Improve the recording of Patients’ Smoking Status

What is the aim of this QI activity 

• Improve the smoking recording rate of active patients in your practice

• Record the smoking status of 30 active patients who are aged 15 years and over in a 4-week period.

What will I need to do?

Record the smoking status of your active patients in the correct field of patient file in your clinical software.

How will I complete this activity?

• Record smoking status – current smoker, ex-smoker, never smoked 

• Date of smoking status recorded

Where do I document my results?

• QI summary register 

• Model for improvement/PDSA template

Who can I contact for support?

For support with this activity please contact the General Practice Quality Improvement team on Ph. 38647540 or email [email protected]

1. Identify active patients with missing smoking status record

Using Primary Sense, identify 30 patients whose smoking status is not recorded. To do this we suggest reviewing the “patients booked in with missing PIP QI measures” report twice a week or more until 30 patient files have been updated with smoking record. This is because your appointment book changes regularly.

2. Flag patients who require smoking status update

Discuss as a team how and where patient records can be flagged when a smoking status update is required.  Agree on a consistent process and use this method to flag the patients identified in Step 1. 

3. Update patient’s smoking status when attending the appointment

With patient flagging process in place, team members are to confirm and update patient’s smoking status in the correct field in your clinical software.

For Best Practice users:

There are two options to access the smoking recording field: 

1. A single click on the tobacco field in the patient details section. 

2. Access from the family/social history section on the left-hand side pane, click on “social” then “tobacco” to update the record.

For MedicalDirector users:

There are two options to access the smoking recording field:

1. Click on the smoking icon on the top bar.

2. Click on the “smoking Hx” field to record the status.

4. Document progress

Document the progress of your activity. You can use the MFI/PDSA template to record your progress and results or simply document your results in the QI summary register. 

Tracking results

This section will assist you to track your results and answer the following questions:

• How will you know that change is an improvement? 

• What data will be used to track the improvement?

• What is the current data showing?

Suggested measures and data sources

• With a goal of updating 30 records for this activity, manual tracking is a simple and convenient option. You can opt for a tally table or cross the list in the Primary Sense report each time a patient’s smoking status is updated until the goal is reached. 

• For ongoing monitoring, practices can use “accreditation % compliance” report in Primary Sense or Practice Report Dashboard to track your proportion of patients with smoking status recorded

How did you go?

As a team, reflect on how the activity went.  

• What were the challenges/barriers?  

• What worked well? 

• Are there any changes that you could implement to support the recording of smoking status of your patients in your practice? 

Share your results

Share your results with your team and Brisbane South PHN.

Next steps

Consider how smoking status can be used to tailor the interventions and screening programs to meet your patients’ individual health needs.

QI activity example

View the Model for Improvement (MFI) diagram and Plan, Do, Study Act (PDSA) example of a practice aiming to increase their proportion of active patients with smoking status recorded.