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Allied Health Science

Admission requirements, general undergraduate admission requirements.

Note: Not all Online Program offerings are available to residents of all U.S. states.  Please contact an admissions representative for further information.

To be admitted to any of the undergraduate programs at South University, the prospective student must provide proof of high school graduation as recognized by the state of residence on the date the degree was earned, or the equivalent (e.g. GED with no single test score below 145 or numeric score equivalent to 2.0 on old version or state-issued certificate designated as the equivalent of a High School Diploma) with a minimum CGPA of 2.0 on a 4.0 scale within 5 weeks of the start date (refer to Conditional Acceptance). The prospective student must also complete the university administered placement tests prior to the start of the first quarter for campus students and during the first session of attendance for online students. South University accepts the International Baccalaureate Program diploma as meeting the requirement for high school graduation. Credentials earned outside the United States must be evaluated by a NACES or AICE-member credential evaluation service.  Please speak with an admissions representative for more information.

Students with less than the minimum CGPA of 2.0 on a 4.0 scale may meet admissions requirements by submitting a minimum combined SAT (Evidence-Based Reading and Writing, and Math) score of 700 or 900 on the old SAT, a combined ACT score of 18, or meet the criteria established for acceptance as a transfer student.

Students with less than the minimum CGPA of 2.0 on a 4.0 scale may be admitted provisionally for two quarters. Failure to achieve a 1.5 CGPA in the first two quarters of attendance will result in dismissal.  Students may appeal the dismissal by following the Procedures for Appealing Academic/Financial Aid Dismissal Policy.

Acceptable verification of high school graduation or the equivalent would include a copy of the high school diploma, high school transcript (official or unofficial), GED  certificate, or  GED  scores and  state-authorized examination scores (ex. HiSET, TASC) or a state- issued certificate designated as the equivalent of a high school diploma. In states that maintain a database that serves as an official registry of high school and GED  graduates, an excerpt from the official database documenting the student's graduation or GED  completion may be used.

Campuses in South Carolina must be provided with official high school transcripts or GED scores or state-issued certificates designated as the equivalent of a high school diploma.

Please see the policy on GPA Calculation for Admission for additional information

Conditional Acceptance

Students may be conditionally accepted by submitting unofficial copies of documentation required for the admission requirements. Conditional acceptance is allowed for 5 weeks beyond the start of the student’s first session. Failure to provide acceptable, official documentation, as stated in the admissions requirements, within 5 weeks from the start date will result in the following:

• Removal from class
• Cancelation of enrollment
• No final course grades
• No transcript

Students who do not provide acceptable documents for full, unconditional acceptance within the 5 week period will not be responsible for tuition and related fees. South University may grant exceptions to the 5 week period for unusual situations or circumstances. All exceptions must be submitted to the Office of the University Registrar for approval.

Admission of Transfer Students

To be eligible for admission, transfer students must complete the application procedures and satisfy the following criteria:

• Submit a completed application for admission.
• Have earned 24 or more credit hours, or the equivalent (e.g. 16 semester hours), with a cumulative GPA of 2.00 from an acceptable accredited collegiate institution.
• Submit official transcripts (including verifiable faxed transcripts) from all colleges and universities attended.
• Submit self-certification of high school graduation or GED completion.

For transfer of credit practices refer to the applicable section under the  Academic Affairs  section of this catalog.

To be admitted as a Transfer student into South University the prospective student must have earned 24 or more quarter credit hours or the equivalent (e.g. 16 semester hours), with a cumulative GPA of 2.00 from an acceptable accredited collegiate institution. Official transcripts from the collegiate institution(s) must be received within 5 weeks of the start date (refer to Conditional Acceptance), and who are not required to take ENG0099 and/or MAT0099, will be exempt from taking the UVC1000 Strategies for Success. Students will select another 4 credit course in consultation with their Academic Advisor or Academic Counselor to fulfill the degree requirements.

Students with 24 or more quarter credits with less than a 2.0 GPA may be admitted provisionally for two quarters.  Failure to achieve a 1.5 GPA in the first two quarters of attendance will result in dismissal.  Students may appeal the dismissal by following the Procedures for Appealing Academic/Financial Aid Dismissal Policy.

Students who are citizens of countries other than the United States should refer to the section entitled International Student Admissions Policy.

Students who are transferring from or to a school within the University of North Carolina or the North Carolina Community College System should be aware of the Comprehensive Articulation Agreement approved by both governing Boards on March 1, 1996 and revised in September of 2008. This agreement may be found in its entirety at the following website . For additional admissions information please see the admissions section here . 

Program Overview and Outcomes

Offered at Austin, High Point, Montgomery, Online Programs, Orlando,  Richmond, Savannah, Tampa, Virginia Beach, and West Palm Beach.

Note: Not all Online Program offerings are available to residents of all U.S. states. Please contact an admissions representative for further information.

The Associate of Science in Allied Health Science degree program is designed to expose students to a broad education in general studies combined with an emphasis on life science subjects such as anatomy and physiology, chemistry, nutrition, and pathophysiology. It offers students interested in health careers a knowledge base from which they may achieve their professional goals. Students within this program may consider entry into the Bachelor of Science in Health Sciences or other professional programs upon graduation.

Program Student Learning Outcomes 

Graduates should be able to: 

• Utilize principles of the natural, social, behavioral, and health sciences to serve as competent, ethical, and compassionate healthcare professionals.
• Demonstrate effective written, oral, and interpersonal communication skills in healthcare environments.
• Apply critical thinking skills to develop solutions for healthcare system issues and challenges.
• Effectively research, analyze, and report on a wide range of healthcare related topics.

Associate of Science in Allied Health Science: 90 Credits

Area i general education requirements: 44 credits, professional development.

Credits : 4

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Basic Communications

Choose one additional course from the list below: 

Mathematics and Statistics

Natural sciences.

CHM1010 is a survey course of general chemistry, organic chemistry and biochemistry. Fundamental concepts and principles will be presented including atomic theory, bonding, nomenclature, solutions, acids and bases, and an introduction to organic chemistry and biochemistry. Emphasis will be placed on the application of these topics in various health fields. This overview provides the health-care worker the ability to appreciate physiological and therapeutic processes at the molecular level. The course will also explore the role of chemistry in society today by applying a problem-solving approach to understanding chemistry.

Arts and Humanities

Choose three additional courses from the list below:

Organized by period, genre and theme, this course explores global viewpoints as expressed in novels, poems, plays, short fiction, and philosophical and theological works from the very first written texts up until the middle ages. Parallels and contrasts will be drawn between cultures and across time.

Organized by period, genre and theme, this course explores global viewpoints as expressed in novels, poems, plays, short fiction, and philosophical and theological works from the period of the late 17th century to the present day. Parallels and contrasts will be drawn between cultures and across time.

