Using the Ottawa Model for Smoking Cessation to Improve Tobacco Cessation Efforts in Transitional Care

Abstract

Tobacco cessation improves health and prevents death in patients who smoke. An evidence-based practice (EBP) project was implemented within an outpatient transitional care office to improve tobacco cessation efforts. The purpose of this doctoral project was to determine if the Ottawa Model for Smoking Cessation (OMSC) increased tobacco cessation counseling and referral rates. Counseling rates were defined as the percentage of smokers who received advice about quitting smoking. Referral rates represented the percentage of smokers referred to tobacco cessation services through the Maryland Quitline. The OMSC intervention emphasizes a three-step approach of ask, advise, and act to guide tobacco cessation assessment, counseling, and referral. Additional intervention components included outreach, training, electronic health record (EHR) enhancements, resource materials, and follow-up. The Stages of Change Model provided the theoretical framework for the project, and EBP implementation was guided by the Iowa Model. Participant data was collected from the EHR pre- and post-implementation with a total sample size of 248 participants, (n=125 pre; n=123 post). Data were analyzed using a z-test to compare the two groups’ mean counseling and referral rates, a t-test for equality of subgroups, and Chi-square test for analysis of other demographic characteristics. After implementation of the OMSC intervention, counseling rates increased by 22.1% (p = < .001) and referral rates increased by 6.5% (p < .002). Age group and race/ethnicity had a moderate association with referral rates (p < 0.05). Project findings provided support for this EBP change within the practice setting.