Our Work With Health Systems
When you go to the doctor, your vital signs – height, weight, blood pressure– are routinely checked. ClearWay MinnesotaSM is working with health care systems to make sure checking about tobacco use becomes as routine as checking for high blood pressure. Identifying tobacco users and offering treatment has the potential to reach and help large numbers of people. This work reflects ClearWay Minnesota’s focus on sustainable strategies to address tobacco use across the state.
Health care providers and health systems play an important role in addressing tobacco use with each patient. Data from the Minnesota Adult Tobacco Survey (MATS) shows there is room for improvement in assisting tobacco users with quitting. More information and calls to action for health care providers can be found here.
Curated here are the best resources and tools to help increase the capacity of health systems to routinely intervene with their patients that use commercial tobacco.
PRIMARY RESOURCES
American Lung Association: Tobacco Cessation and Prevention
Association of Clinicians for the Underserved (ACU): Tobacco Free: This website offers information and resources on the most effective tobacco use interventions for underserved patients, including fact sheets, motivational interventions and pharmacotherapy.
Centers for Disease Control and Prevention – Information for Heath Care Providers
Minnesota Department of Health
QUITPLAN® Services from ClearWay Minnesota
Smoking Cessation Leadership Center (University of California San Francisco)
Twin Cities Medical Society’s Physician Advocacy Network: Tobacco tools and more.
University of Wisconsin Center for Tobacco Research and Intervention: Information for providers.
TRAINING AND RESOURCE TOOLS
“HOW TO” TOOLS AND RESOURCES
Agency for Health Care Research and Quality: This website provides clear systems change strategies, recommendations, evidence and the cost-effectiveness on systems change efforts to treat tobacco use dependence.
American Academy of Family Physicians Ask and Act: A Tobacco Cessation Program Manual: This manual provides information on assessing your current health system and defining a new system based on the Ask and Act protocol. It also includes helpful tips around motivational interviewing, referrals and follow-up, and standardizing your systems change approaches.
DIMENSIONS: Tobacco Free Toolkit for Healthcare Providers: This is designed for a broad range of health care providers and includes information on tobacco use, skills for tobacco cessation discussions and interventions, and efficient methods to assess a patient’s readiness to quit, plus cessation treatment resources. You’ll also find several supplements for priority populations, including those with mental illness, low-income individuals and pregnant and postpartum women.
Healthcare Provider Reminder Systems, Provider Education and Patient Education: This action guide provides information on working with health care delivery systems to improve the delivery of tobacco use treatment to patients. It includes clear implementation action steps, determining your resource needs and key resources.
Help Your Patients Quit Tobacco Use: An Implementation Guide for Community Health Centers: This popular guide provides clear steps on how to plan, prepare and implement tobacco treatment interventions into Community Health Centers. It includes a section on how to deal with challenges and a sample intervention model and EHR builds with specific case studies shared at the end of the guide.
Million Hearts Tobacco Cessation Protocols: This website includes a number of tools and resources. There are also templates where providers can “Create Your Own Protocols” for tobacco cessation interventions.
New York City Department of Health and Mental Hygiene: Tobacco Quit Kit: The Tobacco Quit Kit contains clinical tools, resources for providers, and patient education materials to promote evidence-based practices for tobacco cessation.
Tobacco Health Systems Change Starter Toolkit for Clinics: This toolkit provides key resources and practical tools to help clinics and health systems improve how they address tobacco use. Many of these resources have been used by our network of champions advancing tobacco as a priority across their health system.
OTHER PROVIDER TOOLS
American Academy of Family Physicians: Coding Reference
American Academy of Family Physicians: Pharmacologic Product Guide
Free Cessation Services Available to Medical Assistance and MinnesotaCare Enrollees
Health Care Providers Can Help Minnesota Smokers Quit
Million Hearts Tobacco Cessation Action Guide: Identifying and treating patients who use tobacco: An action guide for clinicians. This is a short and simple action guide that includes three tables; 1) Actions to improve tobacco cessation delivery systems design; 2) The 5 A’s Tobacco Cessation Brief Intervention Model; and 3) FDA-Approved Tobacco Cessation Medications
Million Hearts Protocol for Identifying and Treating Patients Who Use Tobacco
Return on Investment for Tobacco Cessation
The Brief Tobacco Intervention 2 A’s & R and 5A’s Pocket Card
Tobacco Use Fact Sheets for the Clinical Team
WellShare International: WellShare International utilizes a Community Health Worker model for all of its programs, including its East African and Karen Smoke-Free Programs. You can find free health education resources on their website, including Somali and Karen-language educational videos.
