Tobacco Treatment Service (TTS):
The TTS is comprised of Certified Tobacco Treatment Specialists (CTTS) who visit, at their bedside, patients in the inpatient setting that are identified as current smokers. In addition to helping collect data for the ViTAL Center's research team, the CTTS perform clinical smoking cessation counseling services. Specifically, the CTTS document a variety of smoking-related health and demographic information. They educate patients about the dangers of smoking, the benefits of quitting smoking, and existing resources that are available to help people quit. They assist patients with the quitting process by helping manage withdrawal symptoms, cravings, and medication prescription and use. At discharge, the CTTS helps arrange for continuing medication and counseling as patients transition out of the hospital.
In 2012, the North American Quitline Consortium (NAQC) established a workgroup to help guide efforts to establish electronic referral (eReferral) systems between tobacco quitlines and healthcare providers. Referral systems are one of three interventions deemed effective at increasing use of quitlines, increasing both the use of quitline services and the number of patients who successfully quit using tobacco. Currently, most provider referrals to quitlines use fax referral, a manual and cumbersome process that does not take advantage of electronic health record (EHR) technology. The implementation of eReferral services helps enable easy, effective, bi-directional communication between quitlines and EHRs of healthcare providers. Members of the workgroup include interdisciplinary representatives from clinics, hospitals, physician groups, quitline and service providers, state health departments, and universities. The ViTAL Center's director, Dr. Hilary Tindle, has been closely involved with the implementation of eReferral systems in Pennsylvania, and is now involved with eReferral projects in Tennessee and Mississippi.
In its fiscal year 2015 final rule, the Centers for Medicare & Medicaid Services (CMS) required reporting of tobacco treatment quality measures as part of the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and began implementing financial penalties for inadequate performance on these measures. Dr. Hilary Tindle and the ViTAL Center have worked closely with the Vanderbilt Psychiatric Hospital (VPH) to adapt the tobacco fields to be more conducive to the reporting requirements. We have also worked with nurse educators to ensure that VPH staff was properly trained in the new CMS requirements and how to use the EHR fields. Additionally, in preparation for these measures the ViTAL Center has proactively taken steps to ensure appropriate staff training and that similar changes to the EHR are implemented at Vanderbilt's primary medical hospital.
Other Clinical Resources:
Smokefree.gov - Offers resources to help quit smoking such as:
- SmokefreeTXT - a free texting service for quit smoking assistance and counseling
- quitSTART app - a phone application, originally designed for teens, that takes smoking history information and provides individually tailored tips, inspiration, and challenges to help one become smoke free and live a healthier life
- Quit planning assistance - assistance in planning, managing, and maintaining a quit attempt, including setting a quit date, identifying triggers and other barriers, and recruiting support from friends and family