Organized by period, genre, and theme, this course explores viewpoints expressed in American literature, including prose and poetry from 1845 to the present. Parallels and contrasts will be drawn both synchronically and diachronically among different genres and themes.

This course covers the major themes and events in world history from prehistoric times to 1500. The course will focus on history from a variety of perspectives: social, cultural interactions, environmental, political, economic, and the people and events that shaped our world's history. Various themes that appear across time will be explored from the perspective that all cultures and all events are influenced by the interactions with other peoples, geography, and the environment; and in turn these events influence and shape future events.

This course covers the major themes and events in world history from 1500 to the present. The course focuses on history from a variety of perspectives: social, cultural interactions, environmental, political, economic, and the people and events that shaped our world's history. Various themes that appear across time will be explored from the perspective that all cultures and all events are influenced by the interactions with other peoples, geography, and the environment; and in turn these events influence and shape future events.

This course introduces students to philosophical thinking. Students will confront fundamental questions of self and identity, of freedom and determinism, of belief and truth, and of ethics and morality. Critical thinking activities will challenge students to incorporate philosophy into their personal and professional lives by applying the questions of philosophy to themselves and their world.

Social and Behavioral Sciences

Area ii foundation requirements: 16 credits.

Statistics provides students with lecture and extensive practice in the concepts of descriptive and inferential statistics. The course emphasizes practical calculation and application. It begins with sample statistics and population parameters, proceeds to measures of central tendency, dispersion, and position, introduces the least-squares best-fit line and several key probability distributions, and concludes with the sampling distribution of sampling means, and hypothesis testing. MyStatLab or a comparable resource may be required in the course.

Area III Major Requirements: 30 Credits

Bio1011 and bio1012.

(must be taken concurrently)

Credits : 2

BIO1013 and BIO1014

Anatomy and Physiology II is a continuation of Anatomy and Physiology I. BIO1013 is an introduction to the structure and functions of the human body including the endocrine system, circulatory system, respiratory system, GI system, urinary system, reproductive system, and genetics.

Anatomy and Physiology II Lab is designed to support, amplify, and clarify the material presented in the theory class BIO 1013 through demonstration and exercises utilizing chart, models, tissues, and organs, as well as typical laboratory equipment. The second part of the term will include a whole specimen dissection, which will assist the comprehensive review of both BIO1011 and BIO1013 . Laboratory topic content shall follow the theory class very closely.

BIO2070 and BIO2071 or BIO2073

( BIO2070 and BIO2071 must be taken concurrently)

Microbiology introduces the student to microorganisms with particular emphasis on their role in health, wellness and disease. In this course students perform laboratory exercises, experiments and tests that correlate with the lecture material of BI02070. Emphasis is placed on aseptic technique, proper handling of lab specimens, universal precautions and proper waste disposal. BIO2071 must be taken concurrently with BI02070. This laboratory course is for online students only.

Microbiology introduces the student to microorganisms with particular emphasis on their role in health, wellness and disease. In this course students perform laboratory exercises, experiments and tests that correlate with the lecture material of BI02070. Emphasis is placed on use of a microscope, aseptic technique, proper handling of lab specimens, universal precautions and proper waste disposal. This laboratory course is for campus students only.

This course surveys the principles necessary to promote optimum nutrition throughout the life cycle. Consideration is given to informed evaluation of areas of controversy, as well as influence of socioeconomic and culture on nutritional practices.

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Office of Prospective Student Programs & New Student Orientation Mobile Townhouse 5910 USA South Drive Mobile, AL 36688-00002 Ph: (251) 341-3951 [email protected]

Schedule a Campus Tour

Are you a high school senior who has already toured South?  Want to visit campus again to see more of what Jag Nation has to offer? Email us at  [email protected]  with your requests for more visit options.

Campus Tours

• a ride through our beautiful tree-, pond- and trail-covered campus
• a peek into a freshman residence hall
• an opportunity to explore our incredible Student Recreation & Wellness Center, complete with indoor and outdoor pools, state-of-the-art equipment, and more
• a look at academic buildings, dining facilities, and student support service areas

Tours also include an admissions info session about academic programs, scholarships, support services, and student engagement.

Tours primarily serve high school students, but we host  other college-bound groups as well.

Check out our  FAQs  to learn more.

We are so glad that you are interested in connecting with us. We can't wait to show all of our prospective Jaguars what South Alabama is all about. Check out the options below for visiting with us! Students who attend an on-campus tour with a South Guide or one of our special events are eligible to receive a $100 visit credit.*

Special Events

Group Tours

Graduate Student Visit

Virtual Admissions Meeting

Seeing is believing! Students and two family members will spend a day on the beautiful South Alabama campus engaging in a host of opportunities to learn more about academic programs, student life, and more. Get a taste of what belonging feels like at South.

USA DAY is one of South Alabama's premier prospective student visit days.

At USA Day, you and your family will have the opportunity to:

• Chat with representatives from the college that houses your academic major of interest to learn more about the programs they offer. 
• Learn about admissions, scholarships, financial aid, and campus involvement.
• Enjoy a complimentary lunch!
• Browse our university campus fair of student organizations, academic departments, student services, and recruitment representatives.
• Tour campus.

Check back for registration updates in Fall 2024.

Honors College Events

We are excited to welcome our future Jaguars to campus to learn more about what South has offer. Among many great attributes, we like to boast about the diverse community of interdisciplinary excellence designed to stimulate the thinking and intellectual curiosity of highly motivated students that is known as the USA Honors College .

In the fall, the USA Honors College & Admissions will host a special Scholastic Excellence Tour for aspiring honors students.

At SET, students and their families will:

• Tour the residence hall where Honors College students live, study, and have fun together
• Meet current Jags and the Dean of the Honors College
• Learn about admissions, scholarship, and student life
• Tour the Honors facility, known as the Seaman's Bethel

Transfer Student Showcase

At our showcases,  we present our support services, resources,  colleges and campus community to prospective students and their families.

Southbound Showcases

Transfer Student Showcase is an event that is crafted specifically for students who are planning to transfer from their current institution and want to learn more about what South has to offer. During this showcase, students will have the opportunity to:

• Meet with admissions and advising staff
• Chat with faculty and staff from their academic college of choice
• Tour campus
• Enjoy lunch with current Jags and other transfer students 

Virtual Tour

Take a look around and get a glimpse of our beautiful 1200-acre campus.

Our students talk about campus life, academics and activities at South. See more videos.

Self-Guided Tour

Can't make one of our scheduled tour times? Visit campus anyway! Follow our self-guided tour to see and learn more about South. The self-guided tour allows families to navigate campus at their own pace.  Just click the link below and drive. No registration required! When you're done, you can set up an appointment to meet with one of our   Admissions Counselors   to have your questions answered. It's just that easy!

