COE for HSE Insider

Center of Excellence
April 1, 2016
Pat Folan, Director, & Andrea Spatarella, NP, Center for Tobacco Control, Northwell Health

The COE for HSI is excited to feature Drs. Pat Folan and Andrea Spatarella from the Center for Tobacco Control (CTC) team at Northwell Health in this issue of the COE for HSI Insider. Both Pat and Andrea have Doctorates in Nursing Practice (DNP), with a focus on implementing evidence-based practice (EBP), quality improvement strategies, and systems leadership. These topics intersect directly with their work as New York State Department of Health Bureau of Tobacco Control health systems grantees, where they have been able to strengthen their team’s partnerships with medical and behavioral health organizations in Long Island based on these strategies described in further detail below.

How does your DNP degree relate to work in health systems change?

Implementing EBPs such as Treating Tobacco Use and Dependence was a focus of the DNP program, which we use when implementing tobacco dependence evidence-based best practices with medical and behavioral health organizations. Additionally, we work closely with organizations to implement quality improvement strategies and monitor the implementation of different tobacco dependence treatment components within their health systems’ structure. We have worked closely with leadership to collect data, specifically patient quit outcomes, which has been used to evaluate the effectiveness of different interventions provided to the patient. System leadership is able to use this information to improve their quality improvement efforts and update clinical interventions and workflow accordingly.

 Pat was able to leverage her DNP work on policy analysis Mandatory Tobacco Dependence Education for healthcare providers, which helped formulate the implementation and evaluation plans that were used for the Bureau of Tobacco Control’s Tobacco Education Task Force. This workgroup ultimately was instrumental in changing policy for test questions for physician licensing exams to include tobacco dependence treatment content. Andrea focused a portion of her DNP on health literacy. She has been able to use this knowledge to assist health care organizations in ensuring that their patient information on tobacco use is appropriate for the populations that they serve. Having patient education materials and medication descriptions that the patient is able to read and understand is essential to improving the patient’s chances of making a successful quit attempt.

 Are there any theories or practices that you use to help guide your work in improving tobacco dependence treatment with medical and behavioral health organizations?

 Pat: In the DNP curriculum, the theory course examined many theories and their relationship to practice and scholarship. As a real world experience, we had to integrate one of the theories into practice. The theory I selected was about the Health Promotion Model. The health promotion model focuses on helping people achieve higher levels of well-being. It encourages health professionals to provide positive resources to help patients achieve behavior specific changes. The goal of the health promotion model is not just about helping patients prevent illness through their behaviors, but also looking at ways in which a person can pursue better health or ideal health. As you can see, this was a very good fit for the work we do with the Bureau of Tobacco Control, both medical and behavioral.

I also took a leadership theory course, which helped me to reflect upon, understand, and alter my own leadership style. I think it improved my leadership of my own team, as well as my interactions with groups outside of our center, including other organizations and DSRIP groups.

 Andrea: One of the required courses in my DNP curriculum that guides my work in the field of tobacco dependence was Population Health. I had been a front line clinician for most of my nursing career and, in retrospect, I did not fully appreciate the impact that individual practitioners could have on improving the well-being of large groups of people. Having a heightened awareness of chronic disease prevention, along with implementing strategies to address the needs of individuals with low health literacy, became somewhat of a driving force in our work here at the Center for Tobacco Control. Being part of a team that can influence the development and implementation of policies that support health promotion and disease prevention is very rewarding.

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