Team approach increases available counseling for pregnant smokers.(Clinical Rounds)

ORLANDO -- Family and ob.gyn. practices in Maine improved their identification of pregnant smokers and improved their assessment of cessation after remodeling their office systems based on a chronic care team approach.

The goal of the project was to increase the smoking cessation treatments offered to pregnant women, Dr. Susan Swartz, of the Center for Tobacco Independence at the Maine Medical Center in Portland, said at the annual meeting of the Society for Research on Nicotine and Tobacco.

Dr. Swartz and her colleagues recruited ob.gyn. and family practices across Maine who delivered prenatal care. Each practice was asked to form a team of at least three staff members, including a nurse midwife, nurse, and medical assistant or practice manager, who would focus on making office changes that would make it easier to assess and treat smokers.

Some of the suggestions that were tested include integrating tobacco documentation into electronic medical records, using patient education materials, having smokers watch a video on smoking and quitting, and having providers attend a conference on tobacco treatment.

The teams from each practice attended three, 1-day learning sessions adapted from a model developed for the treatment of chronic diseases by the Institute of Healthcare Improvement. In addition, practices were asked to collect data using a flowchart prompting clinicians and staff to ask about smoking ...