TRAINING AND CME COURSES FOR PROVIDERS
American Academy of Pediatrics – Training and CME Courses: This website provides a comprehensive list of effective training and CME courses to build tobacco use cessation and secondhand smoke exposure knowledge. This includes a list of courses from the AAP and other organizations.
Rx for Change – Clinician-Assisted Tobacco Cessation: Rx for Change: Clinician-Assisted Tobacco Cessation is a comprehensive tobacco cessation training program that provides health professional students and practicing clinicians with evidence-based knowledge and skills for assisting patients with quitting (University of California, San Francisco).
Tobacco Treatment Specialist Training Information
Where can you or your providers get certified as a Tobacco Treatment Specialist? See the full list of accredited training programs from the Council for Tobacco Treatment Training Programs
University of Massachusetts Medical School: The UMASS Medical School Center for Tobacco Treatment Research and Training has a Train the Trainer in Tobacco Treatment (T4) program.
SPECIALTY POPULATIONS & SETTINGS
American Indian Community
American Indian Cancer Foundation: You can also sign up for their iQuits Tip of the Week, a brief weekly e-mail to share tips and resources for treating tobacco addiction in clinical practice.
HeathCare Partnership – Native American Resources: This website provides key reports, resources and specific tools to set up and implement a commercial tobacco dependence treatment process. It includes an assessment survey tool, a patient intake form, and a follow-up form that can be freely modified to fit your needs.
Dental Setting
Treating Tobacco Use and Dependence: A Toolkit for Dental Office Teams: This toolkit was created by the University of Wisconsin – CTRI, Wisconsin Dental Association, and Delta Dental. It includes the 5A’s model for treating tobacco use, medication resource materials for clinicians, patient education materials, and more.
Tobacco Cessation Toolkit for Indiana Dental Practices: This toolkit provides information needed to effectively address patient tobacco use, including a step-by-step process for developing a tobacco cessation program with key roles for each member of the dental team. It also include common barriers and potential solutions. PDF shared with permission of the Indiana Dental Association.
Hospital Systems
Treating Tobacco Use and Dependence in Hospitalized Patients: A Practical Guide: Developed by the University of Wisconsin Center for Tobacco Research and Intervention and Wisconsin Hospital Association, this guide provides practical steps to developing a successful hospital-wide cessation program.
Pediatrics/Family
American Academy of Pediatrics; Clinicians and Clinical Practice: This website includes helpful clinical practice information and tools and resources to address tobacco use in the clinical setting.
CEASE: The Clinical Effort Against Secondhand Smoke Exposure (CEASE), is a program developed at Massachusetts General Hospital to effectively address family tobacco use.
People Living with Mental Health & Substance Abuse Disorders
About 1 in 4 Mental Health Treatment Facilities Offered Services to Quit Smoking (SAMHSA Data Spotlight)
DIMENSIONS: Tobacco Free Toolkit for Healthcare Providers – Supplement for Behavioral Health
Smoking and Mental Illness (SAMSHA National Survey on Drug Use and Health Report)
Tobacco Use Cessation Policies in Substance Abuse Treatment: Administrative Issues(SAMHSA Factsheet)
Tobacco Use Cessation During Substance Abuse Treatment Counseling (SAMHSA Factsheet)
Pregnancy/OB-GYN
Smoking Cessation for Pregnancy and Beyond: A Virtual Clinic
The American Congress of Obstetricians and Gynecologists: Toolkits for Health Care Providers
Respiratory Health
American College of Chest Physicians – Tobacco Dependence Toolkit: A user-friendly, interactive online toolkit.
