In the April to June 2018 quarter Pinnacle MHN achieved both enrolment volumes and successful quit rate targets in the
Waikato - with the quit rate sitting at an amazing 54.9 per cent!
Across the year there was a total of 2,976 Waikato enrolments with a successful quit rate of 50.3 per cent. Previous quit smoking programmes have achieved quit rates of at best around 37 per cent - so we're really proud of our Once and For All (OAFA) programme, and all those who support it.
All three practices contribute their success to a full team effort - but acknowledge their champions are absolutely essential to the process.
At Oto Med Gwynneth Purdie and Pauline Reynolds, two incredibly passionate nurses, run the OAFA programme. They hope to train up the medical care assistant (MCA) to become a quit coach too.
Meanwhile Mahoe Med think their MCA Andrea Gilshnan does an absolutely exceptional job of delivering the service singlehandedly, and in Te Awamutu Med two HCAs, Sheryll Olsen and Tina Beale, run the programme.
Checking the enrolment forms of new patients and letting the quit champions know of anyone to touch base with is working really well for these practices. Being passionate about offering brief advice, and connecting that to the stop smoking service was also a common theme.
"The OAFA programme works really well for us, everyone feeds into it. The patient prompt is used to offer brief advice and as a practice we're passionate about that. We then connect those conversations to the quit smoking service," says Andrea at Mahoe.
"My first question is always 'do you want to quit' because if they are doing it for someone else and not totally ready in themselves they usually won't get that success. I want the experience to be really positive without any setbacks."
Oto Med is also using text campaigns. "The MCAs run these and we've had a really good response. Often people call us back and say they got our text, they've been thinking about quitting and are ready to talk to us," says Gwynneth.
'Fishing' on the doctors templates is also working well at Te Awamutu, with the HCAs checking through each day to make sure patient prompts are up and running prior to the consult.
Oto Med regularly advertise OAFA in their patient newsletters and on their Facebook page, and they use their Facebook page to celebrate and congratulate those who have become smokefree.
"It's quite powerful sharing the real stories on Facebook," says Pauline. "I still get a thrill each time someone makes it and I enjoy sharing their success and watching for the reaction on Facebook. Their friends and family are always so proud of them, it is a lovely thing to see."
Mahoe also note they are seeing more interest from younger people, and that patients are initiating the conversations themselves. They have a dedicated noticeboard up in the waiting room to profile the quit smoking programme and have advertised in their local paper.
Each of these champions have been helping people get smokefree for around 2-4 years. Some have their own experience of quitting, while others are just truly passionate about the work, understanding the addiction is a tough one to beat.
Sheryll at Te Awamutu Med says "Tina has quit for herself so she is able to relate and share her own personal tips and tricks. I go with what I think it must be like. I always tell people I wish I could wave a magic wand over them and make it simple and easy, but I can't. Instead what I can do is be beside them, listening, empathising and helping to work out some strategies."
As a former smoker herself - smokefree for eight years now - Andrea at Mahoe is able to really walk alongside people in their efforts to get smokefree. "I know what they are facing - how they are going to feel. Being able to share my first-hand experience makes me really relatable I think," she says.
Gwynneth has undertaken training in motivational interviewing (MI) and is a real advocate of the approach, seeing it really work at Oto Med.
"In general people seem to be more ready for it now, it's never a hard sell. I use MI to help the patient to come around to making the decision for themselves. It's important they are the driver and they don't feel pressured," says Gwynneth.
All champion's spoke of the importance of understanding the quit journey is different for everyone - there is no one size fits all approach.
Gwynneth recommends people don't start until they are absolutely ready, everything is right in their life and they have a plan.
"I don't like people to start with gum, lozenges, patches or anything else until we've talked about their plan. We figure out their triggers and figure out a new response or way to change the patterns that may have been a part of their life for years. Things like managing stress, getting through the morning routine and dealing with social situations - all without lighting up."
"The morning routine is a big one. So many people wake, have a cigarette and coffee so we need to have a new idea in place for when that urge hits - because it will."
Getting her people through the morning is also part of Sheryll's approach.
"That morning coffee is such a trigger. We talk about changing the routine a little. "It's about taking people out of that moment where they want a cigarette. Sometimes it is as easy as changing the coffee for herbal tea, so it is a new habit with a positive focus and not that same mind set or association with smoking."
Combining in other healthy lifestyle ideas seems to naturally happen - as people address their smoking they often start to think about their diet and exercise too. At Oto Med Gwynneth and Pauline often refer people to the Sport Waikato green prescription service as part of the OAFA process.
Oto Med are also recommending smartphone apps, which some people find really helpful.
"The app is like a friendly monkey on their back - reminding and encouraging with notifications such as how much money they have saved. This is really cool when people are a bit busier and might not always be able to come in to see us for that same level on constant support."
Because she's done it too, people often open up to Andrea at Mahoe Med about their reasons for quitting. "I've never had a single person do it because it is costing them too much. It is usually because they don't want their kids to see them smoking."
Family seems to hold true as a good reason, but at Te Awamutu Med Sheryll has observed sometimes it needs to run deeper than that.
"People will want to do it for their children, but ultimately if they don't want it truly for themselves, it isn't enough. Often smoking has been a part of their life for decades and the decision to stop is incredibly personal. Being a quit coach makes me feel like a counsellor, people really unburden and sometimes those conversations really make a patient feel lighter and more motivated, more ready. It's a privilege to hear those stories and to be a part of the positive change in a person's life."
Financial incentives of quitting are appreciated, but not central to the decision.
"The voucher at the end of the process is always appreciated and well received, but it isn't why people are signing up for the programme," says Sheryll.
Andrea also thinks there is a change of societal norms at play.
"Smokers are finding their lifestyle increasingly antisocial. Maybe the majority of their friends are not smoking anymore and they are starting to feel the 'odd man out'. There is a lot more harsh judgement about smoking now, and a lot of people just want to fit in."
Sheryll thinks people commit differently to the OAFA programme. Part of that is the regular check in with the smokerlyzer.
"Those weekly appointments are essential. Patients seem to respond really well to having someone track weekly progress with them. It's a bit of extra accountability that holds the commitment. People take it as a real challenge to see that number go down on the smokerlyzer each week."
Andrea also sees the smokerlyzer results as a handy tool for encouragement.
"Sometimes I think it gives a bit of extra pressure or can be a bit confronting. But people soon realise it is not a way to try catch them out, it is a way to capture progress week by week. Watching their numbers drop is really rewarding and helps to keep people on track."
Oto Med attribute their success ultimately to respecting people and giving them individualised treatment with no judgement, pressure or guilt.
"Even when people don't quite succeed we coach them to see every attempt as part of the process, a step to success. Maybe the timing was wrong this time around, but we'll revisit it again when the time is right. Our door is always open," ends Gwynneth.