The Impact of Documented Electronic Referrals to the Smoking Cessation Clinic Before Discharge From Medical Wards on Patients' Adherence to Clinic Follow-Up.

Objective The objective of this study is to evaluate whether the implementation of a mandatory electronic inpatient referral pathway to the Smoking Cessation Clinic (SCC) improves referral completion and post-discharge clinic attendance. Methods A six-month prospective quality improvement study was conducted from May to October 2025 in the Department of Medicine at King Fahad Armed Forces Hospital (KFAFH), Jeddah. This study aimed to identify hospitalized smokers, assess readiness to quit, and implement documented electronic referrals to the Smoking Cessation Clinic (SCC) prior to discharge. Baseline data were collected from 27 medical inpatients with a smoking history who agreed to referral. The intervention incorporated systematic smoking status documentation, motivational counseling using the "5 As" framework, provider education, and audit-feedback cycles. Clinic attendance was assessed within 90 days of discharge. Results Among the 27 admitted patients with a six-month follow-up, 100% were identified as current smokers. Readiness and motivation to quit were assessed in all the patients. One hundred percent (27/27) were referred to a Smoking Cessation Clinic, with 100.0% (27/27) of referrals made electronically. A documented appointment was booked for all 27 patients prior to discharge. The primary outcome, clinic attendance within 90 days, was achieved in 100.0% (27/27) of patients. The end-to-end success rate (identification → assessment → referral → appointment → attendance) was 100.0%. Conclusions Embedding a mandatory electronic smoking cessation referral pathway within inpatient workflows resulted in complete adherence to referral and follow-up processes. Integration within the electronic health record (EHR), pre-booked appointments, and provider engagement were key enablers. This model is scalable and supports the implementation of a hospital-wide mandatory smoking cessation pathway for admitted smokers.