Improving Screening and Education for Secondhand Smoke Exposure in Primary Care Settings.

A nurse-led QI initiative used interventions such as clinician education, visual reminders, flag reminders, and a monetary incentive to increase the number of secondhand smoke screenings providers performed and the number of patients screened and counseled. Exposure to secondhand smoke (SHS), also known as environmental tobacco smoke, adversely affects human health across the life cycle and has important economic consequences. The fact that many health care providers don't routinely screen all patients for SHS exposure and educate them on the risks associated with it is exacerbated by the lack of any requirement to do so, as well as the absence of adequate SHS screening questions in many electronic health record (EHR) systems. Further research on improving screening and education interventions is therefore warranted. In this quality improvement initiative, we introduced flag reminders, visual reminders, education, and a monetary incentive for providers, which improved their screening for and education on SHS exposure in the patients in a primary care clinic. The clinicians' behavior change in response to these interventions supports our proposal that an effective screening question with a flag reminder be added to the EHR, and confirms the need for continued research on screenings, EHR efficacy, and clinical behavior change. [ABSTRACT FROM AUTHOR]