Tobacco Free Campus Policy
Communications Plan for Hospitals and Health Facilities
As part of our National Tobacco Control Framework, the HSE has committed to making all its workplaces and campuses smoke-free by 2015. This process is already well underway, with 17 hospitals now tobacco free, as well as HSE Headquarters at Dr. Steevens’ Hospital in Dublin.
Many other hospitals and facilities are planning to introduce smoke-free campuses and a range of resources is available to help in this planning and implementation process. This communications plan is designed to support HSE teams and Area Communications Offices in implementing a Tobacco Free Campus. It should be deployed as soon as the decision to go smoke-free has been made, to allow time for a quality communication process with the public, service users, staff and visitors. It is based on the experience of hospitals and locations that have already successfully gone smoke-free. The term hospital is used throughout the plan, but this can be replaced with the appropriate facility name as required, e.g. primary care centre, health centre, administrative offices etc.
Printing of supporting materials and signage etc is best arranged by each hospital or site, as local arrangements will be in place for print needs, and hospitals are likely to wish to add their own crest or logo, customize the sample templates provided here as a guide, and ensure signage is in keeping with existing estate style.
Going Tobacco Free – Communications Plan
Objectives
· To support the smooth implementation of the Tobacco Free Campus Policy
· To outline the rationale for the policy to all
· To ensure service users, staff and visitors are informed of the policy and how it affects them
· To inform patient advocates, public representatives and media of the policy and its purpose
· To provide an ongoing feedback mechanism on the policy
Target Audiences
· Service users
· Visitors
· Staff at all levels
· Suppliers and contractors
· Patient Advocates, Public Representatives, Media
Key Messages
· This policy will help change social norms around tobacco use
· To protect people’s health and reduce smoking prevalence, all HSE campuses will become tobacco free by 2015
· Smoking is the leading cause of death, heart disease and chronic illness in Ireland, affecting the 1 million people who smoke in Ireland, their families, and our health service
· The HSE’s role is to provide health care and enable people to live healthier more fulfilled lives. We are committed to reducing the use of tobacco and its harmful health effects
· This hospital is going completely smoke-free on X DATE. Smoking or use of any tobacco products will not be allowed anywhere on the grounds of this hospital/site from this date
· This policy will provide a supportive environment for service users, visitors and staff to enable them to successfully quit smoking
· The HSE offers a range of smoking cessation support to service users, visitors and staff who want help to quit smoking
· We thank everyone involved for their co-operation with this important policy
Communication Phases
1. Announcement Phase
When the decision is made to go smoke-free, the toolkit for implementation gives guidance on setting up an implementation group within your facility if that is deemed necessary, and how good communications will support this. As much notice as possible should be given to staff when announcing the policy implementation date, which will allow adjustment to the new system. A minimum lead in time of three months and a maximum lead in of 12 months from announcement to implementation is recommended, however, it may not be necessary to adhere to this timeframe in some instances.
The announcement should be made by the Hospital Manager/site manager, via notice boards, emails, websites/intranet, and should be placed on team meeting agendas. Service users and visitors should also be made aware of the smoke-free date, however due to throughput, it will only be relevant to frequent or repeat service users and visitors at this stage. A notice or sign in reception stating that the hospital campus will be smoke-free from x date will suffice.
Hospitals may wish to survey staff and/or service users and visitors when the initial announcement is made, to measure the views of all involved concerning the implementation of going smoke-free. A sample survey is available, which may be adapted for use in your hospital. The results of this survey are often helpful in later stages, as there is a trend of majority support for such a policy.
