Tobacco Free Futures Survey of Smokers on University of Alberta Hospital Site
Feb 2013 Facilities: Walter MacKenzie Center Kaye Edmonton Clinic
Number Summary 3 Purpose 4 Methods 4 Results 4 to 7 Table 1: Number of Smokers Observed Jan and Feb 2013 4 Figure 1: Smokers by percentage at all four locations. 4 Figure 2: Number of smokers for Jan 2013 5 Figure 3: Number of smokers for Feb 2013 6 Table 2: Number of Smokers/Hr 7 Figure 4: Number of Smokers/Hr from each location 7 Recommendations 8 to 9 Appendix A. 10 to13 Data Table 3: Data from Jan to Feb 2013. 10 to13 Appendix B. Survey Locations 14 to 16 Figures 5 to 10: 112 Street 14 Figures 11 to 18: Magic Tree 14 to 15 Figures 19 to 24: 114 Street 15 to 16 Figures 25 to 27: Edmonton Clinic/Aberhart Center 16 Appendix C. Report from Edmonton Zone Protective Services 17 to 18 References 19
The starting point was The Tobacco Free Futures Guidelines1 to ask who smokes and where do they smoke? After approximately two months, 27 hours and 35 minutes and 502 smokers a number of patterns resulted. Smokers congregate at the main entrances to Walter Mackenzie Center, The Magic Tree and the Edmonton Clinic. The majority of staffers are smoking during weekdays, as the highest numbers of staff members are on site Monday to Friday. Staff smoked most often at The Magic Tree and Edmonton Clinic. Most of the smokers were identified as visitors. This is potentially because any plain clothed staff or patients were classified as visitors. Visitors and the majority of smokers used tobacco at the 114 Street most frequently. Approximately 18.4 smokers per hour were observed in the evenings and weekends. Recommendations were made with assessment section in mind but all sections of the guidelines as required should be implemented. 3.5 Review current policy compliance by facility, staff, patients and visitors (# of tickets and warnings issued by protective services). Is there current tobacco use permitted on AHS owned or leased property? • 112 street entrance • 114 street entrance • The Magic Trees • Edmonton Clinic/Aberhart 3.6 If applicable, establish plan to phase out tobacco use on site. Are there ashtrays or smoking areas that need to be removed? • Would we consider removing all, one or a few smoke areas? If yes, how could we remove smoking areas? 3.7 Review need for policy signage at site. Are there entrances or areas on site that require signs? Order updated signage if needed. • Edmonton Clinic only has a few outdoor signs in the main entrance. More signage is between the Aberhart and the Edmonton Clinic. 3.8 Develop communications plan to inform staff and patients of policy. Going forward the intent would be to work towards fulfilling the Alberta Health Services quality and patient dashboard objective2 of increasing the “percentage of patients who smoke discharged with a smoking cessation plan” with the goal of decreasing the use of tobacco in Alberta.
Summary
1 Alberta. Alberta Health Services and Canadian Cancer Society. “Tobacco Free Futures Guidelines.” Sept 2012. http://tobaccofreefutures.ca/resources.html (2 March 2013). 2 Quality and Patient Safety Dashboard Indicators. 2012. Alberta Health Services. http://www.albertahealthservices.ca/1329.asp 2 March 2013.
Who smokes? Where do they smoke? Plain clothed visitors will be the highest number of smokers and will include patients, staff and volunteers.
Methods:
Figure 1: Smokers by percentage at all four locations. (See appendix B for locations.)
Staff
Visitors
Patient
Total by Category
42
380
80
Grand Total
502
Table 1: Number of Smokers Observed Jan and Feb 2013
In certain time intervals (5 min, 15 min or 30 min) the observer counted the number of staff, visitors, volunteers, and patients who were smoking. They had a light cigarette in their hand, exhaled second hand smoke or had a cigarette in their mouth. Staff were those in scrubs, wearing an ID badge or AHS issued lanyard. Patients were identified as individuals with a wristband and if they were in gowns and hospital clothing. The remainder of smokers who were in plain clothes were classified as visitors.
Purpose:
Results:
Figure 3. Number of Smokers for Feb 2013
As of Feb 27, 2013 – 1635 minutes or 27 Hours 35 min (0.25 = 35 min) Smokers/Hour (502 smokers/27.25 hours = 18.4 Smokers/Hour)
Patients
Staff members were observed smoking 19 times. Only four days or 20% of the time they were observed on a weekend or holiday. The dates were Saturday Jan 19, Saturday Feb 9, Sunday Feb 17 and Holiday Monday Jan 18, 2013.
