Achieving minimum standards for australian quitline services
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Achieving minimum standards for Australian Quitline Services. Suzanne Stillman: Quit Victoria (The Cancer Council Victoria) Caroline Miller: The Cancer Council South Australia Catherine Mahony: The Cancer Council Queensland Helen Taylor: Queensland Health. Overview.

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Achieving minimum standards for Australian Quitline Services

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Achieving minimum standards for australian quitline services

Achieving minimum standards for Australian Quitline Services

Suzanne Stillman: Quit Victoria (The Cancer Council Victoria)

Caroline Miller: The Cancer Council South Australia

Catherine Mahony: The Cancer Council Queensland

Helen Taylor: Queensland Health


Overview

Overview

  • Background: Australian Quitlines review 2004/05

  • Key findings

  • Minimum standards summary

  • Meeting the challenges/conclusions


Australian quitline 13 7848 13 quit

Australian Quitline 13 7848 (13 QUIT)

  • National number

    • each state and territory is responsible for the calls in their own jurisdiction

    • each state and territory funds the Quitline in their own jurisdiction and pays a share of the number rental

    • cost of a local landline call for the caller from anywhere in Australia

    • all callbacks are free of charge

    • number and Quitline logo ownedby The Cancer Council Victoria


Quitline number on cigarette packaging

Quitline number on cigarette packaging

  • Legislation required the Quitline number to be included on all cigarette packaging manufactured in or imported into Australia after March 2006.

  • The number on the packs remains the ‘old’ 131 848 number pending a review of the regulations. Both numbers go to the same answering points.

  • Commonwealth Department of Health and Ageing pays rental for 131 848


Australian quitline services background

Australian Quitline services background

  • National Quit Group

    • comprises representatives from organisations responsible for implementing cessation campaigns in Australia

    • provides a forum for Quit organisations across Australia and New Zealand to collaborate on the development of resources and campaigns and to share cessation and campaign expertise

  • Quitline Managers Group

    • represents those organisations providing Quitline services

    • part of the national network


Background

Background

  • June 2004: Review commissioned by Commonwealth Department of Health and Ageing to identify possible impact on Australian Quitline Services of the Quitline number appearing on tobacco packaging

  • Review undertaken by Tobacco Control Research and Evaluation, The Cancer Council South Australia

  • Part of the brief was to make recommendations that would enable Quitline services to deliver a responsive, consistent, evidence-based service to Australian smokers

  • July 2005: Final report


Key findings of the review

Key findings of the Review

  •  Australian Quitline Services

    • deliver a good level of service in all jurisdictions

    • more similarities than differences

  • The review made a number of recommendations including Minimum Standards for the Australian Quitline

    • to improve consistency of the Service

    • to ensure that a high-quality service is delivered to all callers, irrespective of location


Minimum standards for the australian quitline services

Minimum Standards for the Australian Quitline Services

  • The Quit Group endorsed the recommendation

  • Agreement to aim for the delivery of a contemporary, best-quality, well-evaluated service, rather than be constrained by a common denominator

  • Working group (of the Quit Group) established to progress development

    • Quit Victoria, The Cancer Council South Australia, The Cancer Council Queensland, Queensland Health


Development of the minimum standards 2006 2007

Development of the Minimum Standards: 2006–2007

  • Incorporated feedback from Quit Group and Quitline Managers

  • Resolutions from the Quit Group:

    • minimum standards are an important quality improvement mechanism which act as a means of enhancing and protecting the reputation of the Quitline.

    • importance of maintaining a national commitment to the standards.

    • importance of funders being involved with and recognising the importance of the standards.