South Alabama Self-Guided Tour

*Visit credit is limited to a singular $100 credit per eligible undergraduate student. The student must enroll in courses at South in 2024 to receive the credit, which will be issued within 30 days of the start of the student's first term. Event registration and attendance are also required for credit to be issued. Prospective students who plan to enroll at South in Spring 2024 must visit by December 16, 2023.  Prospective students who plan to enroll at South in Summer or Fall 2024 must visit by May 1, 2024 to be eligible for the credit.

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South University Announces Its New 2023 Impact Report

South University has recently published its new impact report for 2023.  Please visit this link South University 2023 Impact Report .

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South College

Your Career Starts Here

Visit South College

Our admissions staff will help you get a feel for our campuses and answer any questions as you picture yourself as a South College student. Set up your visit today by filling out the form below, and a South College representative will get in touch with you.

Applicants to graduate programs (PharmD, DPT, EdS, MHS, MEd, MBA, MS, MSN, MS in Criminal Justice, or Graduate Certificate programs) and all other Graduate level programs should visit the section of the  catalog  dedicated to these programs for information regarding all admission and application procedures.

University of South Florida

Office of Admissions

Main navigation, tampa campus tours.

Head into the city to get to know USF’s Tampa campus! Take a tour that will explore the acclaimed facilities and vibrant student life of our largest campus, located in the transformative Uptown District. You will also get the chance to learn more about the application process during an information session with an admissions counselor.

Student-Led Campus Tours

Tours are available  Monday through Friday and are open to all students.  You’ll get an up-close view of our top-rated academic facilities, dining options, a suite-style residence hall, student support offices, recreation and other points of pride. In addition, you will hear from current USF students about what life is really like at our dynamic university!  

Before scheduling a visit, please keep the following in mind:

• Dates: Tour space is limited to provide our guests with a positive experience. Please have a few dates in mind before making your reservation in case your first choice is not available.
• Academic calendar :  To get the best feel for USF, check our academic calendar and visit when there are students on our Tampa campus attending classes.
• International students : Contact  [email protected]  to add a meeting with an International Admissions Advisor to your campus tour. 
• Weather : The Tampa campus is located in a subtropical climate and tours are held outdoors. Wear comfortable shoes, sunscreen, hats, sunglasses and temperature-appropriate clothing. And don't forget to bring a water bottle to stay hydrated! It can get hot in Tampa, especially on a walking tour of campus.

Register Now

Self-Guided Campus Tours

Mobile and Desktop Tours

Our self-guided tour is a great way to explore USF's Tampa campus at your own pace.   Follow the steps below to get started!

Mobile Instructions

• Follow the link below and select “iOS” or “Android” to install the self-guided tour app on your phone.
• Once installed, open the app, search for “University of South Florida” and select “Get Started.”
• Enter your information, then select the premade “USF Tampa Campus General Tour.”
• Start exploring! 

Access Mobile Tour

Desktop Instructions

Follow the link below and select “Desktop” to access the desktop version of the self-guided tour. Start exploring! 

Access Desktop Tour

Points of Interest Map

You can also navigate through campus with our Points of Interest Visitor Map! Download the map below and get started. 

Note: access to all buildings is not guaranteed, and guests will need to purchase a parking permit from USF parking services.

Group Tours (10+ Students)

Come join us for a group visit of the University of South Florida’s Tampa campus! These visits are comprised of groups of 10+ high school or transfer-level students. If your group is comprised of other types of students, we invite you to join us for a self-guided tour. Find our Points of Interest map linked above.   During your group tour, you’ll explore our academic facilities, a suite-style residence hall, dining options, student support offices, recreation and other important campus stops. Tours include an information session where you and your group will learn about admissions requirements, financial aid, scholarships, campus life, dining and more.

Scheduling Your Group Tour

Due to the large volume of requests we receive for group tours, our guided tours are limited to high school and transfer-level students. We offer guided group tours on weekdays and dates and times are subject to availability.   If your group is comprised of high school or prospective transfer students, please follow the directions below to set up your visit:

• Submit your request at least 30 days prior to the requested visit date.
• Please include your requested date(s) and time(s) in order of preference in the “Date Preferences” field.
• After receiving your request, a representative from our office will contact you. Submitting a request does not guarantee a scheduled visit.
• Should you wish to eat on campus with your group, we recommend our all-you-care-to-eat dining hall. For information on hours and pricing, please visit Dining Services .

Submit Request

Virtual Tours

Explore USF’s Tampa campus online – from anywhere! Led by student guides, our virtual tour offers 360-degree panoramic views of our beautiful 1900-acre campus as real USF students tell you about their favorite stops.   Picture yourself in our state-of-the-art classrooms. Discover our modern residence halls. Imagine yourself lying under the Florida sun at Castor Beach – in February!

Disability Accommodations

Disability accommodations can be requested when you register for a campus visit or by contacting the tour staff at 813-974-7878 (Florida Relay Service TTY: 800-955-8771) or [email protected] at least two weeks in advance for mobility assistance, visual impairment assistance or American Sign Language interpreting.    USF is an Equal Opportunity/Equal Access Institution and therefore complies fully with the requirements of the Americans with Disabilities Act of 1990 (ADA) and all other federal and state laws and regulations prohibiting discrimination on the basis of disability or handicap.

Directions to Campus

Address: University of South Florida 4202 E. Fowler Avenue Tampa, FL 33620, USA   From the East:

• Take I-4 West to Exit 9 / I-75 North
• Travel North on I-75 for 3.8 miles to Exit 265 / Fowler Avenue
• Head West on Fowler Avenue 4.4 miles to the University's main entrance at Leroy Collins Boulevard

From the West/Tampa International Airport:

• Take I-275 North to Exit 45B / I-4 East
• Travel East on I-4 for 8.1 miles to Exit 9 / I-75 North

Parking on Campus

Just past the entrance to USF on Leroy Collins Boulevard, turn right into the Campus Information Center (CIC) . Pull up to an available drive-through window and inform the staff that you are here for a campus visit with the Office of Admissions. They will provide you with a parking pass and campus map. If you are visiting on a Saturday, the CIC will be closed, and a permit will not be necessary.   After obtaining the parking pass, turn right onto Leroy Collins Boulevard and proceed to the Collins Boulevard Parking Garage (located at the end of Leroy Collins Boulevard, just past the Library). Your parking pass allows you to park on level 3 and above. Before exiting your vehicle, be sure your parking pass is visible.   From the garage, it's just a short walk to the Interdisciplinary Sciences Building (ISA). Check-in begins one hour prior to the visit on the 7th floor.   Note: Please arrive at least 15-30 minutes prior to your scheduled visit to ensure adequate time for parking and check-in. 

Hotels and Accommodations

If you're visiting from out of town, there are a number of convenient hotels located near our Tampa campus. This is not a comprehensive list, so visitors are encouraged to search for other hotels near the campus they are visiting.   Many of the hotels listed offer a special USF rate. If you choose one of these hotels, state that you are visiting the University of South Florida to access the special rate. Some also offer free shuttle service to the campus.

