Summary: | Cigarette smoking is a critical issue in caring for patients of chronic kidney disease
(CKD). However, there is no routine care program designed for combining both
smoking cessation and CKD care.
The process of our quality improvement (QI) collaboration used data under
our routine payment-for-performance for pre-end-stage renal disease (P4P Pre-
ESRD) in Taichung Veterans General hospital from 2020 to 2022. We share
our experience with a QI project that integrates the Ottawa model for smoking
cessation (OMSC) with the Pre-ESRD care program as part of routine CKD care.
The electronic health information systems were improved to reduce workload
of medical staff. The number was more for both qualified CKD educators and
nephrologists for smoking cessation.
The access and availability for smoking cessation were immediate and convenient
for patients. Specifically, all the actions were performed by CKD educators, with
nephrologists overseeing the process in routine care. By combining OMSC with
the Pre-ESRD program, we were able to provide smokers with satisfactory access
and availability to smoking cessation services within our healthcare facility. The
smoker cases found were more in number (206 in 2020, 344 in 2021, and 421 in
2022). Before the integrated OSTC-Pre-ESRD program (in 2020), the proportion
of smokers was 3.88%. After implementing the integrated program, smokers
increased significantly on a yearly basis (9.69% in 2021 and 9.82% in 2022).
Finally, case numbers of on-site smoking cessations increased significantly after
implementing the integrated system (0 in 2020, 17 in 2021, and 20 in 2022). All
CKD patients for smoking cessation were also more (8 in 2020, 46 in 2021, and
38 in 2022).
After implementing the QI program, focusing on the integrated OMSC-Pre-
ESRD program, we found more smokers undergoing smoking cessation. This QI
program highlighted the importance of better access and availability for smoking
cessation.
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