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Q clinic Hospital experience

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Presentation on theme: "Q clinic Hospital experience"— Presentation transcript:

1 Q clinic Hospital experience
Lau Chee Lan Hospital UKM

2 Background Counselling week HUKM : Good response to Quit smoking booth
: avr visits smokers population in Cheras : 12.9% CSCSP programme ’TAK NAK’ campaign

3 Objective To provide professional help to aid smokers quit smoking
To provide continuous support and monitoring for smoker to quit To prevent or reduce smoking related disease among HUKM patients

4 Set up Support from hospital administrator Consultation : Prof. Haniki
Pn. Faridah Training : MPS- CSCSP

5 Preparation Literature search and counselling aids
Proposal and Budget approval Protocol and work flow Clinic Location and Day Staff Training and certification

6 Equipments Breath Analyzer (PICO®)
Nicotine Replacement Therapy (Patch +Gums) - FOC for 1st 3 mth for staff BP set Weighing scale Posters and leaflets Appointment log Bed Head Tickets

7 Implementation Staffing Clinic Session Consultant : Doctor
Medical assistant 11 pharmacists : 2 per clinic session Dietitian Clinic Session Staff clinic Tuesday : p.m

8 Implementation Target clients
HUKM staff referred from Polyclinic or ‘walk in’ Each clinic session : - max 8 clients (including max 4 new clients)

9 Flow chart /Work Process Pre-clinic
Flow Chart of Work Process Flow chart /Work Process Pre-clinic Patients walk-in or referred - Gives name and contact to MA at Klinik Warga MA arranges appointment date, calls to inform patients Every Monday - informs Pharmacist number of appointments and prepare patients BHT

10 On clinic day Take Blood Pressure and weight. - Assess patient
- fagerstrom test - CO level - counselling - Refer to Doctor / Dietitian Pharmacist dispense NRT to staff and fill in log book. Non-staff to buy NRT from Kedai Farmasi (Pharmacist to fill in Order Form for patient) Follow up appointment : 1st month : Every week 2nd & 3rd month : Every 2 weekly Till 6th month : Every month

11 Monitoring Initial visit Initialvisit_form25.5.06.doc
Follow up FU_form doc Treatment chart Txchart_form doc Monitoring chart Patient monitoring chart_Quit clinic.xls

12 Statistics ( Apr 06- Jan 07) Demographic of clients Frequency
Percent (%) < 3 months 5 12 3- < 6 months 11 27 months 9 22 >9 months 4 10 Only one visit 7 17 Defaulted F/up or withdrawn Total 41 100 Number of client and stage of follow up Number of client and stage of follow up

13 Characteristics Number of client No (%) Fagerstrom score 1-3 Low 12 (41) 4-5 Medium 9 (31) 6-7 High 6 (21) 8-10 Very High 2 ( 7) Smoking history 1-5 years ( 7) 6-10 years 14 (48) > 10 years 13 (45)

14 Cigarettes smoked /day 10 or less 8 (28) 11 to 20 16 (55) 21 to 30 2
Characteristics Number of client No (%) Cigarettes smoked /day 10 or less 8 (28) 11 to 20 16 (55) 21 to 30 2 ( 7) 31 or more 3 (10) Previous quit attempts Never (27) 1-2 times 9 (31) 3-4 times > 4 times

15 Characteristics Number of client No (%) Expired CO ≤ 10 ppm 7 (24) 11-20 ppm 14 (48) >20 ppm 8 (28)

16 Abstinence rate N = 29

17 Obstacles Fluctuating client motivation /determination
- Default appointment - ? Stress at work ? Counsellor – young, nonsmoker ? Rapport issue Location? – privacy -

18 Client survey Impression on pharmacist % Mean score
Pharmacist is reliable and helpful 92 4.1 understand what was bothering me 88 3.8 Hardly explain my problem 17.8 2.6 made me feel foolish 57 2.7 should tell more how to manage my condition 71 3.9 Strongly agree : 5 agree : 4 uncertain: 3 Disagree : 2 Strongly disagree:1 N = 28

19 Client Survey Convenience % Mean score
Missed appointment due to work commitment 86% Appointment should be reminded 82% 3.8

20 Client Survey Overall Satisfaction % Mean score
felt much better after clinic 68 3.9 will recommend to other smokers 86 4.2 All things considered satisfactory 82 4.0

21 Future plan One to one counselling
Motivational Interviewing (MI) skill Updates and training

22 Audience at CSCSP refresher course

23 Thank you for your attention


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