Embassy Suites Tampa 3705 Spectrum Boulevard Tampa, FL (813) 977-7066   Fairfield Inn & Suites Tampa North 12260 Morris Bridge Road Temple Terrace, FL (813) 989-0007   Holiday Inn Express 13294 Telecom Drive Tampa, FL (813) 972-9800   

Holiday Inn Express & Suites Tampa - USF Busch Gardens 2807 E. Busch Boulevard Tampa, FL (813) 936-8200   Holiday Inn Tampa North 3751 E Fowler Avenue Tampa, FL (813) 402-2982   Home2 Suites by Hilton Tampa USF 11606 McKinley Drive Tampa, FL (813) 750-8844   Hyatt Place Tampa/Busch Gardens 11408 North 30th Street Tampa, FL (813) 979-1922   La Quinta Inn & Suites USF 3701 East Fowler Avenue Tampa, FL (813) 910-7500   Residence Inn Tampa at USF/Medical Center 13420 N. Telecom Parkway Tampa, FL (813) 972-4400    TownePlace Suites Tampa North/I-75 Fletcher 6800 Woodstork Drive Tampa, FL (813) 975-9777   SpringHill Suites Tampa North I-75/Tampa Palms 5396 Primrose Lake Circle Tampa, FL  (813) 558-0300  

Explore Tampa (and Beyond)

One of the best parts of attending USF is the location. Our sprawling Tampa campus is packed with all the student amenities and resources of a large university, and it’s conveniently located a short drive from downtown, historic Ybor City, theme parks and more. USF offers something for everyone, from beach lovers to sports fans to art aficionados.    Plus, USF students have access to the rich professional resources afforded by the bustling metropolitan area. This includes a strong economy anchored by major companies. Our business community relationships offer students valuable internship and practicum experiences that prepare them for rewarding careers when they graduate.   Check out the Visit Tampa Bay website or download our Gulf Coast Visitor Guide to make the most of your trip and explore everything the Tampa Bay area has to offer, from sports to arts to nature. 

Download Guide

Contact the Campus Visitation Office

Have questions about life at USF or want to learn about visiting the USF Tampa campus? Contact our team! Email: [email protected] Phone: 813-974-7878

Visit Campus

Take a closer look at what makes a University of South Carolina education special. Explore campus. Get a taste of student life. We believe you'll be ready to join our Gamecock family for good.

They say seeing is believing and, as Gamecocks, we can't help but agree. Our campus community is a special place that holds your heart long after you graduate into the wider world.

From walking the age-old brick paths of the historic Horseshoe to seeing how sustainability integrates into everyday life at the Green Quad, South Carolina is a place to experience. Plan a visit and get your future started here.

Schedule your Visit

Take a closer look at our downtown campus in Columbia, South Carolina. Tour options make it easy to see how South Carolina fits your goals and life. Have a big group? Schedule a group visit to campus. Short on time? Explore on your own with a self-guided option.

I chose USC because when I stepped on campus, it instantly felt like home!

Explore Virtually

Experience the University of South Carolina campus on your time. You can take the tour all at once or jump to an area that interests you from the menu on the left side of the screen. 

Speakers On: Tour audio will auto-play when you begin the tour.

Prepare for your visit.

Before your tour, check out tour tips to prepare for your visit. You'll learn what to expect and see our suggestions for making your visit as comfortable as it is fun.

Explore Columbia

Columbia is an ideal place to call home. Small enough to feel comfortable and large enough to help you spread your wings. See why our hometown is a place you'll want to come back to for years to come.

Use the interactive map to find your way around campus or get the scoop on where to find university services such as parking, dining and even gender neutral restrooms.

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South Carolina Official Visit List - June 21st

Fisher brewer | jun 20, 2024.

• South Carolina Gamecocks

The University of South Carolina is hosting several top recruits for official visits. Here is the list of players scheduled to visit Columbia this weekend:

• Four-Star DL Bryce Davis
• Four-Star DL Caleb Williams
• Four-Star DL Zavion Hardy
• Four-Star S Kendall Daniels Jr.
• Four-Star OT Shedrick Sarratt Jr.
• Three-star QB Cutter Woods
• Three-star DL Anthony Addison
• Three-star S Damarcus Leach
• Three-star LB Donovan Darden
• Three-star DL Eric Thomas
• Three-star WR Jayden Sellers

Another huge weekend is headlined by top 100 prospect Bryce Davis. After announcing his commitment date of July 20th and his final three schools of Georgia, Clemson, and Duke, Davis added this official visit to South Carolina. After taking two of his three visits, he attended the Gamecocks' spring game back in April just before announcing his original group. This is the only visit left for Davis.

Another name considered a co-headliner is Zavion Hardy. The former Gamecock commit was recently ranked as the No.1 JUCO player in the country. Last week, Gamecock Digest broke the news of his official visit for this weekend and highlighted how South Carolina still holds a special place for Hardy despite receiving offers from schools like Georgia, Alabama, and Florida.

The staff will count this weekend as a win with the amount of talent that will be on campus, especially with Kendall Daniels Jr. returning. Daniels, a player they expected to commit a few months ago, delayed his decision after schools like Virginia Tech asked for a little more time. Since then, he earned an offer from Clemson, but the Gamecocks remain firmly in the mix for Kendall at this point in time.

This weekend presents a significant opportunity for South Carolina to make a lasting impression on these top recruits and potentially secure key commitments for their future. The presence of high-caliber players like Bryce Davis, Zavion Hardy, and Kendall Daniels Jr. demonstrates the program's strong recruiting efforts and its commitment to building a competitive team.

Join the community:

• Follow Fisher Brewer on Twitter:  @USCTalk
• Follow Alex Joyce on Twitter:  @AlexJoyceSI
• Follow Matthew Peavy on Twitter:  @TheMattPeavy
• Follow Isaiah Collins on Twitter:  @IsaiahCEC
• Follow Joseph Griffin on Twitter:  @JosephGriffinJG
• Follow Luke Brumm on Twitter:  @lukebrummcfb
• Follow USCTalk on YouTube for more video-based content:  USCTalk YouTube

You can follow us for future coverage by clicking "Follow" on the top right-hand corner of the page. Also, be sure to follow us on  Twitter  and  Facebook !

FISHER BREWER

Fisher has been covering the Gamecocks for 5 years as a freelancer under the name of USCTalk, a popular page in the Carolina community that led to his first reporting job for Rivals.com. He left to go back to being a freelancer and then, a year later, joined the Sports Illustrated family in January 2023.

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Police still searching for suspect after telling residents to “seek shelter” near Furman University

TRAVELERS REST, S.C. (FOX Carolina) - The Travelers Rest Police Department advised residents to seek shelter and lock their doors as they searched for a suspect Saturday afternoon.

