AAFP Office Champions Leading
Tobacco Cessation in FQHCs
Family Health Centers of Georgia, Inc.
Theresa Jacobs, M.D. , FAA...
Disclosure
• The American Academy of Family
Physicians (AAFP) Office Champions
Tobacco Cessation Federally Qualified
Healt...
3
AAFP Office Champions Tobacco
Cessation Project
• AAFP recruited FQHCs to participate in the
Office Champions Tobacco Ce...
4
What is Office Champions?
A team-focused quality improvement model
that incorporates practical, proven strategies:
• Dev...
AAFP Tobacco Cessation Resources
5
http://www.aafp.org/patient-care/public-
health/tobacco-cessation/ask-act.html
Burden of Tobacco Use
6
The annual burden of smoking-attributable
mortality in the U.S. is currently estimated to
be 480,0...
National Uniform Data System &
Office Champions Outcomes
79.5
85.6
96.1
52.7
57.6
74.5
0
20
40
60
80
100
120
National UDS
...
Who We Are
• Family Health Centers of Georgia, Inc.
(FHCGA) began providing comprehensive
preventive healthcare in 1976.Th...
Behavioral Health Services
• FHCGA has a licensed clinical social worker
on staff that counsels patients, as needed.
All p...
Behavioral Health & Tobacco
Cessation
• More that 1 in 3 adults (36%) with a mental
illness smoke cigarettes, compared wit...
Clinical Environment
• More than 40% of FQHC patients use
tobacco, double the national prevalence
rate
• Health disparitie...
Office Champion & Physician
Champion Role
Office Champion
• Provide health
education to patients
• Help develop
cessation ...
Team Approach
In order for Office Champions to be
successful, the practice team must
collaborate to meet the common goal o...
Systems Changes
• The AAFP Office Champions FQHC project
was instrumental in improving clinical
practice patterns at FHCGA...
1) Implementation Plan: Referrals
• Patients were referred to behavioral health
counselors, case managers, social workers,...
2) Implementation Plan:
Staff Communication/Education
• Several health education classes were
made available to patients. ...
3) Implementation Plan: Marketing
• AAFP’s Ask and Act resources including
patient education materials, flyers, posters,
l...
Tobacco Cessation 2013 rates at
FHCGA
• 1,133 patients were enrolled in the tobacco
cessation program, 30% of the patients...
Challenges
The barriers that were identified while
implementing the changes:
• Finding affordable medication for the
patie...
Successes!
• FHCGA has initiated a comprehensive
tobacco cessation program because
tobacco use screening and intervention ...
Patient Centered Medical Home
• FHCGA, whose framework is based on the
Patient Centered Medical Home (PCMH),
has incorpora...
Achieving Goals
• By participating in AAFP’s Office
Champions project, FHCGA achieved its
goal to incorporate cessation in...
23
Thank You! Questions ?
Theresa Jacobs, M.D., FAAFP
trjacobs1@yahoo.com
Niambi Lavender, Medical Assistant
nlavender@att.ne...
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AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA

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From the the first Annual National Conference on Tobacco and Behavioral Health, which occurred May 19-20, 2014 in Bethesda, MD and was hosted by the Central East Addiction Technology Transfer Center, a program of The Danya Institute. You can see videos from the conference on our website www.ceattc.org (go to “Tobacco and Behavioral Health Resources” under “Special Topics”).


PRESENTERS: Theresa Jacob, MD, FAAFP, Family Medicine Physician, Family Health Centers of Georgia
Niambi Lavender-Coleman, MA, National Certified Medical Assistant, Family Health Centers of Georgia
This workshop will share practical tips on empowering clinic staff to take a leadership role in making systems changes to support tobacco cessation in Federally Qualified Health Centers. The presenters will explain the success of the American Academy of Family Physicians (AAFP) Office Champions FQHC Tobacco Cessation project overall, and specifically at the Family Health Centers of Georgia. This workshop will provide information on how to support a tobacco-free culture with the Office Champions model by integrating changes into the clinical system thus increasing positive health outcomes by utilizing AAFP resources/patient education materials.

Participants will be able to:
- Define a Federally Qualified Health Center
- Describe the American Academy of Family Physicians (AAFP) Office Champions Tobacco Cessation project
- Discuss the link between tobacco cessation and behavioral health in patient care
- Describe the role of the Office Champion and Physician Champion in tobacco cessation
- Identify the steps on how to apply the AAFP Office Champions model in any practice
- Describe the health outcomes and successes of Family Health Centers of Georgia

Published in: Health & Medicine
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AAFP Office Champions Leading Tobacco Cessation in FQHCs with Theresa Jacob, MD, FAAFP and Niambi Lavender-Coleman, MA

