CF-5A's Sustainability

A sustainability mechanism is recommended for maintaining the CF-5A's Intervention in a clinic practice. Sustaining the CF-5A's Intervention through needed improvements will allow the innovative PhreesiaPad technology benefits to continue supporting providers and staff in the 5A's gold standard intervention for smoking  cessation. Continued surveillance and commitment to maintenance is necessary to sustain and adapt the program as needed, over time and as trends in clinic protocols change. Even though data are important, they alone are not sufficient to sustain a program. Ongoing surveillance and commitment to maintenance by integrating (and adapting) success measures and QI should be a job element assigned to specific members of the clinic staff.1 Key facilitators of the program’s sustainability should include aligning clinic policies and workflow with the newly established program, while soliciting input from providers and staff on a regular basis on how to best sustain and improve the CF-5A’s Intervention, as time enables changes and clinic trends present themselves.

Using CF-5A's Intervention data to sustain the program
Clinic practices can use their collected information on smoking cessation in three ways.2

1. Examine your rates monthly for trends which show improvement or worsening of the use of the 5A's. Can you relate CF-5A's changes to changes in practice? What has or has not been doing well over the past month(s) in relation to whether usage rates are better or worse? Note: When a practice implements the CF-5A’s program documented rates of smoking in clinic patients may increase. It may be alarming but it is also possible that staff is becoming better at identifying previously missed smokers.

2. Disseminate this information to stakeholders and staff. Post rates where all staff can see how the practice is doing with the program. Dissemination of information on performance is critical to quality improvement and sustainability efforts for best practices and potential funding sources.

3. Study in detail what is leading to patients’ desire to quit smoking. When a smoker finally expresses their desire to quit, it can reflect a system's gap in delivery or that the message to quit finally got through. Thus, smoking cessation requests for help represent a learning opportunity in aspects of care that may need improvement.


1. Agency for Healthcare, Research and Quality. Using Health Information Technology to support Quality Improvement in Primary Care. White Paper. Higgins, T., et al. 2015.

2. Agency for Healthcare, Research and Quality. Accessed December, 2016.