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Q clinic Hospital experience Lau Chee Lan Hospital UKM.

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Presentation on theme: "Q clinic Hospital experience Lau Chee Lan Hospital UKM."— Presentation transcript:

1 Q clinic Hospital experience Lau Chee Lan Hospital UKM

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

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

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

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

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

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

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

9 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 Flow Chart of Work Process

10 Take Blood Pressure and weight. - Assess patient - fagerstrom test - CO level - counselling 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 On clinic day - Refer to Doctor / Dietitian

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

12 Statistics ( Apr 06- Jan 07) Number of client and stage of follow up Frequency Percent (%) < 3 months < 6 months months 922 >9 months 410 Only one visit 717 Defaulted F/up or withdrawn 512 Total41100 Demographic of clients

13 CharacteristicsNumber of client No(%) Fagerstrom score1-3 Low12(41) 4-5 Medium9(31) 6-7 High6(21) 8-10 Very High2( 7) Smoking history1-5 years2( 7) 6-10 years14(48) > 10 years13(45)

14 CharacteristicsNumber of client No(%) Cigarettes smoked /day 10 or less8(28) 11 to 2016(55) 21 to 302( 7) 31 or more3(10) Previous quit attemptsNever8(27) 1-2 times9(31) 3-4 times9(31) > 4 times3(10)

15 CharacteristicsNumber of client No(%) Expired CO 10 ppm7(24) ppm14(48) >20 ppm8(28)

16 N = 29 Abstinence rate

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

18 Client survey Impression on pharmacist % Mean score Pharmacist is reliable and helpful understand what was bothering me Hardly explain my problem made me feel foolish should tell more how to manage my condition 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 will recommend to other smokers All things considered satisfactory 824.0

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

22 Audience at CSCSP refresher course CSCSP Refresher course

23


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