Police said after identifying a stolen pickup truck along N HWY 25 and Roe Ford Road, they attempted a traffic stop. During that attempt, they said the suspect collided with another vehicle and then took off on foot. The driver of that vehicle is expected to be okay.

Officials described the suspect as a man who weighs around 300 pounds and is about 6 feet 2 inches tall. They also said he was last seen wearing a white shirt and green pants.

Travelers Rest Police, Greenville County blood hound, K-9, and drones were actively searching for the driver of the stolen vehicle near Furman University.

“Residents in the area are advised to seek shelter and lock their doors. Please call 911 of you see anything out of the ordinary,” Travelers Rest police said in a statement.

Officials suspended the search around 6 p.m. Sunday.

They are asking residents to stay cautious and call 911 with any information that may lead to the suspect’s arrest.

Stay with FOX Carolina as we work to learn more.

Copyright 2024 WHNS. All rights reserved.

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Putin Does Not Rule Out Sending Arms to N.Korea, U.S. ‘Incredibly’ Concerned

V ladimir Putin said Thursday he does not rule out Russia sending arms to isolated North Korea in what Washington called an "incredibly concerning" statement that threatens instability on the divided Korean peninsula.

On a trip to Vietnam following a state visit to Pyongyang where Russia and North Korea signed a mutual defense pact, Putin also warned South Korea not to arm Ukraine.

The Russian president said prospects of Moscow providing weapons to North Korea are repercussions for the West arming Kyiv, which is battling against a Russian invasion now in its third year.

"Those who send these [missiles to Ukraine], think that they are not fighting us, but I said, including in Pyongyang, that we then reserve the right to supply weapons to other regions of the world, with regard to our agreements with the DPRK," Putin said, using the acronym of North Korea's official name.

"I do not rule this one out."

South Korea on Thursday called Russia's treaty with the North a "grave concern," with a senior official saying Seoul would "reconsider" its policy of not sending arms directly to Ukraine.

Putin brushed off the response, saying "South Korea has nothing to worry about."

But he warned Seoul not to supply weapons to Kyiv, saying: "This would be a very big mistake."

The United States expressed deep unease over Putin's threat to send weapons to Pyongyang, warning such action could destabilize the Korean peninsula.

"It is incredibly concerning," State Department spokesman Matthew Miller told reporters.

"It would destabilize the Korean peninsula, potentially, depending on the type of weapons, and might violate UN Security Council resolutions that Russia itself has supported."

Pact with Vietnam

Russia and Vietnam, a close Moscow ally since the Cold War, pledged to deepen ties during Putin's state visit aimed at bolstering alliances.

The Russian leader did not receive as clear a declaration of support in Hanoi as he did in Pyongyang, where he got a rapturous reception. But Vietnamese President To Lam indicated a desire to boost defence cooperation.

Russia has been Vietnam's main arms supplier for decades, but orders have dropped off in recent years as international sanctions related to the Ukraine conflict have intensified.

The two sides said in a joint statement that their defence and security cooperation was "not directed against any third country" and contributed to "peace, stability and sustainable development" in the region.

Putin told reporters the talks were constructive and that both sides had "identical or very close" positions on key international issues.

Putin later held talks with Nguyen Phu Trong, the powerful general secretary of the ruling Communist Party, and laid a wreath at the memorial to independence leader Ho Chi Minh.

Drumming up support

Putin's Asia tour came as the United States, Britain and the European Union all announced new sanctions aimed at constraining Russia's war in Ukraine.

The G7 meanwhile agreed to use profits from frozen Russian assets to provide a new $50 billion loan to Kyiv.

Making his first visit to isolated North Korea in 24 years on Wednesday, Putin signed a strategic treaty with leader Kim Jong Un that included a commitment to come to each other's aid if attacked.

Washington and its allies accuse North Korea of supplying ammunition and missiles to Russia for its war, and the new treaty has fuelled fears of more deliveries.

The two countries have been allies since North Korea's founding after World War II and have drawn even closer since Russia's invasion of Ukraine in 2022 isolated Putin on the global stage.

Kim vowed his "full support and solidarity" over the Ukraine war, which has also triggered rafts of United Nations sanctions on Moscow.

Mykhailo Podolyak, a senior aide to Ukraine's President Volodymyr Zelensky, said Putin's trip was a tour of "yesterday's satellites of the U.S.S.R." in search of "military and technical aid and cannon fodder."

His reception was reserved in Vietnam, a major global manufacturing hub that has carefully hedged its foreign policy position for years, seeking to be friends with all but beholden to none.

It has particularly sought to avoid picking sides in the growing U.S.-China rivalry as both superpowers look to boost their influence in Southeast Asia.

U.S. President Joe Biden visited Hanoi in September to promote ties as his administration seeks to build up Vietnam as an alternative supplier of key high-tech components to reduce American dependence on China.

Chinese President Xi Jinping followed suit, making his own state visit barely three months later.

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Caring Doesn’t Take a Break

Josh Randall, the production manager at Southeastern’s Document Source Print and Mail Center, started the Fall 2023 semester with a surprise visit from a student asking about mail.

Brock Sanders

May 16, 2024

One Staff Member’s Unexpected Journey into Filling a Gap for International Students

Josh Randall, the production manager at Southeastern’s Document Source Print and Mail Center, started the Fall 2023 semester with a surprise visit from a student asking about mail. The simple interaction between Randall and Imole Olugbola, a student from Nigeria studying music performance, opened the doors to a problem in dire need of a solution.

Olugbola had come to the Mail Center to ask about the delivery of his Social Security card, which would allow him to work at the on-campus dining services. Working on campus provided Olugbola with finances to pay for his off-campus apartment and not need transportation to work. However, the card never came in after weeks of asking. Randall took it into his own hands to produce results that the Social Security card office was not providing to Olugbola.

“Let’s just get in my Jeep and drive to the Social Security office to figure this out,” Randall said.

The pair were told that the paperwork had gone through some rerouting but would arrive. Olugbola received his paperwork days later and was able to work on campus. However, this wasn’t the end of their friendship.

Randall inquired about his new Nigerian friend at lunch after the mystery of the lost Social Security card was solved. Olugbola grew up in an impoverished area of Nigeria, according to Randall, and learned how to play the violin at his local library where YouTube was accessible on the free computers. He later moved to Hammond, Louisiana, on a scholarship to play the violin in the Department of Music and Performing Arts.

Throughout the semester, Randall readily kept up with Olugbola until the cusp of finals in November. It was then that the international student came to the Mail Center asking about job opportunities over the winter break when the university would be shut down.

Due to departments being closed, Olugbola would be out of a job for close to three weeks. An initiative to produce results and try to find a solution drove Randall down a rabbit hole of more questions than answers.

Lack of a work visa or transportation posed a precarious situation in finding a job for one international student and an even larger problem when Ogubola introduced his friend.

