| Assessment of the degree to which these functions are happening: | All visits by patients aged ≥18 y to 1 of the 8 clinics during the study period |
| Ask: smoking status ascertained |
| Advise: recommended quitting |
| Assess: assessed readiness to quit now |
| Connect: offered referral to assistance with quitting (ie, QL or FFS services) |
| Patient's smoking status |
| Current smoker, previous smoker, nonsmoker |
| Patient's readiness to quit in the next 30 d |
| Referral accepted or declined |
|
Data source: referral data returned to EHR
| |
| QL | Patients who accepted a referral to tobacco-cessation counseling |
| Successfully contacted |
| Enrolled |
| No. of counseling sessions completed |
| FFS |
| Successfully contacted |
| Enrolled |
| No. of counseling sessions completed |
| Received NRT |
|
Data source: patient survey
|
Population
|
| Items measuring patient experience with the primary care teama | Random samples of patient aged ≥18 y who smoked were seen during the study period and had a discussion about smoking |
| Example items: |
| Were you treated with respect? |
| Did you feel listened to? |
| Were you able to honestly speak your mind about quitting? |
| Was the advice you received helpful? |
|
Data source: in-depth interviews
| |
| Patient narratives about experiences with e-referral to the QL | 3 groups from the sample of patients who agreed to be referred to the QL and subsequently (1) declined participation in the QL, (2) were unreachable by the QL, (3) completed the QL program |
|
Key covariates
| |
| EHR | |
| Clinic site | |
| Provider type: family medicine, internal medicine | |
| Patient's primary insurance: commercial, Medicare, Medicaid, uninsured | |
| Patient demographics: age, sex, race/ethnicity | |