    • need for regular, national evaluation on the Quitline


Minimum standards cover

Minimum standards cover…

  • Opening hours, response times, hold times, answering rate

  • Availability and despatch times of Quit Pack

  • Access to counsellors, recontact times if counsellors are not immediately available, hours of counselling

  • Referral program from health professionals to Quitline

  • Tailored assistance for callers with special needs

  • Evidence-based counselling content and advice


Minimum standards cover1

Minimum standards cover…

  • Recruitment (including requirement that counsellors be current non-smokers)

  • Counsellor training: initial, ongoing professional development

  • Referral to other agencies: cessation services and cessation products

  • Collection of data: minimum data set

  • Evaluation


Minimum standards example

Minimum standards: example

1.1The Quitline is answered 24 hours a day 7 days a week

1.2Someone answers the Quitline number at all times. This could be a call centre agent (eg Link operator), a Quitline Counsellor or Quitline reception staff

1.3Call answered within a maximum of 5 rings

1.4The Quit Book is readily available and offered to all callers (universally) to the Quitline, irrespective of whether they are ready and willing to discuss issues more fully with a counsellor


Minimum standards

Minimum standards

4.1Counselling available during minimum hours ie. business hours (0900-1700)plus out of hours as dictated by call demand and determined by each jurisdiction

5.1 A pro-active call-back service is available, which takes the caller through the process of quitting and which has a well-structured schedule according to best evidence about outcomes


Minimum standards example1

Minimum standards: example

6.1A referral program from health professionals and other sources is integrated that enables all health professionals to refer clients to Quitline

6.2The referral is received in a confidential secure location

6.3A return fax or email is made to confirm receipt of referral and scheduling of call for GP at minimum

6.4Where desired/appropriate, a feedback loop is maintained with health professional about outcome


Minimum standards example2

Minimum standards: example

7.1Tailored assistance for callers with special needs is available

7.2Tailored assistance is consistent with national protocols for:

a.  Culturally and Linguistically Diverse group – linking with Translation and Interpretation Service &/or bilingual counsellors

b.Callers with mental illness

c.Pregnant callers – planning for pregnancy, pregnancy and post-partum

d.Young callers

e.Aboriginal and Torres Strait Islander callers

f.Crisis calls

As part of the development of Minimum Standards the Quitline

Managers’ Group led the development of protocols for each of the

special needs groups


Minimum standards example3

Minimum standards: example

12.1  Initial training in smoking cessation counselling, ongoing training and updates on tobacco control that are consistent with the national protocol are in place

12.2  Counsellors’ initial training includes:

  • the quitting process;

  • the different needs of smokers at different stages of quitting;

  • accurate assessment of caller needs;

  • brief intervention skills;

  • callers' motivation to change;

  • Smoking related information and issues;

  • Pharmacotherapies;

  • Resources available;

  • Relapse;

  • Coping with staying stopped.

  • Callers with mental illness.


Minimum standards example4

Minimum standards: example

15.1A minimum data set on all calls is maintained

15.2The minimum data set includes:

a.Age

b.Gender

c.Postcode

d.Indigenous status

e.Current smoking behaviour and measures of dependence

f.No. of previous quit attempts

g.Nature of call

h.Outcome of call (counselling, call-backs scheduled, resources)

i.Callers’ special needs.


Challenges

Challenges

  • Range of government/non-government agencies involved in funding and delivery of Quitline Services

  • Variation in level and process of sign-off by jurisdictions

  • Time required for some jurisdictions to feel comfortable that they could sign-off on standards

  • Ongoing monitoring and quality control


Ongoing quality control

Ongoing quality control

  • Best achieved through a shared and transparent process

  • The Quit Group, through the Chair, will be responsible for ongoing monitoring and quality control through reports (as per agreed template) submitted by each jurisdiction

  • In this way, those jurisdictions only partially or not achieving standards are accountable to, and can be assisted by, the group


Conclusion

Conclusion

  • The Australian Quitline Services Minimum Standards have been signed off by every State and the Northern Territory (the Australian Capital Territory is not a signatory)

  • Covers more than 98% of the population

  • The process took longer than had been anticipated

  • Has been well worth the effort: greater confidence that smokers ringing Quitline will receive high quality support

  • Next step is the first collection of status reports

  • Acknowledgement to all members of the National Quit Group and the Quitline Managers’ Group


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