Next Article in Journal
Who Benefits from An Intervention Program on Foundational Skills for Handwriting Addressed to Kindergarten Children and First Graders?
Next Article in Special Issue
An Implementation Trial to Improve Tobacco Treatment for Cancer Patients: Patient Preferences, Treatment Acceptability and Effectiveness
Previous Article in Journal
Cohort Profile: Effectiveness of a 12-Month Patient-Centred Medical Home Model Versus Standard Care for Chronic Disease Management among Primary Care Patients in Sydney, Australia
Previous Article in Special Issue
Integration of Tobacco Treatment Services into Cancer Care at Stanford
Open AccessArticle

A Lean Quality Improvement Initiative to Enhance Tobacco Use Treatment in a Cancer Hospital

1
Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27759, USA
2
Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(6), 2165; https://doi.org/10.3390/ijerph17062165
Received: 14 February 2020 / Revised: 18 March 2020 / Accepted: 20 March 2020 / Published: 24 March 2020
(This article belongs to the Special Issue Tobacco Use and Treatment among Cancer Survivors)
Sustained tobacco use after cancer diagnosis decreases treatment effectiveness while increasing treatment side effects, primary cancer recurrence, and the occurrence of secondary cancers. Delivering tobacco use treatment to fewer patients due to inefficient workflow represents missed opportunities to deliver life-saving care. In 2017, the National Cancer Institute initiated the Cancer Cessation Initiative (C3I) to push new tobacco cessation resources into cancer centers across the United States. This grant allowed the University of North Carolina Tobacco Treatment Program (UNC TTP) to dramatically expand tobacco use treatment (TUT) services to patients at the North Carolina Cancer Hospital (NCCH). With this push, the team saw an opportunity to utilize Lean Six Sigma, a set of quality improvement (QI) tools, to streamline their processes and uncover the root causes of program inefficiencies. A 12-month QI project using the Lean A3 problem-solving tool was implemented to examine the team’s workflow. The study team mapped out the processes and, as a result, developed multiple “experiments” to test within the NCCH to address workflow efficiency and clinical reach. Outcome measures from the baseline to follow-up included: (1) the number of new patient referrals per month, and (2) the number of counseling sessions delivered per month. From the baseline to final state, the team’s referrals increased from a mean of 10 to 24 per month, and counseling sessions increased from a mean of 74 to 84 per month. This project provided a deeper understanding of how workflow inefficiencies can be eliminated in the clinical setting, how technology can be harnessed to increase reach, and finally, that soliciting and using feedback from NCCH leadership can remove barriers and improve patient care. View Full-Text
Keywords: tobacco use; smoking cessation; cancer patients; process improvement tobacco use; smoking cessation; cancer patients; process improvement
Show Figures

Figure 1

MDPI and ACS Style

Meyer, C.; Mitra, S.; Ruebush, E.; Sisler, L.; Wang, K.; Goldstein, A.O. A Lean Quality Improvement Initiative to Enhance Tobacco Use Treatment in a Cancer Hospital. Int. J. Environ. Res. Public Health 2020, 17, 2165.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop