Abstract: Poster Presentations |


Eleana R. Conway, MSN*; Timothy R. Wu, MD; Leslie Mitchell, PharmD
Author and Funding Information

Lahey Clinic, Burlington, MA


Chest. 2009;136(4_MeetingAbstracts):23S-b-24S. doi:10.1378/chest.136.4_MeetingAbstracts.23S-b
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PURPOSE:  Tobacco use is the single most important preventable cause of death and disability. Further, exposure to environmental tobacco smoke can seriously threaten the health of nonsmokers. A comprehensive look at the tobacco free conversion of a total health system unique in varied geographical locations and target populations and problems encountered.

METHODS:  A diverse oversight committee, representing tobacco and non-tobacco users, guided the 18 month implementation of the tobacco free program. Subcommittees included policy development, compliance, communications, and cessation benefits. Goals included: improve the health of our community, recognize the impact of second-hand smoke, and support tobacco users in their quit attempt or in finding alternate ways to cope while on Lahey property.

RESULTS:  The conversion was successful with few reported problems requiring innovative solutions. Lahey Clinic maintained its leadership role in the community as the source for health with emphasis on wellness and health promotion and has been invited to share its experience with other organizations.

CONCLUSION:  Problem/Solution #1: Varied geography and populations posed a unique challenge. Lahey consists of three large medical centers and eleven community group practices spanning 25 miles. Sites vary from urban to rural ranging from a 4 person office to a hospital staffed with over 1500 colleagues. To create positive outcomes, relationships with surrounding communities, including town officials, businesses and resident neighbors were considered.Problem/Solution #2: Patients may experience symptoms of nicotine withdrawal in a tobacco free environment. In order to maintain quality patient care and safety, we developed systems including nicotine withdrawal order sets, nursing care plans and practice guidelines. Problem/Solution #3: Supporting tobacco users was imperative. To ease the transition we implemented a crisis team, offered wellness and smoking cessation programs, and provided “Tobacco Free Toolkits.” A website provided clear communication to colleagues of benefits including contests, group support, wellness programs, and medication benefits.

CLINICAL IMPLICATIONS:  We offer strategies to facilitate conversion of a major medical center to a tobacco free environment and outline opportunities for improved health of patients, visitors and colleagues.

DISCLOSURE:  Eleana Conway, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM




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