HSE Tobacco Free Campus Policy Working towards a Tobacco Free Ireland by Ms. Miriam Gunning, HSE National TFC Lead

Transcription

1 HSE Tobacco Free Campus Policy Working towards a Tobacco Free Ireland by 2025 Ms. Miriam Gunning, HSE National TFC Lead miriam.gunning@hse.ie

2 1 st Smoke Free Hospital Campus 1 st January : Commitment from Senior management Legal advice sought Meetings with Unions Presentations to Hospital Executive & Medical Board

3 St Vincent s University Hospital Established 1834 by Irish Sisters of Charity Teaching hospital affiliated to University College Dublin Capacity: 478 beds Duration of stay 10.8 days Health Service Executive (publicly funded)

4 Smoke-Free Campus Patient Pathway hospital signage patient information leaflet GP Out-patient clinics ambulance Admission desk doctors allied health staff catering staff ward A&E nurses porters ward assistants discharge

5 International/National Tobacco Management in Irish health services Tobacco Free Campus Policy in ALL health services

6 Huge engagement with stakeholders Internal consultation with each directorate External consultation with the joint council of unions Labour court decision affirmed and commended the HSE on this policy initiative

7 Intends to minimize and eliminate: Tobacco addiction in all it s forms Nicotine addiction Exposure to tobacco smoke

8 TFC policy aims Treat tobacco use as a care issue thus providing a better outcome for patients Denormalise tobacco use in healthcare settings Senior Management Commitment, Education/Training and Cessation support are key elements of the policy all of which are integral to the ENSH-Global standards On going monitoring and evaluation of the policy/tobacco control generally is vital

9 Organisational Considerations Health and wellbeing of staff & service users Delivery of Safe Quality care A person centred approach & risk management Local considerations A change model built on collaboration with staff, service users, and HP personnel Promote local ownership of the policy Identify Champions and harness existing supports

10 National Policy Priorities

11 ENSH-Global Quality Standards Standard 1 - Governance and Commitment Standard 2 - Communication Standard 3 - Education and Training Standard 4 - Identification, Diagnosis and Tobacco Cessation Standard 5 - Tobacco-Free Environment Standard 6 - Healthy Workplace Standard 7 - Community Engagement Standard 8 - Monitoring and Evaluation

12 Social Marketing Campaign 1 in 2 stories; reality of loss = why to quit Support services; peer to peer = how to quit

13 Our QUIT Service Freephone Freetext Proactive phone counselling Daily texts & s Social Media Webchat Social media Online QUITplan 1-1 Clinics & Groups Health Professional Referrals Trained cessation support staff

14 1. NSP BISC training targets 2. On-line registration Server/fs-2016BISC.aspx 2016 BISC target Mental Health = 4.5% frontline staff CHO 1 CHO 2 CHO 3 CHO 4 CHO 5 CHO 6 CHO 7 CHO 8 CHO

15 Resources and Tools 8 Quality Standards - for tobacco management in healthcare Self Audit Tool translated & available for online use Recognition Process GOLD Forum Process Networking sharing and learning events, website

16 TOTALS 23 19% % Assessing the size of the problem! Centre Staff % Participants % Admin 0 0% 0 0% Thomas Court 1 17% 22 52% Airdnua 1 17% 28 57% Castleview 1 25% 17 63% Cherryfield 1 25% 25 39% Conai 0 0% 33 56% Estuary 4 36% 22 33% Goirtin 2 40% 14 56% Harvest 2 67% 12 38% HSE Print 1 11% 0 0% Larine 1 20% 27 63% SAOL 1 33% 15 31% New Dawn 0 0% 23 43% New Horizon 1 25% 15 47% Phoenix 1 25% 30 47% Plantmarket VT 1 20% 16 55% Platinum 0 0% 30 34% Riverview 2 40% 6 32% Suaimhneas 1 20% 39 48% Tuiscint 1 14% 5 16% Rainbow 1 17% 17 26%