“[Ogubola] came in one day and asked, ‘Mr. Josh, I have a friend who is in the same shape and needs a job, can you help him too?’” Randall said.

Curious as to how many other international students were in the same boat as Ogubola and his friend Ayomide Olubuse, Randall asked if a poll could be done. The survey, conducted by Olubuse, produced a list of 34 students at Southeastern from Nigeria who were going to be without a job or family during the winter break.

“It was Christmastime, and you can’t go pinching pennies at Christmastime. That’s not what we do here,” said Randall.

Randall, again, pushed himself to try harder.

He contacted business owners, department heads, and members of the Greater Hammond Chamber of Commerce to give these students a chance to not only live but thrive during the four-week break.

“If there is something that can be done, why can’t it be done?” Randall said, living by the mantra to help people where help is needed.

This urge to help flows into his pastimes, where he is a volunteer fireman; assistant director at his local youth association in Springfield, Louisiana; and the owner of a 20-year-old jeep club.

Randall said he only brings problems to the table if solutions are readily available. He proposed that departments that have to work over winter break and have room on their budget from students who return home promote those open positions for students who are eager to work. Forming a network of business owners that could offer cash jobs for short periods could also open a larger door for other international students that attend Southeastern.

Randall is hopeful and driven that he will do his part to be part of the solution. “I promise you I will do what I can to not let this happen again,” he said.

To further help combat this predicament, the Office of Student Engagement jumped in to arrange a food program to provide for international students remaining close to campus during the break through the Lion Pantry food pantry program. The Lion Pantry provides perishable and non-perishable items to any active Southeastern students who are in need of services throughout the year, and during breaks, this critical resource can make an especially big difference to members of the campus community.

Within the Office of Student Engagement, Southeastern’s Multicultural and International Student Affairs (MISA) office provides support services, along with social and leadership opportunities, to international students throughout the year, including hosting a popular International Night and housing international student organizations. MISA and other university departments are continuing to investigate additional ways to make sure all students have everything they need to achieve a successful and happy experience at Southeastern, no matter the time of year.

There are close to 160 international students currently enrolled at the university, a number which continues to rise as Southeastern’s reputation for academic excellence mixed with caring support in a welcoming community continues to grow across the globe.

During the Hammond Christmas Parade in December, Southeastern President William Wainwright was adamant that a magnet be placed on one of the floats stating “We love our international students.”

“At Southeastern, you matter here,” Randall said. “I live by that.”

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• Open access
• Published: 17 June 2024

Implementation of an “opt-out” tobacco treatment program in six hospitals in South Carolina

• K. Michael Cummings 1 ,
• Vincent Talbot 2 ,
• Avery Roberson 1 ,
• Asia A. Bliss 1 ,
• Emily Likins 3 ,
• Naomi C. Brownstein 4 ,
• Stephanie Stansell 5 ,
• Demetress Adams-Ludd 5 ,
• Bridget Harris 5 ,
• David Louder 6 ,
• Edward McCutcheon 7 ,
• Rami Zebian 8 ,
• Alana M. Rojewski 4 &
• Benjamin A. Toll 4  

BMC Health Services Research volume  24 , Article number:  741 ( 2024 ) Cite this article

163 Accesses

Metrics details

Describe the screening, referral, and treatment delivery associated with an opt-out tobacco treatment program (TTP) implemented in six hospitals varying in size, rurality and patient populations.

Between March 6, 2021 and December 17, 2021, adult patients (≥ 18 years) admitted to six hospitals affiliated with the Medical University of South Carolina were screened for smoking status. The hospitals ranged in size from 82 to 715 beds. Those currently smoking were automatically referred to one of two tobacco treatment options: 1) Enhanced care (EC) where patients could receive a bedside consult by a trained tobacco treatment specialist plus an automated post-discharge follow-up call designed to connect those smoking to the South Carolina Quitline (SCQL); or 2) Basic care (BC) consisting of the post-discharge follow-up call only. An attempt was made to survey patients at 6-weeks after hospitalization to assess smoking status.

Smoking prevalence ranged from 14 to 49% across the six hospitals; 6,000 patients were referred to the TTP.The delivery of the bedside consult varied across the hospitals with the lowest in the Charleston hospitals which had the highest caseload of referred patients per specialist. Among patients who received a consult visit during their hospitalization, 50% accepted the consult, 8% opted out, 3% claimed not to be current smokers, and 38% were unavailable at the time of the consult visit. Most of those enrolled in the TTP were long-term daily smokers.Forty-three percent of patients eligible for the automated post-discharge follow-up call answered the call, of those, 61% reported smoking in the past seven days, and of those, 34% accepted the referral to theSCQL. Among the 986 of patients surveyed at 6-weeks after hospitalization quit rates ranged from 20%-30% based on duration of reported cessation and were similar between hospitals and for patients assigned to EC versus BC intervention groups.

Findings demonstrate the broad reach of an opt-out TTP. Elements of treatment delivery can be improved by addressing patient-to-staffing ratios, improving systems to prescribe stop smoking medications for patients at discharge and linking patients to stop smoking services after hospital discharge.

Peer Review reports

Purpose and objectives

Hospitalization provides an opportunity to identify and engage patients who smoke cigarettes to stop smoking [ 1 , 2 , 3 , 4 ]. Continued smoking can adversely impact clinical outcomes for patients if they persist in smoking [ 5 , 6 , 7 ]. In 2012, the joint commission issued the Tobacco Cessation Performance Measure-Set to encourage hospitals to improve documentation and delivery of smoking cessation treatments to patients [ 8 , 9 ].

We and others have previously demonstrated the effectiveness of implementing a brief inpatient Tobacco Treatment Program (TTP) modeled after the Joint Commission’s (JC) guidelines [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. However, most of the published studies documenting the impact of hospital based smoking cessation interventions are based on short-term research demonstration projects often conducted in large well-resourced health care settings [ 4 , 10 ]. The reality is most health care is provided in community hospitals where the systematic delivery of smoking cessation interventions is largely absent.

Over the past decade, the health care system of the Medical University of South Carolina (MUSC) has expanded to include the management of multiple hospitals across the state of South Carolina varying in bed size, rurality and patient populations allowing an opportunity to evaluate and compare implementation of the opt-ou t TTP in wider range of hospital settings compared to earlier published studies [ 6 , 7 , 19 , 20 ].

Herein, we describe and compare the implementation fidelity of an opt-out TTP in each of the six hospitals reporting on screening to identify patients who currently smoke cigarettes, referral to the TTP, and treatment delivery to patients. We also report on the post-discharge smoking status of a sample of patients selected from each of the five acute care hospitals conducted 6-weeks after hospitalization as a way to evaluate the effectiveness of the TTP.

