey included 27 items and was completed by hospital staff. Items addressed documentation practices, counseling methods, training programs, evaluation practices, and perceived barriers. Fisherís exact tests were used to compare survey results of hospitals identified as high or low performers based on their smoking cessation counseling performance measure rates. Results: Statistically significant differences in counseling practices, perceived organizational barriers, and perceptions of hospital leadership were observed between hospital groups. Conclusion: Despite widespread knowledge of the harmful effects of smoking for acute myocardial infarction, heart failure, and pneumonia patients and the well-established benefits associated with smoking cessation counseling for these patients, more needs to be done to take advantage of hospitalization as an opportunity to provide smoking cessation counseling.
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