Background and Objectives Recognition of hospitalized individuals who smoke has shown significant improvement in recent years but provision of evidence-based tobacco cessation treatment remains a challenge. counseling at the time of discharge. Results There were 52 and 42 smokers in the pre-and post-intervention cohorts respectively. On the 3 months following implementation of the EHR order arranged prescription of NRT at the time of discharge did not switch significantly (27% vs 19% p=0.30). Referral for outpatient smoking cessation counseling improved in the post-intervention group but did not reach significance (64% vs 72% p=0.20). Conclusions Implementation of a brief tobacco dependence treatment order set in an existing EHR improved cessation counseling referrals on a vascular surgery inpatient unit. One potential limitation of the study was the moderate sample size. Not being able to Syringin make smoking cessation treatment a required component in discharge orders may also have contributed to the moderate effect. Assessing the differential effect of EHR-based order implementation will be important in future study on this Syringin topic. INTRODUCTION Systematic comprehensive treatment of tobacco dependence in hospitalized individuals has been identified as a national healthcare priority from the Centers for Medicare & Medicaid Solutions (CMS) and The Joint Percentage (TJC). In addition TJC released a tobacco use overall performance measure set in 2012 which greatly expands on previously required interventions for tobacco users; namely the limitation to individuals admitted with acute myocardial infarction congestive heart failure or pneumonia has been eliminated. Utilization of the electronic health record (EHR) offers been shown to increase adherence to these recommendations.(4) High risk patient populations such as patients admitted for complications of peripheral arterial disease (PAD) can be the focus of targeted interventions to improve the quality of healthcare delivery. Inpatient hospitalization for complications of PAD is an unequaled Syringin chance for evaluation of readiness to quit using tobacco to provide individuals with evidence-based appropriate treatment while hospitalized as well as continued treatment upon discharge with scheduled follow up. Smoking cessation and subsequent abstinence from tobacco use have been shown to decrease PAD-related morbidity and mortality.(5) The U.S. Division of Health and Human being Solutions Public Health Services tobacco treatment recommendations (2008 upgrade) emphasize the effectiveness of counseling and pharmacologic interventions especially in combination in increasing smoking-cessation rates.22 The use of EHRs offers increased exponentially over the past decade and this technology offers a unique chance for efficient integration of system level changes aimed at improving the quality of health care delivery. A recent Cochrane review helps the use of the EHR as a tool to increase documentation of tobacco use status and referral to cessation counseling12. A Syringin standardized evidence-based tobacco cessation evaluation and referral EHR module having a focus on tobacco use treatment at the time of hospital discharge was designed and implemented on a vascular surgery inpatient unit. The aim of this study was to assess the effect of the new EHR module on provision of tobacco cessation treatment including counseling and pharmacotherapy at the time of discharge. METHODS Using a pre-post study design we tested the effect of adding a tobacco cessation module Syringin to an existing vascular surgery discharge order set in the EHR (Health Link Epic) utilized at the University or college of Wisconsin Hospital and Clinics (UWHC) in Madison WI (Number 1). Number 1 Tobacco cessation module component of the Vascular Surgery Discharge order set as it appears within the electronic health record. A standardized discharge order template is used to discharge all patients Rabbit Polyclonal to SERINC2. from your Vascular Surgery inpatient services at UWHC. A “tobacco abstinence” module was designed and added to the existing order set already in use (Fig 1). The module includes medical decision support by instantly populating the patient smoking status as documented from the admitting nurse. If clinicians do not total the tobacco abstinence module they are still able to total the discharge Syringin order set and the overall process of discharging the patient from the hospital. An electronic quit on the discharge process for failure to total the tobacco abstinence module was not implemented. A chart review of vascular surgery inpatients carried out from May 2012.