17 Challenging the Rights Issue A Rights Issue Right to accurate information regarding tobacco use and options for quitting Right to achieve optimal health and well being Right to achieve personal recovery

18 Tobacco Free Campus journey 2013 HSE NSP Implement HSE TFC Policy in All acute hospitals & 35% of PC centers (82% Acute sites/35% PCC achieved) Commitment to train 1,350 HC staff in BISC (1395 trained) 9000 clients to receive intensive SC support (10,525 clients) 2013 HSE NSP Implement HSE TFC Policy in 100% Hospitals & 70% PC (100% Acute/72% PCC achieved) Commitment to train 1,350 healthcare staff in BISC (1303 trained plus 165 undergrad) 9,000 clients to receive intensive SC support (9,309 clients) No. of smokers quit at 1 month (2,450) (2,184 ) QPS Audit of Tobacco F Campus 8 sites (complete)

19 Tobacco Free Campus journey 2015 HSE NSP Implement HSE TFC Policy in 100% Approved MH, (39% achieved) 25% Residential MH (24% achieved), 20% Older Persons Residential ( 45% achieved), 25% Disability Residential) ( 14.7% achieved) Train 1,350 HC staff in BISC (1, % on target) 9,000 clients to receive intensive smoking cessation support (11, %) No. of smokers quit at 1 month (2,450) (achieved 2,490)

20 Tobacco Free Campus journey 2016 HSE NSP Implement HSE TFC Policy in 100% Approved MH, 25% Residential MH, 75% Older Persons Residential, 25% Disability Residential) Train 1,350 HC staff in BISC 11,500 clients to receive intensive smoking cessation support % of smokers quit at 1 month (45%) Launch Toolkit for TFC, Mental health Briefing resource Host 6 National TFC support workshops

21 Challenges to Policy Implementation Shared campuses with other HSE facilities, with residential facilities and with commercial companies Managing risk Managing inconsistency in addressing policy implementation issues/challenges Changing hearts and minds among professional and health care worker staff and the culture and acceptance of smoking as just a bad habit within some services Lack of consistent monitoring and review once policy has been implemented initially

22 HSE have to continuously.. Acknowledge and address local organisational barriers Ensure cessation options are made available to our service users Incorporate tobacco management into our programmes & services Acknowledge & address staff attitudes/concerns regarding tobacco use/cessation among clients

23 Doing the right thing isn t always easy!! Both staff & service users all acknowledge the benefits of smoking cessation Many are dealing with life long addiction & challenge of living in homes where smoking is the norm Organisationally selling a health and wellness message is key Important to see this initiative in a broader context of personal wellness

24 Treating tobacco as a care issue WHO 1994 Classification of Disease ICD-10: Nicotine Dependence a chronic relapsing disease Diagnosis code Z72.0 current tobacco use, Z86.43 past history of tobacco use, F17.1 harmful tobacco use, F17.2 tobacco dependence o F17.3 withdrawal state Treatment code Z 71.6

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28 New TFC Supports A suite of tools available on-line in the TFC Toolkit & Implementation Guide 6 TFC Workshops Sligo: Wexford: Limerick: Ardee: Cork: Dublin: Thursday April 7 th pm Monday April 18 th 1pm 4.30pm Tuesday April 19 th pm Wednesday April 20 th pm Friday April 22 nd pm Monday April 25 th pm

29 Next steps Individual Care Plans Quality Compassionate Care Individual Risk Assessment Quality & Patient Safety Statement of Purpose External Audit Proposed Reward system Acknowledge innovation Staff incentives/h& WB for staff NRT for staff/cessation support Professional bodies - buy - in of Doctors & HR (addressing the culture of smoking breaks) SLAs Money follows the patient/activity based funding Tobacco actions clearly embedded in CHO and Hospital group HI plans

30 Thank you for listening Any Questions?