Center of Excellence for Health Systems Improvement for a Tobacco-Free New York: Advisory Committee Meeting Minutes February 23, :30pm 3:00pm

Transcription

1 Center of Excellence for Health Systems Improvement for a Tobacco-Free New York: Advisory Committee Meeting Minutes February 23, :30pm 3:00pm Attendees - Patricia Bax, Marketing Coordinator, NYS Smokers Quitline - Patricia Folan, Director, Center for Tobacco Control and Health Systems Regional Contractor for the Long Island Region - Colleen Foreman, Chief Nursing Officer, Community Health Center of Buffalo - Scott McIntosh, Director, Health Systems Regional Contractor for the Finger Lakes Region - Sara Phelps, Community Programs Manager, Bureau of Tobacco Control, New York State Department of Health - Erin Sinisgalli, Director, Seton Health/St. Peter s Health Partners and Health Systems Regional Contractor for the Capital Region - Maxine Smalling, Acting Director, Coordinated Nursing Services, New York State Office of Mental Health - Julie Wright, Program Manager, Health Systems, Bureau of Tobacco Control, New York State Department of Health - Daren Wu, Chief Medical Officer, Open Door Family Medical Centers, Inc. CAI - Michelle Gerka, Vice President, Family and Community Education, CAI - Elizabeth Jones, Director, Health Systems Improvement, CAI - Francesca Sherman, Deputy Director, Health Systems Improvement, CAI Members not present - Dorothy Farley, Vice President, Social Services, Community Healthcare Network - Catherine Guzman, Orange County PROS Program Director, Access: Supports for Living Meeting Minutes I. Needs Assessment: Preliminary Results Regional Contractors require an enhanced proficiency on and familiarity with electronic health record (EHR) systems so they can make comprehensive

2 2 recommendations to health care systems on customizing templates to support the integration of evidence-based practices into workflows. Regional Contractors also could benefit from a centralized effort to negotiate template changes and updates with the common EHR systems corporate headquarters. o Advisory Committee members agreed there is a need to assess the EHR systems being encountered by the Regional Contractors in their work to determine the most commonly-used systems. o As a next step, the COE for HSI will survey Regional Contractors about which EHR systems they are encountering in their work and any changes already made or planned This assessment will inform the COE for HSI s potential coordination of regional efforts to negotiate template changes and updates with EHR vendors o Based on feedback received, the COE for HSI will include EHR screen shots when developing resources for regional contractors, as some users would benefit from having a "visual" of what these EHR systems look like Regional Contractors reported a need for up-to-date information on what tobacco dependence treatments Medicaid Managed Care (MMC) plans cover through their formularies in order to offer health care systems sound technical assistance (TA) on how to promote the routine assessment and delivery of evidence-based treatment of tobacco use at every clinical encounter. o Advisory Committee members discussed the lack of accessibility to current information on MMC plan coverage and were in agreement that this should be an area of focus for the COE for HSI - The COE for HSI Advisory Committee will revisit this issue after dedicating attention to higher priority issues, specifically, integrating tobacco dependence treatment prompts into clinical workflows and EHR systems

3 3 The New York State Smokers Quitline is not intended to replace on-site cessation interventions; it enhances site-based tobacco dependence treatment services by extending supports for patients over several months. Regional Contractors can promote the Quitline as a complement to on-site tobacco dependence treatment, most notably the best practice of prescribing and dispensing pharmacology to patients on-site that same-day. o One Advisory Committee member mentioned that Quitline staff currently are developing a script to triage callers with health insurance to health care delivery sites, where they can access same-day tobacco dependence treatment on-site o The COE for HSI will work with the Quitline and the Bureau of Tobacco Control to provide recommendations to Regional Contractors about best practices for promoting the use of the Quitline as one component in the larger continuum of cessation services available to tobacco users through health care settings Many sites targeted by Regional Contractors have high rates of tobacco use among both patients and staff, most notably mental health treatment settings, and Regional Contractors cite the need for a shift in organizational culture to accompany systems-level changes. Several Regional Contractors expressed a need for improved strategies for garnering the administrative/staff buy-in needed to make systems changes happen. o One Advisory Committee member described challenges that come with working in these facilities: - Providers are not diagnosing patients with tobacco use disorder - Some clinicians are uncomfortable ordering tobacco dependence medication - There is a limited number and availability of clinicians to prescribe medication at sites - Though trends are observed in mental health treatment facilities, they are not substantiated by data