This is a descriptive study to compare implementation of an opt-out TTP in six MUSC hospitals varying in size, rurality and patient populations. At the time this study was initiated in March 2021, MUSC managed eight hospitals – one of which was a children’s hospital (not included in this study), while the other seven hospitals provided care to adult patients (≥ 18 years). One of the seven hospitals was devoted to caring for patients with psychiatric and/or substance use disorders (Charleston Institute of Psychiatry). For the purposes of this study, we have combined Ashely River Tower Hospital and University Hospital in Charleston into a single group for reporting purposes because the same tobacco treatment specialists (i.e., referred to as specialists hereafter) provided care to patients in these two hospitals both of which were located within walking distance of each other.The two acute care hospitals in Charleston are referred to as Charleston Non-Institute of Psychiatry (Non-IOP). The other four acute care hospitals in the study were located in: Chester, Florence, Lancaster, and Marion South Carolina respectively. The six hospitals ranged in size from 82 to 715 beds.

The workflow of the TTP included 4-steps: 1) Screening to identify adult patients who currently smoke cigarettes; 2) Referral of patients to the TTP offering two treatment options: Enhanced care (EC) which consisted of a tobacco treatment specialist bedside consult plus an automated post-discharge follow-up call designed to connect those smoking to the South Carolina Quitline (SCQL) or 2) Basic care (BC) consisting of the post-discharge follow-up call only; 3) Treatment delivery documentations (i.e., offered and accepted); and 4) Follow-up evaluation. Each of these steps are described below.

In step 1 (Screening), between March 6, 2021 and December 17, 2021, adult patients (≥ 18 years) admitted to six hospitals were screened for their cigarette status. EHRs of patients admitted to the hospital were scanned daily to identify patients who currently smoke cigarettes. All of the hospitals in this study utilized Epic™ software to record smoking status and other information about the patient during their hospital stay.

In step 2 (Referral), all adults identified as currently smoking in the EHR were automatically referred to the TTP with the following exceptions: a) patients who did not speak English; b) patients receiving hospice care; and c) patients who had previously been admitted to the hospital and referred to the TTP in the past 6-months. The 6-month referral criterion was put into place to maximize limited resources directed toward enrolling those patients newly identified as currently smoking. Those currently smoking and eligible for the TTP were automatically referred to one of two randomly assigned treatment options: 1) EC or 2) BC. Randomization assignments were carried out in a ratio of approximately 3:1 for every EC to BC patient.

In step 3 (Treatment delivery documentation), we documented the offer and receipt of treatments to patients assigned to either the EC or BC groups. Three full-time specialists provided bedside consults to eligible patients assigned to the EC group in the six hospitals. In the Charleston hospitals the specialist also received additional counseling support from two part-time psychology interns who saw patients approximately two days per week. A second full-time specialist was assigned to see patients in the Florence and Marion Medical Center hospitals, and the third specialist was assigned to see patients in Lancaster and Chester Medical Center hospitals. The bedside consult utilized motivational interviewing to engage with patients. Patients were able to opt-out of the bedside consult if they wanted. Consult dispositions were categorized as follows: 1) Received consult; 2) Refused consult; 3) Ineligible for consult because the patient reported not smoking currently (i.e., false positive based on intake screening); and 4) Unavailable for consult when visited in the hospital. Among patients receiving consults, we recorded whether the consult was conducted in-person or by phone and the length of the consult coded as ≤ 10 min or > 10 min. Patients receiving the consult were asked to confirm their smoking status and answer questions about their smoking history, current use of other tobacco products, nicotine dependence, past quit attempts, readiness, and confidence in stopping smoking, all of which were used to create a personalized quitting plan. Specialists were not authorized to prescribe or dispense stop smoking medications to patients, however the specialist could recommend (in Epic™ this is referred to as “pend”) a medication order in the patient’s medical record which could then be acted upon by the attending physician or other members of the care team who were authorized to order or prescribe medications to patients.

All patients who provided a working phone number and were discharged to their home or to assisted living facilities were eligible to receive automated post-discharge IVR follow-up calls starting seven days after hospital discharge with the following exceptions. Patients in the EC group who were visited by a specialist and reported that they did not smoke or that they did not want a consult (i.e., opted out of the consult) were also automatically excluded from receiving the automated post-discharge call. Those patients who did receive the automated call were asked if they had smoked any cigarettes in the past seven days; those answering “yes” were asked if they wanted help to quit smoking or stay quit; those answering “yes” to the second question were asked if they wanted to be transferred to the SCQL, where they could get free stop smoking assistance. Those who answered “yes” were transferred to the SCQL, those answering “no” to an immediate “warm” transfer were asked if they would like the SCQL to call them back at a later time instead. Up to six call attempts were made to reach each patient beginning seven days after discharge from the hospital. If a patient failed to answer any of the calls, then we attempted to reach them again one week later (i.e., 14 days after discharge). For patients eligible to receive automated post-discharge calls, we report on the number who answered the call, the number of current smokers who accepted a referral to the SCQL, and among those referred to the SCQL, the number who received services from the SCQL.

In step 4 (Follow-up evaluation), we attempted to contact patients referred to the TTP six-weeks after discharge from the hospital to their home to assess their satisfaction with the care they received while hospitalized, their smoking status, and efforts made to refrain from and/or stop smoking during and following hospitalization. Follow-up evaluation calls were only made to patients with working telephone numbers who were discharged home. The follow-up evaluation survey excluded patients in the one psychiatric hospital, because the quality improvement study that paid for the 6-week follow-up evaluation survey was limited to patients receiving care in the five acute care hospitals only. For the first three months of the study, we used a random selection process to identify approximately 60 patients per week (i.e. ~ 50%-60% of eligible patients in a week) that would be eligible for the follow-up survey. However, because of the lower than expected completion rate for survey we abandon the random selection process and attempted to reach all eligible patients released for follow-up each week.Overall, there were 3,246 patient deemed eligible for the follow-up survey of whom we secured complete interviews with 986 (i.e., ~ 30%). The completion rate for the survey was similar for patients in each of the five acute care hospitals and for patients assigned to either the EC or BC intervention groups.

Staff conducting follow-up interviews were not involved in providing treatment to patients. To encourage participation in the follow-up evaluation survey, we sent a letter to eligible patients explaining that they had been selected to participate in a brief 10-min phone survey asking them about their recent hospitalization and alerting them to expect a call within 7–10 days. Patients who participated in the survey were given a $10 Amazon e-gift card to compensate them for their time.

Data sources

Data reported in this paper come from: (1) hospital EHRs; (2) the bedside consult electronic form, which captured information about the patients smoking history and treatment plans; and (3) the six-week phone follow-up evaluation survey conducted using REDCap.

Ethics approval and consent

Informed consent occurred verbally for the 6-week follow up survey. Consent was obtained from all of the participants that should be informed. All methods were carried out in accordance with relevant guidelines and regulations. The quality improvement study was reviewed by and received ethics clearance through the Medical University of South Carolina IRB Committee (IRB#107,000) with a HIPAA Waiver of Authorization for Research in which approval was granted for: 1) limited protected health information (PHI) in the EHR; and 2) verbal consent for the 6-week telephone follow-up survey. A copy of the study protocol is available from the authors upon request.

