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Health Care and Tobacco Cessation – A Perfect Partnership

There is an important and historical development in healthcare that has taken place. The Joint Commission, which accredits approximately 18,000 healthcare organizations in the United States, has developed a new set of performance measures to address the assessment and treatment of tobacco dependence for all hospitalized patients.

The Joint Commission had first introduced incentives for hospitals to address tobacco dating back to 1992. Then in 2004, the Joint Commission implemented performance measures for the delivery of evidenced-based tobacco dependence treatment to patients who had history of smoking, as well as specific cardiac diseases. These measures were ineffective as they left out an important component of treatment:  they were not required to connect patients to post discharge care.

The new Joint Commission measures require acute care hospitals to screen all inpatients for tobacco use and to offer counseling and medications to patients 18 years of age or older who use tobacco. These services should be offered both during the hospital stay and at discharge to maximize patient health and reduce the likelihood of re-hospitalizations. Thereafter, patients must receive follow-up contact within 30 days of discharge to ascertain tobacco use status.

Unlike the earlier measures, the new measures do not target a specific diagnosis. Rather, they are broadly applicable to all hospitalized patients 18 years of age and older. The Joint Commission encourages hospitals that provide tobacco cessation interventions to patients younger than 18 to continue this practice, though these data will not be a part of the new measure set. One standard, Meaningful Use, however, does require all patients 13 years of age and older be screened for tobacco use and for this information to be documented in their electronic health record (EHR).

Source: www.jointcommission.org and www.prevent.org

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