Category
Number/Hour
Smokers/Hour
18.4
Staff/Hour
1.5
Patients/Hour
2.9
Visitor/Hour
13.9
Smokers
No patients at the Edmonton Clinic were identified, as there was no one wearing hospital issued attire or a white wristband. Plain clothes patients and staff may have been classified as visitors. Majority of staff were at The Magic Tree and The Edmonton Clinic. The largest numbers of patients were identified at the 114 street entrance way. The largest numbers of visitors were observed at the 114 street entrance way. The most smokers per hour were found at the 114 street entrance way.
Table 2: Number of Smokers/Hr
Following the section 3.0 Assessment in “Tobacco Free Futures Guidelines”. 3 3.1 Review of AHS Tobacco and Smoke Free Environments Policy. Discuss the role of Protective Services and other staff in enforcement of policy. Section 1. 3.2 Determine patient populations at site that policy special considerations may apply to. • For example: o Preoperative Care o Emergency and Urgent Care 3.3 If applicable, establish site approval process in accordance with policy for special considerations 3.4 If applicable, establish tobacco use area for patients with special consideration in accordance with policy 3.5 Review current policy compliance by facility, staff, patients and visitors (# of tickets and warnings issued by protective services). Is there current tobacco use permitted on AHS owned or leased property? • Yes it appears four areas exist. o 112 street entrance o 114 street entrance o The Magic Trees o Edmonton Clinic/Aberhart 3.6 If applicable, establish plan to phase out tobacco use on site. Are there ashtrays or smoking areas that need to be removed? • Compliance will continue to be a problem • Would we consider removing all, one or a few smoke areas? If yes, how could we remove smoking areas? 3.7 Review need for policy signage at site. Are there entrances or areas on site that require signs? Order updated signage if needed. • Edmonton Clinic only has a few outdoor signs in the main entrance. More signage is between the Aberhart and the Edmonton Clinic. 3.8 Develop communications plan to inform staff and patients of policy. • Following suggestions could be considered: o In the advise step of the 5As remind the patient that they and their visitors are not allowed to smoke in the hospital o Each unit and area decides what is the best promotional material for their area and then proceeds to http://tobaccofreefutures.ca/resources.html and order items free of charge. - Posters in the waiting room areas
Recommendations
3 Alberta. Alberta Health Services and Canadian Cancer Society. “Tobacco Free Futures Guidelines.” Sept 2012. http://tobaccofreefutures.ca/resources.html (2 March 2013).
4 Swardon, Sarah. 26 September 2013. Tobacco Free Futures Steering Committee (UAH Site). Word Document. Retrieved from 1 March 2013 from personal email: Swardon, Sarah. “Tobacco Free Futures – Meeting Wed Oct 24.” Email to committee. 17 Oct 2012.
• Tent cards in the waiting room areas • Window cling posters o Posters in the elevators o Target staff in the EDM Clinic and The Magic Tree with Employee Assistance Program posters advertising cessation programs o Posters to Communications Department (6) and they will go on each of the floors o Internal mail in the WMC (35) and the EDM Clinic (35) • Tent cards to all units at all locations In a report from the Edmonton Zone Protective Services Department the University of Alberta Hospital (UAH) was compared to several other sites in the Edmonton Zone. They included Alberta Hospital Edmonton (AHE), Royal Alexander Hospital (RAH), Glenrose, Sturgeon and Leduc. UAH had the highest number of violations. More adults then youth were involved in the tobacco restriction incidents and more warnings were given out then fines. UAH could look to reduce the number of violations. For 14 days at the UAH a Tobacco Free Futures kisok was set up in the foyer. 500 people were reviewed. 30% staff, 30 % visitors, 30% patients and of these groups 20 to 30 % wanted help quitting.4 for assistance and hope smokers will be successful in quitting attempts. This indicates a need for assistance and hope smokers will be successful in quitting attempts.
References
Alberta. Alberta Health Services and Canadian Cancer Society. “Tobacco Free Futures Guidelines.” Sept 2012. http://tobaccofreefutures.ca/resources.html (2 March 2013). Milligan, Lindsey. “EDM Zone Tobacco Free Futures – Meeting Minutes & Action Items.” Emailed to committee. 21 Feb 2013 Quality and Patient Safety Dashboard Indicators. 2012. Alberta Health Services. http://www.albertahealthservices.ca/1329.asp 2 March 2013. Swardon, Sarah. 26 September 2013. Tobacco Free Futures Steering Committee (UAH Site). Word Document. Retrieved from 1 March 2013 from personal email: Swardon, Sarah. “Tobacco Free Futures Meeting Wed Oct 24.” Email to committee. 17 Oct 2012.