Table 3

Summary of OMSC multicomponent intervention components

Intervention componentsDescription
Outreach facilitation visits
  • A trained outreach facilitator worked with each primary care clinic over a 3-month period to implement the programme.

  • A seven-step facilitation process was used to introduce the OMSC 10 best practices. Facilitators acted by supporting clinics to:

    • review current clinic practices in the delivery of evidence-based smoking-cessation intervention and complete needs assessment;

    • provide information and recommendations on the integration of evidence-based smoking-cessation strategies into clinical practice;

    • facilitate development of a clinic tobacco treatment protocol for integrating evidence-based smoking cessation strategies into all clinic appointments;

    • define roles and responsibilities of clinic staff in delivering evidence-based smoking-cessation treatments;

    • support communications and training activities for members of the clinic staff.

Training clinic staff
  • Frontline physicians and nurse practitioners participated in a 3-hour training session that provided information and skills training in addressing tobacco use with patients in the context of a busy primary care practice setting.

  • Key staff who would be responsible for delivering quit plan visits (eg, nurse, nurse practitioner or pharmacist) attended an intensive 1-day training session that taught them how to conduct the quit plan and follow-up visits based on evidence-based practice.

Standardised provider and patient toolsAll materials were designed to support intervention delivery and reduce the amount of face-to-face time required to support tobacco treatment delivery. These included:
  • Patient Tobacco Use Survey to document smoking history.

  • Checklist style Smoking Cessation Consult Form.

  • Patient Quit Plan booklet for Smokers Ready to Quit.

  • Booklet for Smokers Not Ready to Quit.

  • Clinic waiting room posters and materials.

Real-time prompts and electronic medical record tools
  • Real-time point-of-care reminders (eg, standard smoking status questions) were introduced and embedded in vital sign screening forms and prompts to deliver brief advice.

  • Standardised forms embedded into electronic medical records to guide tobacco treatment delivery for advice, quit plan and follow-up visit.

Adjunct follow-up support and counsellingPatient’s ready to quit could be referred to the telephone-based Smoker’s Follow-up System, which included five triage calls over a 2-month period delivered by Interactive Voice Response System. Patients struggling with their quit attempt received additional telephone-based support from trained smoking-cessation counsellors.
Coaching and feedback sessionA supplemental 1.5-hour group-based coaching session was delivered approximately 4 weeks following the launch of the OMSC at their clinic. This was facilitated by a trained tobacco treatment specialist using a standardised facilitation guide. The performance coaching session was designed to increase provider self-efficacy in tobacco treatment delivery, identify personal barriers to tobacco treatment delivery and exchange experiences in addressing these barriers.