Implementation of a collaborative smoking cessation referral process in a psychiatric setting

Tobacco use is more prevalent in persons with psychotic disorders than in the United States adult population. Tobacco use is associated with an increased risk for the development of psychotic disorders. Tobacco also alters medication pharmacodynamics increasing the likelihood of non-therapeutic doses. Tobacco treatment specialists (TTS) are healthcare personnel trained to counsel patients on smoking cessation. The aim of the quality improvement project was to create a standardized smoking cessation referral process for inpatients and outpatients at Vanderbilt Psychiatric Hospital and educate about available TTS resources. A patient list was created and select providers were granted access to add patients to the list. Pre-intervention and post-intervention questionnaires allowed for analysis of provider tendencies and opinions. The pre-intervention questionnaire indicated providers were unfamiliar with TTS availability. After provider education on TTS and implementation of the referral process, 69 patients were referred in 16 weeks. Provider familiarity with TTS and listing of “smoking” on the problem list increased, though there was no statistically significant change in provider view of smoking cessation importance. The standardized referral process was successful in increasing referrals to TTS and was more effective in the inpatient setting than the outpatient setting. Continued education on smoking cessation resources is required.