Improving 5A's Tobacco Cessation Counseling Usage in Adult Clients of the Health Department


Impact Statement: 
Even the implementation of evidence-based public health interventions poses challenges for most health departments. Using rapid-cycle tools and regular status monitoring, Cleveland County Health Department dramatically improved completion of the 5A’s smoking cessation service.

The Cleveland County Health Department (CCHD) conducted a quality improvement (QI) project to increase the use of the 5A's Tobacco Cessation Counseling program among health department clients. The project aim statement was to increase the percentage of completed 5A’s Tobacco Cessation Counseling forms from baseline to 90% in all adult Children First clients and all adult clinic clients with a chart. Through the project, many process improvement suggestions were obtained from the nursing and clerical staff involved in the 5A's process, which were then tested and implemented through rapid Plan-Do-Check-Ask (PDCA) cycles. By the end of the project, completion rates increased to 92%. In addition, morale improved, buy-in from the clerical and nursing staff implementing the 5A's program within the health department was gained, and QI knowledge among staff throughout the health department improved.

Organization that conducted the QI initiative: 
Cleveland County Health Department

James, A. Public Health Quality Improvement Exchange. Improving 5A's Tobacco Cessation Counseling Usage in Adult Clients of the Health Department. Thu, 11/07/2013 - 15:13. Available at Accessed May 29, 2024.

Submission Status: 
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bethvw's picture
Submitted by bethvw on

Great process map for this project! Really liked the red boxes at the bottom of each page with process value-added steps and insights. What software was used to create these maps?

1 user has voted.

Public Health Services Manager
Clark County Health Department, KY

Submitted by sashmore on

These were created in Excel, but PowerPoint has also been very useful in creating similar process maps.

1 user has voted.

Sarah Ashmore
Accreditation Coordinator
Cleveland & McClain County Health Departments
Norman, OK