Announcement Steps:
1. Message to staff from Hospital Manager/site manager with rationale for the change
2. Use email, intranet, website, notice boards, team meetings, signage/posters, notices in smoking areas
3. Service users and visitors should be made aware via a simple sign or poster in reception
4. GPs should be informed by letter, along with other primary care professional and public bodies; Pharmacists, Dentists, Ambulance Services, Taxi Companies, Libraries, Garda Stations, local public representatives
5. Contact local city/county council to advise them of impending new policy
6. Deploy staff survey or service user/visitor survey as required, via website, intranet, email or hard copy
2. Preparation Phase
The hospital team will now put in place a range of preparations for the implementation date. Staff and service users/visitors should be made aware of the survey results, if available, and kept up to date on the timeframe. This is also a good time to begin promoting support services for smokers who want to quit. Ideally these would be available within the hospital, but may also be accessed in alternative locations. Supports available to all include the www.QUIT.ie website, the National Smokers’ Quitline 1850 201 203, and the ‘You can QUIT’ Facebook Page at www.facebook.com/HSEquit. The existing QUIT campaign posters for hospitals and health facilities are ideal for this promotion phase and can be ordered from www.healthpromotion.ie. (Register as a health professional in order to facilitate ordering of bulk supplies).
The hospital/site environment also needs to be prepared. The Facilities Manager will need to survey the site and check if any existing smoking signage requires amendment e.g. ‘This is a no smoking building’ – needs to become ‘This is a Smoke-free Campus’. Areas where staff and service users/visitors currently smoke will need to be surveyed and plans made for removal of any shelters. Plans should be made to erect signage at entrance to the grounds, and at car parks. Some hospitals have chosen to paint the boundary of the hospital grounds with a blue line, as a reminder of the no-smoking boundary and/or paint a No Smoking symbol on the ground at entrances. Information leaflets should be drafted and printed, along with optional reminder cards, which can be used to give to people who are smoking and need to be reminded of the policy. All of this should be co-ordinated to be in place on the implementation day.
Letters or meetings should be arranged to inform local GPs and primary care sites of your implementation date, outlining quit supports, and seeking their help in informing service users. (See sample letter).
This phase involves preparing the public information element of this project. On implementation day, we will need to provide clear information, and support services, to the staff, service users and visitors who will be affected. While most smokers – over 70% – want to quit, and all smokers should consider quitting to preserve their health, there will be some who find the policy challenging. Good quality communications and local commitment to this policy will support a smooth implementation.
Preparation Steps:
1. Identify and promote Smoking Cessation Services
2. Survey and plan for removal of shelters and erection of signage and boundary marking
3. Draft and prepare information leaflet, reminder cards, details of smoking cessations supports, indoor and outdoor signage and posters for printing
4. Consider:
amending staff email signatures, drafting pop up message for staff PCs, inserting notice on headers/footers on all letters, organising a stamp for your franking machine, amending the recorded message on the public announcement system/or phone lines during call waiting to indicate the new policy
5. Link with stakeholders, local public representatives, advocacy or patient groups, staff groups
6. Plan for the launch event, public relations and media activity. Identify a clinical lead/champion and a site manager to be available in the lead up to, and on the implementation day for media work (e.g. local radio interviews, press interviews etc)
3. Launch and Implementation Phase
The launch should take place on the day the hospital/site goes smoke-free. Consider inviting media along with local and community representatives, patient groups, staff and union reps. Going Smoke-Free is a positive step for any workplace, especially one that is dedicated to caring for people and promoting wellness and recovery. A sample press release is attached. After the initial launch, it will be very important to support the implementation of this policy, particularly in the early weeks.
The implementation group will need to draw on its internal relationships and resources to maintain commitment during this adjustment period; capturing the positive feedback, as well as any challenges or non-compliance issues, will be of great support to this project. The reminder cards are useful for staff who will play a role in enforcing the policy, as they avoid the need for any verbal confrontation.
Evaluation and Feedback
It is worthwhile to plan for monitoring and evaluation of implementation of the policy over time. This can be done by seeking service user, visitor and staff feedback, online or within the hospital.
Support for Implementation
Support and advice is available to any site implementation group from your local Health Promotion Department.