4 4 o A needs assessment tool could be utilized at mental health treatment facilities to monitor the organizational change process. - One Regional Contractor developed an evidence-informed tool that it can share with others o The COE for HSI will discuss the challenges that Regional Contractors are facing with the Statewide Stakeholder Workgroup Mental Health Sub- Committee, as well as stay abreast of Regional Contractors progress working with mental health treatment facilities and provide additional resources and Webinars as necessary o The COE for HSI s literature review and will host an upcoming Webinar on tobacco use among those with serious mental illness, both opportunities for Regional Contractors to gain increased understanding of best practices for integrating evidence-based tobacco dependence treatment into care II. Tobacco Use in Individuals with Serious Mental Illness The COE for HSI released its first literature review, Emerging Practices for Tobacco Dependence Interventions and Treatments for Individuals with Serious Mental Illness, on February 13, Major findings from this literature review support: o Integrated care including both FDA-approved tobacco cessation medication and counseling o Systems-level change that impacts staff at all levels of mental health, including those working in inpatient and primary care settings o The importance of garnering prioritization at all levels and educating all staff who will provide direct services to patients The Advisory Committee discussed the findings from the literature review and their alignment with those of the New York State Office of Mental Health (OMH) o A Regional Contractor mentioned that her team sent the literature review to a site prior to a meeting, which assisted them to gain further buy-in o The COE for HSI will create a one-page version of the literature review for Regional Contractors to use at mental health sites The COE for HSI will host its first Webinar, Decreasing Tobacco Use in Patients with Serious Mental Illness: Strategies for Implementing Best Practices in Mental Health Treatment Settings, on March 23, 2015, which has the following learning objectives:

5 5 o Identify best practices for developing and implementing policies designed to decrease patient tobacco use in health care settings serving individuals with SMI o Discuss strategies for garnering leadership and staff support around the institution of policies and practices aimed at decreasing patient tobacco use within healthcare settings serving individuals with SMI o Examine best practices for implementing policy changes aimed at decreasing patient tobacco use within health care settings serving individuals with SMI o Review lessons-learned from a mental health treatment facility that successfully implemented systems changes aimed at decreasing patient tobacco use Maxine Smalling, Acting Director of Coordinated Nursing Services at OMH and a member of the COE for HSI Advisory Committee, will highlight best practices for implementing tobacco-free policies and integrating the delivery of evidencebased tobacco dependence treatment into care within health care settings serving individuals with SMI. o Sonia Vilgorin, Deputy Director of Quality Assurance, and Rachel Mathew, Chief Nursing Officer, at Rockland Psychiatric Center will present on their experience successfully going tobacco-free. Advisory Committee members agreed that this Webinar was timely and relevant. o One member mentioned that the staff at mental health treatment facilities are overwhelmed, so it is important to discuss how to address barriers. o A member discussed her team s development of a resource describing how facilities can integrate tobacco dependence treatment into care while maintaining compliance with OMH standards. While the primary target audience for this Webinar is the Health Systems Regional Contractors, they are encouraged to invite colleagues and representatives from mental health treatment facilities. o The archived webinar will be available on the COE for HSI website. Next Steps 1. The third Advisory Committee Meeting will be a conference call that will take place on May 20 from 1:30 to 3:00pm 2. The COE for HSI will share the meeting minutes with members

6 3. The COE for HSI will survey the Health Systems Regional Contractors about which EHR systems they are encountering at sites and any changes or planned changes 4. The COE for HSI will create and circulate a one-page document detailing major findings from the literature review 6