Table 1.

Themes and Explicatory Quotes.

Theme 1: E-STOPS in the Inpatient Environment
E-STOPS Functionality and Content	P12, Hospitalist, male: The thing that has been brought forward in my mind is the fact that the hospital takes smoking cessation seriously and that it’s not just one person trying to do this, the fact that there’s a team and really trying to connect the inpatient and outpatient [care].
Timing Issues	P13, Hospitalist, female: This discussion, while it is important, I don’t think it needs to be done by me in the middle of the night when I only have about twenty minutes or so to see this patient.
	P6, Internal Medicine, male: I’m not going to order a nicotine patch now because I haven’t even talked to the person yet.
	P5, Internal Medicine, male: Their problem list could be very outdated. So I would not do an intervention just based on what [the EMR] says.
Participant Recommendations to Improve E-STOPS Usability	P8, Internal Medicine, male: So perhaps the first time in a day [or]...the first time I enter into the chart after eight a.m. or in the beginning when you start the progress note for the patient. And it could be a reminder that yesterday it was too busy. Today we can discuss this with the patient... and it should continue [to fire] once a day, and only if we haven’t addressed it earlier.
	P2, Internal Medicine, female: [To] address smoking cessation on discharge may be more helpful for me than every time I go in the chart
	P12, Hospitalist, male: So I think if it were something that when you were entering the admission orders, it was just part of that instead of being a best practice alert. Since the study [started], many more best practice alerts have been added, so people sometimes develop muscle memory to just dismiss them.
	P15, Hospitalist, male: [The order set] is displayed a little differently than the way we’re used to ordering things that are only available in some of the facilities and not all of them. So [to order something,] I have to think about what building am I in. it’s a little hiccup when you’re trying to do this quickly.
Theme 2: Information Needs
Information about EMR and E-STOPS Functionality	P21, Hospitalist, male: Most of the time I’m not even aware that [TUD has been] added to it until I import the problem list into my notes, and suddenly it’s there.
	P7, Internal Medicine, female: I remember my very first day as being an intern, the order set popping up and then feeling like I didn’t even know how to use [the EMR] and I didn’t even know how to do anything, and I specifically remember just cancelling out of it so that I could get back to trying to figure everything out, and then never really. And then I think just moving forward, every time it would pop I’ve just gotten accustomed to just trying to get rid of it.
Information about Treatment Efficacy	P4, Internal Medicine, female: What are the long-term impacts on the things that we implement to help patients quit or there’s the medications or it’s the referral, how effective are they? Honestly, I don’t know, but I am curious.is it effective?
Feedback about Individual E-STOPS Behavior	P6, Internal Medicine, male: I did like it as a reminder, about the update e-mails that we got about my practices.
Participant Recommendations to Address Information Needs	P18, Hospitalist, male: I wouldn’t have minded somebody telling me how effective [the medications listed in the NRT order set were] or where they’re getting this from.
	P8, Internal Medicine, male: If we can distribute the slides or if we can have every six months a small e-mail that would say, “Here is an online refresher course, ” because we have refresher courses for the hospital.
Theme 3: Personal Attitudes and Beliefs
Facilitators of E-STOPS Use	P9, Internal Medicine, female: I definitely think that while they are already not smoking while in the hospital that that’s a perfect time to bridge them to quitting or cutting back as they leave.
	P10, Hospitalist, male: These patients may not be regular consumers of healthcare or may not have regular follow-up. So, I think that when they’re hospitalized, it is an opportunity [to intervene].
Barriers to E-STOPS Use	P17, Hospitalist, male: For a routine patient like somebody who comes in for maybe pneumonia or urinary tract infection, there is no immediate association between the two, so we [wouldn’t talk to the patient about smoking cessation]…it’s only for COPD exacerbations.
	P1, Internal Medicine, female: I make big differences in primary care that I don’t strive to in the inpatient side…And tobacco cessation, drinking cessation, those things are all outpatient primarily.
	P2, Internal Medicine, female: I always try to be cognizant of the amount of information that I give patients during a hospitalization. I do feel like I overwhelm them as it is with just their inpatient [problem]. I just don’t know that they’re ready to take one more thing.
	P13, Hospitalist, female: Not all patients really need [NRT patches] in the hospital, so I would never just order a medicine that someone is not asking for...I think it should be their decision.