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Quality Improvement Initiative: Issue Papers
Issue papers developed as part of NAQC’s Quality Improvement Initiative (QII) are intended to result in the creation of standard methods for data collection and reporting across quitlines and highlight recommendations related to services and operations. All QII Issue Papers are subjected to a rigorous feedback and review process by NAQC members and selected primary reviewers and must be approved by NAQC’s Advisory Council before they are made final.

Integration of Tobacco Cessation Medications in State and Provincial Quitlines: A Review of the Evidence and the Practice with Recommendations (2014 Update)

The purpose of this NAQC Quality Improvement Initiative Issue Paper is to provide an update on the comprehensive review of the literature and practice related to the integration of tobacco cessation medications and quitline services that reflects additions to the evidence base and improvements in practice since the first publication (2009). The author discusses the major factors that must be considered in deciding if medications should be offered as part of quitline services, including topics such as cost-effectiveness analysis, choice of medication, determination of quantity of medication to provide and the method of distribution of medications that will be used. A new section on e-cigarettes appears in the update, as well as new content related to concurrent use of more than one type of tobacco to reflect the FDA’s new warning label regulations. Updated recommendations on key issues related to integration of medications into quitline services are provided by the author.
view issue paper (PDF 645KB)

Quitlines in the U.S.: An Exploration of the Past and Considerations for the Future(2014)

This paper outlines the current status of state quitlines and describes how, as a result of an extremely dynamic political and funding landscape and the opportunity of the Affordable Care Act, quitlines should move forward to improve efficiency and become leverage points for broader cessation initiatives with new and existing partners. The paper illuminates best and promising practices for integrating quitlines into the broader healthcare landscape and informs decisions on strategic planning, determining specific goals and objectives of a state quitline and sustainability planning for the future.

Recommendations found in the Executive Summary express NAQC’s priorities for moving toward the future vision for quitlines defined by NAQC in collaboration with its members, leadership and partners. As NAQC celebrates its 10 year anniversary, the quitline community remains committed to ensuring that tobacco users are encouraged to quit, that high-quality cessation services are readily available to all who want to quit, and that we stand ready to move collectively toward a future vision of the role we will play in this critical effort.
view issue paper(PDF 881KB)
view executive summary (PDF 346KB)

Quality Improvement Initiative Issue Paper: Quitline Referral Systems (2013)

This issue paper aims to explore the current landscape of quitline referral systems with healthcare and other providers and to examine in detail the critical operational and outcome-related components of these referral systems. While the primary focus of the paper is on the U.S. experience, the authors have incorporated critical aspects of the Canadian systems where appropriate. In addition to providing a review of the evidence, authors address the fundamental processes that underlie all referral systems, regardless of the referral method (e.g., phone, fax or electronic) and make recommendations for quality referral systems practices.
view issue paper (PDF 1,487KB)

Quitline Service Offering Models: A Review of the Evidence and Recommendations for Practice in Times of Limited Resources (2012)

This paper aims to present evaluation and research data used to guide decision-making on ways to invest limited funding for quitline services most effectively in an easy-to-use format and to make recommendations for most effectively using limited resources when determining quitline service offering options. Specifically, the paper addresses the following questions:

1) How effective are different service offering models regarding quitline utilization, tobacco abstinence rates, and costs? Are there points at which the return on investment diminishes in terms of amount of counseling (attempted and completed) and medication provided?
2) What impact does the provision of medications through quitlines have on reach and quit rates? Which mechanisms for dosing and delivery of medications are most cost-effective and/or provide other efficiencies?
3) Is there evidence to support the use of advanced technologies (web, interactive voice response [IVR] and texting) to expand quitline service offerings? Are these approaches cost-effective? What other efficiencies are achieved?
view issue paper (PDF 717KB)
view executive summary(PDF 464 KB)
view recommendations for research(PDF 383 KB)
view options table(PDF 323 KB)

The Use of Quitlines Among Priority Populations in the U.S.: Lessons from the Scientific Evidence (2011)

This issue paper is is a systematic review of the scientific evidence regarding cessation services to priority populations (African Americans/blacks (AA/B), American Indian and Alaska Natives (AI/AN), Asian American and Native Hawaiian and Pacific Islanders (API), Hispanic/Latinos (H/L), the lesbian, gay, bisexual and transgender (LGBT) community, and individuals of low socioeconomic status (low SES)) with a specific focus on the use, effectiveness and promotion of quitlines. The review attempts to provide lessons learned from the scientific evidence in order to better inform decision making within quitlines.
view issue paper (PDF 216KB)

Call Center Metrics: Best Practices in Performance Measurement and Management to Maximize Quitline Efficiency and Quality (2010)

This issue paper defines the most critical operational, service performance and efficiency-related call center metrics for establishing and maintaining quitline quality. The paper, authored by Penny Reynolds of The Call Center School (www.thecallcenterschool.com), makes recommendations on important metrics to measure (including why they are important for funders, service providers and callers); recommendations on how to measure and report these metrics; and describes how these reports may be used by both the service providers and funders to improve quality.
view issue paper (PDF 246KB)

See related technical assistance resources:
Fundamentals of Call Center Staffing and Technologies(PDF 184KB)

A Framework for Improving Tobacco Quitline Quality in North America (2009)

The purpose of this paper is to propose a framework for improving the quality of quitlines and to describe the major elements of the framework. The framework highlights the shared responsibilities of funders and service providers alike and makes recommendations that encourage collaborative efforts to move quality improvement forward.

Integration of Tobacco Cessation Medications in State and Provincial Quitlines: A Review of the Evidence and the Practice with Recommendations (2009)

The purpose of this paper is to provide a comprehensive review of the current literature and practice related to the integration of tobacco cessation medications and quitline services. The authors discuss the major factors that must be considered in deciding if medications should be offered as part of quitline services including such topics as cost-effectiveness analysis, choice of medication, determination of quantity of medication to provide and the method of distribution of medications that will be used. Recommendations on key issues related to integration of medications into quitline services are also highlighted.
view issue paper (PDF 288KB)

Measuring Reach of Quitlne Programs (2009)

The purpose of this paper is to provide a standard definition of "reach” and provides recommendations for standard measuring and reporting of the reach of quitline programs. Recommendations that are necessary in order to implement the standard are found in bold-print and recommendations that are viewed as important but not critical to implementation are italicized.
view issue paper (PDF 539KB)

See related technical assistance resources:

Increasing Reach of Tobacco Cessation Quitlines (PDF 166KB)

Reach Standard Calculation Implementation Guide (PDF 68KB)


Measuring Quit Rates (2009)

This paper provides a standard formula for measuring quit rates for quitline programs and recommends standard reporting methods as well. Recommendations that are necessary in order to implement the standard are found in bold-print and recommendations that are viewed as important but not critical to implementation are italicized.
view issue paper (PDF 257KB)

See related technical assistance resources:

Quit Rate Standard Calculation Implementation Guide (PDF 89KB)

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