Veterans & Military
Veterans Health Administration (VHA): Tobacco use cessation treatment guidance. This three-part treatment guidance includes two easy-to-use charts and a table detailing VHA medication options. Part 1 Part 2 Part 3
BACKGROUND READING
A Time to Lead: The Case for Integrating Treatment of Tobacco Use in the Treatment of Other Substance Use and Mental Health Disorders: “A Time to Lead” is an appeal for action. Its purpose is to bring to light the urgent need to integrate evidence-based treatment of nicotine dependence into the protocols for treating substance use and mental disorders in the United States. March 2017,
American Academy of Family Practice 2008, Clinical Practice Guidelines. See Chapter 5, Systems Interventions – Importance to HealthCare, Administrators, Insurers, and Purchasers.
An Argument for Change in Tobacco Treatment Options Guided by the ASAM Criteria for Patient Placement, Williams, Jill et al. Journal of Addiction Medicine, September-October 2016.
Best Practices for Comprehensive Tobacco Control: Cessation Interventions (2014)
Editorial: Prevention Priorities: Guidance for Value-Driven Health Improvement, co-authored by George Isham, M.D., M.S., HealthPartners Institute. Annals of Family Medicine, January/February, 2017.
Louisiana State University Health System Tobacco Control Initiative Treatment Protocol
VIDEOS & WEBINARS
How Can the EHR Help You Identify and Intervene with Patients Who Use Tobacco?: Electronic health records (EHRs) contain tools that can improve how you identify, document, track, and treat patients who use tobacco. One challenge is knowing what tools are available and how to get started making system changes. This presentation explores ways that you can leverage the EHR to deliver efficient evidence-based tobacco dependence treatment interventions and where to start within your organization.
Presenters will include Amy Skora, Regional Outreach Specialist, from the Center for Tobacco Research and Intervention (CTRI) at the University of Wisconsin. Jill Doberstein from Essentia Health will also be sharing their work on how they have been able to utilize their EHR to advance systems change efforts.
Tackling Tobacco Through Re-engineered Primary Care recorded webinar and PowerPoint copy: Hailing from a New York state federally-qualified healthcare clinic (FQHC), Daren Wu, M.D., Chief Medical Officer of Open Door Family Medical Clinics will discuss how team-based care and other innovative systemic changes have successfully translated into improving Tobacco Screening and Cessation strategies. The same concepts can apply to a host of other healthcare topics and disease conditions.
American Academy of Family Physicians: Office Champions, A Systems Change Approach: Includes a 25 minute training video.
Smoking Cessation Leadership Center Webinar Series: On a variety of tobacco control and cessation topics.
CASE STUDIES
Since 2014, ClearWay Minnesota has funded five systems change grants. The purpose of these two-year grants are to advance health systems change to ensure that addressing tobacco use is fully integrated into the health care experience for patients. Three grants were awarded in Fiscal Year 2014 to Hennepin Health Foundation, CentraCare Health Foundation and Mille Lacs Band of Ojibwe. Two grants were awarded in Fiscal Year 2015 to Essentia Health and Apple Tree Dental.
These case studies show how health systems funded by ClearWay Minnesota have integrated tobacco dependence treatment into their routine care systems.
2015 Health Systems Change Grantee Case Studies
2014 Health Systems Change Grantee Case Studies
Case study: CentraCare Health System
Case study: Hennepin County Medical Center
Case study: Mille Lacs Band of Ojibwe
2010 Health Systems Change Grantee Case Studies
Case study: CentraCare Health System
Case study: Essentia Health East
Case study: Open Cities Health Center
Case study: University of Minnesota
ADDITIONAL MATERIALS
Addressing Nicotine Dependence – An Integrated Approach: Pete Dehnel, M.D., & Grace Higgins, M.P.H., Physician Advocacy Network
How to Ask About Tobacco Without Starting a Fire: Joel Spoonheim, HealthPartners
Medication Education for Tobacco Dependence: Krista Rouse, Pharm.D., Essentia Health
Smoking Cessation 2017: The Patient Perspective: Nabeel Ailabouni, D.O., CentraCare Big Lake Clinic
Tobacco Dependence Treatment: A System’s Change Approach, Jill Doberstein, M.A.P.L., C.T.T.S., Essentia Health