Problem/Objective: To collect information about quality of care for various chronic conditions in Washington State. We assessed providers' knowledge, attitudes, and care practices related to chronic disease care. We also assessed their policies and business systems that support the delivery of healthcare to patients. The results relative to the delivery of tobacco cessation services are highlighted here.

Methods: We mailed surveys to a statewide sample of primary care providers and conducted telephone interviews with their clinic office managers. We used chi-square tests to identify associations between provider characteristics/settings and indicators of quality.

Results: The response rates for providers and clinic office managers were 75% and 67%, respectively. The majority of the clinics in Washington were small, consisting of less than 10 providers (63%). Information technology tools (such as electronic medical records, computer based decision support, and computerized reminder systems) were less commonly used in solo or small practice settings compared to larger group practices in Washington State. Though evidence-based guidelines exist for tobacco use treatment in the primary care setting, the data show that not all providers adhere to them and about 50% of clinics do not have any official guidelines for the treatment of tobacco dependence.

Conclusions: Our findings suggest that despite knowledge of the health benefits of tobacco use cessation healthcare providers and health systems are struggling with providing evidence-based treatment services. Opportunity remains in Washington State for educating primary care providers and their clinic systems managers about resources and strategies for incorporating clinical guidelines into their practices.