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Hanka Hospital, Chainat Province http://province.moph.go.th/hankha
Hanka Hospital has announced itself to be a 100% Smoke free hospital since December 2006. The hospital adjusted its surroundings according to the Smoke free hospital model by having a big sign placed in front of the entrance and the exit of the hospital, posting warning statements in various places, and posting stickers that announce its smoke-free status including on moving media such as on all hospital vans, and through public relations via all local media channels. Encouragement has been given to hospital staff who smoke to help them quit smoking. Moreover, trainings were provided to hospital staff in order to prepare them for smoke-free responsibilities. This included training nurses in ways of helping and providing advice to smokers who want to quit smoking, to provide knowledge to people at the Outpatient department (OPD), to set smoking cessation processes to be routine work in the Psychiatric Clinic, and to record smoking histories of smokers that can later be monitored easily. For communities, the hospital has provided training activities for building school leaders and for emphasizing collaboration with public health services as Smoke free places.

Hanka Hospital, Chainat Province. Driving forward quickly to be a real Health Promoting Hospital”

Background of the hospital
Hanka Hospital has announced itself as a 100% Smoke free hospital since December 2006. Initiation as a Smoke free hospital was begun by the staff responsible for addressing the use of addictive drugs and hospital executives. The work performance was clearly defined at the beginning of 2007.

Concept
Because of concerns for health promotion, Hanka Hospital and its staff act as a social models to provide knowledge management on health in order to balance body, mind, society and soul. This knowledge can help people take good care of their health and fight social stress conditions. While helping to promote health, the hospital also provides knowledge on how to decrease health risk factors.
Activity Characteristics

• Apply 5A to be used as a guideline to design a working system for each department in order to integrate smoking solutions and cigarette cessation into routine work.
• Design a tracing system for monitoring patients at 1 week, 1 month, 3 months and 6 months.
• Expand to 11 communities which are under the hospitals responsibility and visit smokers families
• Eleven schools participating against addictive drugs were assisted in building school leaders and those schools collaborated in the Smoke free schools program.
• Collaborations with public health services has resulted in a Smoke free network.

What did happen

• There were a lot of patients so advice for quitting smoking was provided to them as a group instead of individually.
• Encouragement given hospital staff to quit smoking, and smokers were not hired as staff in the hospital.
• Set up an encouragement system to support staff to quit smoking beginning with talking and providing better understanding to those smoking staff, and asking them to strictly follow the hospital regulation.
• Applied 5A to all routine work in all departments with guidance from a patient care manual.
• Staff participated in the training were confident and collaborative.

The result of doing those activities
Policy
(1) Announce all areas in the hospital are to be Smoke Free areas, (2) Hospital staff act as good examples of not smoking; all doctors, nurses and hospital staff give attention to patients smoking history record in order to help and monitor smokers, (3) the Hospital provides a clinic to give advice and a cessation program, (4) the Hospital does not accept smokers as hospital staff, (5) no selling cigarettes and lighters in the hospital, (6) disseminate knowledge continually, (7) set hospital environment to provide a Smoke free hospital according to the legislation by posting a big sign at the entrance and the exit of the hospital, (8) posting stickers saying Hanka Hospital is a Smoke free hospital, (9) make public relations announcements via local media channels, (10) encourage hospital staff to quit smoking, (11) survey the number of staff smoking, (12) provide advice to quit smoking, (13) provide training for applying 5A cessation to routine work, (14) take good care of smokers, (15) set an appropriate information system suitable for work performance, and (16) set monthly meetings for leaders and committees.

Cessation clinic development

1. Apply cessation work processes to routine work of the Psychiatric and drug clinic and set records for data collection for all patients.
2. Provide service on every working day
3. Continually develop the staffs capabilities
4. Change service location to suit the needs of patients
5. Make public signs to be seen easily

Lessons learnt so other people can apply them to further work, problems, obstacles and suggestions:

1. After announcing formally the Smoke free hospital as a policy, some patients did not understand and did not want to collaborate. The suggestion is that various public relations are necessary to respond to different needs of individuals.
2. Initially, hospital staff in relevant departments were not concerned with the information of the Smoke free hospital activities because they were not confident. However, after providing trainings, they were more confident to carry out the work and were encouraged to talk.
3. Establish work directions in order to work together. Sometime, there was not enough staff since there were a lot of patients and services needed to be prioritized to those who were emergency cases.
4. The suggestion is that a manual for taking care of smokers must be issued for each department.

Telling story by: Ms. Apitya Tuntavewong
Summarized by: Ms. Sarinya Laohapunpong
Hanka Hospital 2008. Chainat Province. Driving forward quickly to be real Health Promoting Hospitals. Krongjit Vathesatogkit (Editor) Smoke – Free Hospital Model: Project Hospitals, 69 81 Bangkok: Action on Smoking and Health Foundation Thailand.