Spotlight: CHAS Quit Happens

Tobacco use is the leading cause of preventable death world wide. At CHAS health clinics in Spokane, more than 50% of patients reported using tobacco, meaning half of their patients were at risk for tobacco-related death or illness. The CHAS clinical leadership team took a hard look at this figure, and seeing it as a true public health crisis, decided that helping patients to quit smoking was the single most important action they could take for community health.

In January 2015, CHAS launched their two-year cessation program Quit Happens. CHAS set a lofty goal of reducing the percentage of their patients who use tobacco by 10% in two years.  Knowing that the most important engagement of patients would be happening in the clinics, CHAS leadership gave clinic staff large ownership of the program. Staff even voted on the name, and made Quit Happens tee-shirts and swag to create a quitting supportive culture in their clinics.

CHAS looked at its workflows at every level where they meet patients to create opportunities to offer support. The first change was to normalize asking every patient at every visit, not just if they use tobacco, but if they are ready to quit. Those patients who can say YES are connected to any number of quit-supportive resources: 

•  After their appointment, patients can be referred to a Quit Coach share resources with patients and talk through goals and barriers.
• Two clinics host patient support groups, and Behavioral Health staff offer one-on-one counseling services for struggling patients. 
• CHAS has made agreements with their Pharmacy department to offer Nicotine Replacement Therapy, such as the patch, gum, or prescription meds, at the lowest cost possible to patients.
• CHAS brought in local smoking cessation expert Dr. Kawkab Shishani of WSU Spokane to train staff at each clinic on best practices for supporting patients who want to quit.
• They’ve created a resource for clients that includes health information brochures from the American Cancer Society, Quit Happens swag, and information on local resources like support groups and the Washington State SmartQuit app.  

The big question of course, is it working? The program is only a year old, and quitting often takes multiple attempts so the data is slow to accurately show the impact of these changes. However, in just the first 8 months over 600 people told CHAS staff they were ready to quit smoking. One year in, CHAS has seen a 2% decrease in smoking, totally around 1000 people who have successfully become former smokers.

 “It’s hard to quit, but it’s the number one thing you can do for your health,” says Mellissa Nystrom of CHAS, and the impact of those 1000 former smokers is huge. The health benefits of quitting begin just 20 minutes after your last cigarette, as demonstrated in the infographic to the right. Not to mention the added impact for the families of smokers no longer inhaling smoke second hand. In addition, the CDC estimates that smoking costs the US $300 Billion Dollars a year in medical care and lost productivity from premature death.

No one knows better than a smoker how hard it is to quit, and CHAS knows they don’t need to belabor that point to their patients. Instead they’ve reworked their patient pathways and created a culture in their clinics that is ready to meet patients with support and encouragement when they are ready to quit.  CHAS’s “all hands on deck” approach to smoking cessation shows the value of supportive community in radically improving health, and that’s work we are thrilled to brag about. Way to go CHAS!

If you’d like to know more about CHAS’s work, please contact QI Manager Melissa Nystrom.