The National Tobacco Control Program (PNLT) and the National Health Plan
(PNSP), included in the National Health Strategy, are fighting against
tobacco a public health priority. At the regional level, health establishments
public and private sectors are committed to deploying the Health Places Without Tobacco (LSST) system in
through their Multiannual Contracts of Objectives and Means (CPOM) signed with
the Regional Health Agency.
The establishments of the Clinifutur Health Group, several of which are subject to
financial support in the fight against addictions, work against
smoking in their mission of service to the public, and through campaigns to
awareness such as the #MoisSansTabac in November.
Focus on the Sainte-Clotilde Clinic and the Robert Debré Clinic, which are part of the
pilot establishments in the experimentation of the new tobacco-free company label,
LEST, offered by Intermétra on Reunion Island.
Aurélie LEGER
Tobacconist / Midwife - Clinique Sainte-Clotilde
Clinique Sainte-Clotilde has a staff of 589 employees and 85 doctors. It knows a significant activity in the north-eastern territory of the island, with nearly 50,000 stays of complete hospitalization of medicine, cardiology and obstetrics surgery, approximately 1,700 births per year, more than 28,000 cumulative sessions in radio and chemotherapy, and more 50,000 days in day hospitalization for medicine and surgery. A local clinic, it favors raising the awareness of users and its staff in the areas of public health and prevention (cancer, tobacco, blood donation, vector control, sports activities, etc.).
Its approach to the fight against smoking began in 2017 with patients with the implementation of monitoring and support for smoking cessation in the Mother-Child Centre. Individual consultations dedicated to pregnant women and their families are organized. Then gradually, these consultations extend to other sectors such as cardiology and bariatric surgery. The main objective is to take advantage of hospitalization to improve the health of the smoking patient by offering support, but also to reduce the risks around surgery. Individual and personalized follow-ups are organized and the smoking cessation activity finds its place within the clinic.
Initially launched in the tobacco-free maternity process, the clinic quickly opted to generalize its label to that of Lieu de Santé Sans Tabac. A first audit classifies the establishment at the first “bronze” level of this label.
To continue its approach, the national survey on smoking in healthcare establishments dedicated to users (patients and visitors) and professionals has been launched in the establishment. This makes it possible to carry out an inventory of the functioning of the establishment on its tobacco control strategy, on knowledge and information on the risk of tobacco and on the vision of smoking in health establishments and through care. .
A real starting point for the LSST approach, this survey highlights everyone's major interest in the approach. With the support of the ARS, a coordination team made up of Mattias FELIX, Quality Manager and Aurélie LEGER, Tobacconist, is setting up to manage this project from 2020. Weekly meetings allow the organization:
adapted action plans taking into account the 8 areas of commitment of the LSST approach and the specificities of the establishment,
annual evaluations of the progress of the project with monitoring of the progress of the audit score,
the creation of an LSST steering committee bringing together different corporations within the establishment (management, human resources, health executive, technical service, caregivers, users' commission, CSE, etc.) in order to validate the measures envisaged (this COPIL meets twice a year),
the writing of an OHSA policy and internal regulations distributed secondarily to the entire Clinifutur group,
and finally, smoking areas with a ban on smoking in a “white coat” or uniform, this constituting a new stage in the tobacco control policy which will soon take effect.
In 2021, the tobacco team is expanding with the arrival of a new graduate tobacco specialist and the appointment of tobacco referents in the departments. Tobacco training for all healthcare staff is beginning to allow a better understanding of smoking and an increase in the skills of each professional. The writing of protocols for the management of smoking cessation in hospitalized patients is spreading in the departments and smoking patients are gradually identified systematically, leading to a gradual improvement in patient care.
The clinic has formalized its LSST approach with a policy maintained for patients but decides to turn to all staff.
To support its commitment, it was essential to create a partnership with the occupational medicine of the establishment. Meetings with the clinic's smoking cessation team and the Intermetra team during interprofessional evenings organized by Lib'sans tabac, meetings within SAOME (Santé Addiction Outre-Mer) or during the LSST Colloquium organized by RESPADD in April 2020, led to many exchanges and discussions around the care of our smoking employees.
All his meetings lead to this new partnership with Intermetra. The Sainte-Clotilde clinic is committed by being a pilot establishment under the new LEST label. It will also make it possible to assess the system at all of our establishments, including the cross-functional Economic Interest Groups (EIG).
This is a real plus in favor of our commitment to the fight against this scourge in addition to the LSST approach. Raising employee awareness of this approach will be integrated into the organization already in place and will only be further strengthened because it is fully in line with improving their Quality of Life at Work and that of their patients. Dual labeling
LSST-LEST makes it possible to reach more users and extend the approach.
According to our latest survey, approximately 30% of the staff in our establishment smoke. Many of our employees have already sought to contact our tobacco team for support with their withdrawal. This new collaboration with Intermétra will allow them to move forward
in their approach and to be even more supported.
“Take care of yourself as if you were your own patient”. This is a motto that will take on its full meaning within our establishment.