  1. 1. AAFP Office Champions Leading Tobacco Cessation in FQHCs Family Health Centers of Georgia, Inc. Theresa Jacobs, M.D. , FAAFP Niambi Lavender, Medical Assistant 5/19/14
  2. 2. Disclosure • The American Academy of Family Physicians (AAFP) Office Champions Tobacco Cessation Federally Qualified Health Center (FQHC) Project was funded by Pfizer Inc, in collaboration with the Smoking Cessation Leadership Center (SCLC) 2
  3. 3. 3 AAFP Office Champions Tobacco Cessation Project • AAFP recruited FQHCs to participate in the Office Champions Tobacco Cessation Project. An FQHC is a non-profit private or public entity that serves medically underserved populations and/or areas
  4. 4. 4 What is Office Champions? A team-focused quality improvement model that incorporates practical, proven strategies: • Develop an implementation plan • Provide training and improve staff collaboration • Initiate systems changes • Increase patient engagement • Evaluate results (chart reviews and surveys)
  5. 5. AAFP Tobacco Cessation Resources 5 http://www.aafp.org/patient-care/public- health/tobacco-cessation/ask-act.html
  6. 6. Burden of Tobacco Use 6 The annual burden of smoking-attributable mortality in the U.S. is currently estimated to be 480,000. Millions more are living with smoking-related diseases
  7. 7. National Uniform Data System & Office Champions Outcomes 79.5 85.6 96.1 52.7 57.6 74.5 0 20 40 60 80 100 120 National UDS 2011 National UDS 2012 Office Champions 2013 % Tobacco Use Screening % Tobacco Intervention 7
  8. 8. Who We Are • Family Health Centers of Georgia, Inc. (FHCGA) began providing comprehensive preventive healthcare in 1976.There are eight locations in Fulton and Cobb counties. Healthcare services include medical, behavioral health, and dental care 8
  9. 9. Behavioral Health Services • FHCGA has a licensed clinical social worker on staff that counsels patients, as needed. All patients 13 and older are screened for depression and referred to behavioral health for in-house counseling 9
  10. 10. Behavioral Health & Tobacco Cessation • More that 1 in 3 adults (36%) with a mental illness smoke cigarettes, compared with about 1 in 5 adults (21%) with no mental illness • The most common behavioral health issues linked to nicotine dependence at FHCGA is stress, depression, and anxiety 10
  11. 11. Clinical Environment • More than 40% of FQHC patients use tobacco, double the national prevalence rate • Health disparities that impact the FHCGA community are: race, low socioeconomic status, lack of insurance, low education levels, and unemployment 11
  12. 12. Office Champion & Physician Champion Role Office Champion • Provide health education to patients • Help develop cessation plans based on health risks • Monitored patient progress Physician Champion • Identify cessation modality • Refer patient to behavioral health counseling • Provide patients with treatment options 12
  13. 13. Team Approach In order for Office Champions to be successful, the practice team must collaborate to meet the common goal of achieving a tobacco-free culture • Effective communication • Staff buy-in • Office & Physician Champions sharing a leadership role 13
  14. 14. Systems Changes • The AAFP Office Champions FQHC project was instrumental in improving clinical practice patterns at FHCGA. The goal was to incorporate cessation into routine workflow and reduce smoking prevalence by 10-20% 14
  15. 15. 1) Implementation Plan: Referrals • Patients were referred to behavioral health counselors, case managers, social workers, health educators, and quitlines as needed. In addition, the head pharmacist is a tobacco cessation treatment specialist 15
  16. 16. 2) Implementation Plan: Staff Communication/Education • Several health education classes were made available to patients. Workshops offered included the Office Champion as a speaker and offered a table to display with AAFP’s Ask and Act patient education materials and resources to promote tobacco cessation 16
  17. 17. 3) Implementation Plan: Marketing • AAFP’s Ask and Act resources including patient education materials, flyers, posters, lapel pins, newsletters, etc. helped to encourage a culture of tobacco cessation 17
  18. 18. Tobacco Cessation 2013 rates at FHCGA • 1,133 patients were enrolled in the tobacco cessation program, 30% of the patients enrolled have reduced cigarettes intake to less than 5 per day, 20% of patients no longer smoke 18
  19. 19. Challenges The barriers that were identified while implementing the changes: • Finding affordable medication for the patients on an individual basis • Working on prior authorization from the insurance companies to use approved medications • Patients that have relapse due to life changes 19
  20. 20. Successes! • FHCGA has initiated a comprehensive tobacco cessation program because tobacco use screening and intervention is extremely effective in both cost and health outcomes 20
  21. 21. Patient Centered Medical Home • FHCGA, whose framework is based on the Patient Centered Medical Home (PCMH), has incorporated tobacco cessation into the workflow • The changes made are sustainable, and now are part of the system to support a tobacco-free culture 21
  22. 22. Achieving Goals • By participating in AAFP’s Office Champions project, FHCGA achieved its goal to incorporate cessation into routine workflow and reduced smokers by 10-20%. For more information on Ask and Act and final report results visit: www.aafp.org/askandact/officechampions http://www.aafp.org/dam/AAFP/documents/patient_care/tobacco/office- champions-final-report-2013.pdf 22
  23. 23. 23
  24. 24. Thank You! Questions ? Theresa Jacobs, M.D., FAAFP trjacobs1@yahoo.com Niambi Lavender, Medical Assistant nlavender@att.net Christy Alexander, MPH American Academy of Family Physicians Project Specialist TempPR@aafp.org 913-906-6000 x 3140 24

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