Support is also available from members of the Tobacco Control Framework Implementation Group. Contact: Miriam Gunning 01 8976150
Marie Killeen 045 880204
APPENDICES:
· Frequently Asked Questions for General Audience
· Frequently Asked Questions for Managers
· Frequently Asked Questions for Staff
· Sample Press Release
· Sample letter to Staff
· Sample letter to GPs
· Sample letter to Public Representatives
· Sample Staff Survey
Tobacco Free Campus Policy
General Questions and Answers
Why is the HSE implementing a Tobacco Free Campus Policy?
The HSE as the leading healthcare provider is committed to reducing the use of tobacco and its harmful health effects. As the national body responsible for health promotion, health protection and prevention of illnesses and disease, the HSE is implementing the Tobacco Control Framework (2010) which is based on international best practice. One of the key actions within the Framework is the introduction of a Tobacco Free Campus Policy in all HSE services and settings by 2015. Therefore, smoking by employees, service users, visitors and any other parties will be prohibited within all HSE campuses on or before 31st December 2015.
· Smoking is the single biggest preventable cause of ill-health and premature death
· Ireland led the world in implementing the smoke-free workplace legislation; we are now taking the next logical step in having a smoke-free health service
· Lung cancer is the leading cause of cancer-related death in Ireland
· On average in each of our regional hospitals a Respiratory Consultant tells 2-3 people each week that they have lung cancer.
· 1,600 people die in Ireland each year from lung cancer; 75 die from cervical cancer
How will the Hospital encourage compliance with the policy?
We understand that it is difficult for smokers to quit but ultimately quitting has huge health benefits for the smoker themselves and for the health of their family. We are appealing for people to support us. Good communication is the key to securing compliance.
The policy will be well communicated with appropriate signage throughout the site. Staff may be briefed through various media (email, staff briefings/meetings, communication sent through pay slips etc) and invited to contact their managers to clarify any queries. GPs and other healthcare providers will be advised of the policy implementation prior to its launch. Hospital outpatient appointment letters will advise patients of the policy and the policy will be communicated widely through local media.
Staff will be trained in communication skills which will support policy compliance and also help smokers to quit.
Visitors, service users and staff who are found to be smoking on site will politely be requested to put out their cigarettes and advised that it is a no smoking area. Service users coming to the hospital can request smoking cessation advice and support to help them quit smoking or to manage their addiction during their hospital stay.
People will be requested to comply with the policy which is based on protecting and promoting the health of all in our health services.
To whom does the Tobacco Free Campus Policy apply?
Everyone including service users, staff, visitors, suppliers, contractors and others who work in or visit our HSE owned or rented buildings or grounds.
Does the Hospital/Health Service have the authority to enforce such a policy?
Yes. The HSE has made the decision to introduce a Tobacco Free Campus Policy across the organisation to benefit the health of patients, visitors and staff in accordance with the HSE’s
Tobacco Control Framework. The HSE will continue to provide smoking cessation counselling and tobacco dependence treatments to help service users deal with their nicotine dependence and to support quitting. The tobacco free campus initiative is acknowledged as international best practice. This has already been achieved in hospitals and health-care facilities in the United States, Canada, Spain, Britain, Australia and New Zealand.
What about patients who are terminally ill and still want to smoke?
Compassion will always guide care of the terminally ill patient. However, terminally ill patients will generally have been accessing services prior to this stage. Therefore they will be aware of the policy and smoking may not be an issue. Each patient will be assessed on an individual and case by case basis and in certain circumstances an exemption may be given after a formal risk assessment has been completed.
This initiative sounds like it doesn’t treat smokers with much compassion.
The Policy highlights the importance of treating tobacco addiction as a care issue. The HSE will continue to provide service users with all the support they need including advice, information and smoking cessation support and tobacco dependence treatments to help deal with the cravings. Staff also will be offered assistance to quit smoking, or manage their smoking during working hours. This is about improving the health of our service users and staff and ensuring quality care for all – and we are appealing for support for the initiative.