Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Organizational and Provider Characteristics Fostering Smoking Cessation Practice Guideline Adherence: An Empirical Look

Vaughn, Thomas E. PhD; Ward, Marcia M. PhD; Doebbeling, Bradley N. MD, MSc; Uden-Holman, Tanya PhD; Clarke, William T. PhD; Woolson, Robert F. PhD

Journal of Ambulatory Care Management: April 2002 - Volume 25 - Issue 2 - p 17–31
Quality of Care, Part II
Buy

We examined the relationship between physician adherence with a smoking cessation guideline and organizational structures, policies, leadership support, and physician knowledge and attitudes. A random sample of 844 physicians practicing in 127 VHA hospitals was surveyed. Survey results were aggregated to the hospital level and linked with data on organizational characteristics from the 1998 annual survey of hospitals by the American Hospital Association. Significant predictors of adherence included organizational policies related to nicotine replacement prescriptions, the timing and effectiveness of guideline implementation, physicians' knowledge of VHA clinical guidelines generally, and physicians' beliefs about the receptiveness of patients to smoking cessation.

Assistant Professor, Department of Health Management and Policy, University of Iowa College of Public Health (Vaughn)

Associate Professor, Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa (Ward)

Professor, Department of Epidemiology, University of Iowa College of Public Health; Iowa City Veterans Affairs Medical Center; Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa (Doebbeling)

Assistant Professor, Department of Health Management and Policy, University of Iowa College of Public Health; Institute for Quality Healthcare, Iowa City, Iowa (Uden-Holman)

Professor, Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa (Clarke)

Professor, Department of Biostatistics, and Associate Dean, University of Iowa College of Public Health, Iowa City, Iowa (Woolson)

This research was supported by a grant from the Robert Wood Johnson Foundation Substance Abuse Policy Research Program. Additional support to several authors was provided by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Quality Enhancement Research Initiative (QUERI) grant no. CPI99-126, of which Dr. Doebbeling is principal investigator and staff physician at the Iowa City Veterans Affairs Medical Center. The authors thank Elena Letuchy for conducting the statistical analyses. We also greatly appreciate the participation of the physicians who responded to the survey.

Copyright © 2002 by Aspen Publishers, Inc.