Congratulations to our Respiratory Consultant David Lodge, who’s been named a Healthcare Inequalities Hero by the Healthcare Quality Improvement Partnership (HQIP).
David led a six-month project to improve how nicotine replacement therapy (NRT) is offered to inpatients at St Richard’s Hospital (SRH). It all started, he says, with a simple question that had been niggling him for some time:
“We know that one in two long-term smokers will die from a smoking-related disease and smoking is a major cause of health inequality – so why aren’t we doing more to help our in-patients quit?”
Determined to make a change, the project team of resident doctors, specialist nurses and pharmacists mapped out all the processes involved in the patient journey, so they could identify the barriers to prescribing NRT.
They found that only 40% of patients were having their smoking status recorded on admission, and sometimes up to 24 hours after their arrival. Meanwhile, junior doctors were often unsure which NRT products to prescribe – with multiple options and not enough stock.
So David and the team of junior doctors, pharmacists and specialist nurses took action, supported by the Tobacco Dependency Managers:
- Smoking status is now a mandatory question on our patient monitoring system, PatienTrack, to be completed within six hours of admission.
- Prescribing has been simplified to just two patch options – one for daytime smokers and one for those who smoke around the clock.
- NRT patches are now stocked on medical wards, so patients can start treatment right away.
The result? A big cultural shift in how often NRT is prescribed, with the number of patients receiving high-dose Nicotine Replacement Therapy patches increasing by 50% in the first six months of the project launching.
“We might not help everyone quit, but if we help just one person stop smoking, it’s worth it,” David says.
After winning over 135 other applicants to scoop the HQIP award, David’s team was invited to share the project nationally at the British Thoracic Society Summer Meeting.
The work continues. A team of Tobacco Dependency Advisors have recently joined the Trust to further empower patients to quit smoking during their hospital stay and beyond.
Meanwhile, David is already thinking ahead to his next improvement project – exploring how patients suspected of having lung cancer get diagnosed faster. Watch this space.