Hospital's no-smoke plan wins

Wake Forest University Baptist Medical Center has become the first hospital in North Carolina to achieve statewide "gold star" status for its tobacco-cessation programs.

The rating comes from N.C. Prevention Partners, the advocacy group that successfully lobbied for every acute-care hospital in the state to become 100 percent tobacco free -- the first state to achieve the milestone.

However, a trip yesterday around the main campus of Wake Forest Baptist showed that it's unlikely that the policy -- put in place in July 2007 -- will gain 100 percent compliance from employees, visitors and patients.

About 35 people braved the blustery weather for a smoke around noon, primarily in public areas along the sidewalk, a covered city-bus stop or the Shell service station on Cloverdale Avenue that's yards away from the system's Comprehensive Cancer Center.

The advocacy group has a five-step process for achieving the rating, which includes having a tobacco-free campus; providing counseling, prescription and nicotine-replacement therapies; and offering incentives for quitting and staying quit.

What helped get Wake Forest Baptist the gold star was earning an "A" grade on the group's WorkHealthy assessment on tobacco initiatives and having Dr. John McConnell, the chief executive of the system, and other executives sign a commitment to the policy.

"We believe the commitment to a culture of wellness for our employees, affirmed by our executive management, got us in line first," said Robert Parker, a vice president of special operations and community health for the system. Parker also serves as a board member for N.C. Prevention Partners.

Melva Fager Okun, the senior health-program manager for the group, said that Wake Forest Baptist's ability to reach the standard "will help motivate other lead hospitals to increase and improve their efforts specific to tobacco cessation for their hospital employees."

Wake Forest Baptist officials consider the policy as a major factor in reducing patient, visitor and employee exposure to smoking.

The policy covers Wake Forest University Health Sciences and N.C. Baptist Hospital, which combined have more than 11,500 employees.

Since the tobacco-free policy was established, more than 300 employees have received nicotine-replacement patches and 381 of the patches have been distributed.

"We continue our on-going cessation education for employees by referring them to the N.C. Quitline, medical-center resources and community programs," said Lynn Black, the director of ActionHealth, the employee wellness program.

Yet there remains a tension between a health-care system committed to eliminating tobacco use on its campus and a small group of employees equally determined to tend to their habit.

It also points out the lingering culture clash within a community that was built in large part by tobacco money.

In recent years, smoking has been banned in a number of public places, including most restaurants, even as about 20 percent of adults still smoke in North Carolina and the nation.

Hospital employees are allowed to smoke off campus before and after work and during unpaid meal breaks.

Any other time, including paid breaks, is a violation of the policy.

Employees are monitored at times by hospital security officials to determine whether they are following the policy. Failure to do so can lead to escalating reprimands that could affect their performance evaluation and even their job.

Most of the estimated 200 "policy notifications" to employees were written in the first two weeks of the enforcement period, officials said.

Forsyth Medical Center, which also has a tobacco-free policy, appears to have fewer smoking issues among employees, visitors and patients because they have to walk further to get off campus compared with Baptist.

rcraver@wsjournal.com


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Gold standard

N.C. Prevention Partners has set five criteria as key components for a gold-star ranking for its Healthy N.C. Hospitals initiative:
• Have a tobacco-free campus, with signs posted, and a policy that is communicated to employees and enforced.
• Provide a system to help employees who use tobacco to quit.
• Offer programs to prevent use of tobacco, including counseling, prescription medication and nicotine-replacement therapies.
• Provide incentives for those who enroll in a
tobacco-cessation program and for those who have successfully quit.
• Evaluate the quit-smoking system.

Source: N.C. Prevention Partners