EHRs contain information on the patients admission and discharge dates, unit where the patient was located during their hospital stay, demographics (i.e., age, race, sex, type of insurance), smoking status (i.e., never, former, current, unknown), and identifying information such as full name, address, and phone number. Data on daily admissions were extracted from EHRs and deposited via a secure, HIPAA-compliant transfer protocol to the Quit Plan Manager™ system (QPM 5.0, by TelASK Inc, Mount Pleasant, South Carolina, USA) which identified currently smoking patients eligible for the TTP. Each morning, a generated list of inpatient smokers from the prior days’ admissions were presented to the specialist through the QPM secure web-interface that could be accessed using a desktop computer and/or tablet. The interface loaded patients’ identifying information to a task list that informs the specialist where patients were located in the hospital. For patients seen by the specialist, information on the consult was captured on the tablet and securely uploaded to the patient database system. Data from the EHRs were received daily allowing us to update a patient’s smoking status and also detect patients discharged from the hospital and eligibility for receiving automated follow-up calls. Based on the patients’ hospital-assigned medical record number, QPM identified patients who have been readmitted to the hospital within the previous six-months and excluded these patients from re-enrollment in the service. Patients were eligible for re-enrollment in the TTP if readmitted to the hospital after 6-months. In this paper, we only report on the patients’ first admission to the hospital during the reference period. Data from EHRs, bedside consult, and automated calls were captured in separate databases and carefully linked together for analysis via the patients’ medical record number and hospital admission date.

Data on all patients enrolled in the TTP allowed the specialists and clinical chief of the TTP (BAT) to track the status of patients eligible for the service. Weekly reports were generated to track screening, referral, and treatment delivery results for each hospital. The six-week post-discharge follow-up evaluation surveys were tracked separately to ensure sufficient interviews were completed for patients in each of the participating hospitals involved in the quality improvement study.

Data analysis

Data analyses focus on describing the implementation of the four components of the opt out TTP program: 1) Screening; 2) Referral to the TTP; 3) Treatment delivery of the bedside consult and automated post-discharge follow-up calls designed to link patients to the SCQL; and 4) Follow-up of patients 6-weeks after hospitalization to assess smoking status. The following implementation measures are reported upon for each hospital: (1) the number and proportion of patients screened who endorsed current smoking; (2) among patients reporting current smoking, the proportion of referred to the TTP and assigned to either the EC or BC intervention groups; (3a—EC group only) the proportion visited by a specialist while hospitalized and receiving a bedside consult; (3b – EC and BC groups) the number and proportion eligible to receive a post-discharge follow-up call, the proportion who answered the call, reported currently smoking, and accepted the referral to the SCQL call; and (4) among patients selected for the 6-week follow-up interview, the number and proportion who completed the survey and among survey completers the proportion who reported not smoking at the time of the 6-week follow-up evaluation. Smoking status was defined as a) having not smoked at all since discharge from the hospital (i.e., continuous abstinence); b) not smoking on the day of the follow-up interview (24-h non-smoker prevalence); c) not smoked in the past 7-days (7-day non-smoker prevalence); and d) not smoked in the past 30-days (30-day non-smoker prevalence). For patients who report smoking at the time of the six-week follow-up interview, we also report on the proportion who have made a quit attempt since their hospital stay and the proportion interested in receiving additional assistance to stop smoking.

Frequencies and percentages were reported for categorical variables whereas medians, ranges, means, and standard deviations (SD) were reported for continuously measured variables. All statistical analyses were performed in SAS 9.4™ (SAS Institute, Cary, NC).

Table 1 provides descriptive information on each of the six hospitals and the demographic and health status of current smokers tracked as part of the study. Figure  1 displays the overall workflow of the tracking process from screening patients for smoking status, referral of current smokers to the TTP, and the delivery of treatment interventions to patients assigned to the EC and BC intervention groups.

EHR screening, referral, and treatment delivery documentation

Between March 6th and December 17th, 2021, 35,679 unique patients were admitted to the six hospitals, of whom 19.4% were currently smoking. Smoking prevalence ranged from 14 to 49% with the highest rate of smoking observed among patients admitted to the psychiatric hospital.

Referral to the TTP

Of the 6,911 patients identified as current cigarette smokers, 6,000 were referred to the TTP and randomized to either EC or BC treatment conditions. Approximately 72% of referred patients in each hospital were assigned to the EC intervention condition while 28% were assigned to the BC intervention group. All 4,337 patients in the EC group were eligible to receive a bedside consult, but only 3,354 (77.3%) received a consult visit from a specialist during their hospitalization. Only home discharged patients with a working phone were eligible to receive an automated post-discharge follow-up call. However, patients in the EC group who reported that they did not smoke and those who opted-out of the bedside consult also were automatically excluded from receiving the automated post-discharge call.

Treatment delivery

Bedside consult.

Table 2 shows the delivery of the consult to patients in each of the six hospitals. Patients in the three Charleston hospitals had the highest number of referred patients per specialist and the lowest delivery of the beside consults. Among patients who received a consult visit during their hospitalization, 50% accepted the consult, 8% opted out, 3% were ineligible because they reported not smoking, and 38% were unavailable at the time of the consult visit.

Table 3 shows the characteristics of patients who accepted the consult. Most of the consults were done in-person, although in one hospital 71% of consults were done by phone. About half of the consults were completed in ≤ 10 min, although the time spent counseling varied among the three specialists. The specialist serving patients in the Florence and Marion Medical Center hospitals reporting over 94% of the consults lasting ≤ 10 min, while the other two specialists had the majority of their consults lasting > 10 min.

The majority of patients who received a consult while hospitalized were male, smoked cigarettes daily, with an average age of 50 years old or greater. Patients from the psychiatric hospital were younger (mean age: 38.5 years) and reported higher levels of cigarette dependence as assessed by cigarettes per day and time to first cigarette of the day. About 75% of patients reported having made a previous attempt to stop smoking. Among those reporting a previous quit attempt, cold-turkey was the most common method reported. About 23% of patients reported past use of stop smoking medications, and only 3% mentioned using an e-cigarette to stop smoking. About 35% of patients reported having strong cravings to smoke while in the hospital, although this varied widely by hospital (i.e., 17% to 62%). Overall, 28% of patients reported receiving stop smoking medications while in the hospital with wide variations seen across the six hospitals (10% to 67%). Patients from the psychiatric hospital were much more likely to report using nicotine replacement medication while in the hospital compared to patients in the acute care hospitals. Readiness and confidence to quit varied among patients in the six hospitals, with about 55% of patients overall contemplating quitting.

Automated post-discharge call

Table 4 shows the response to the automated IVR calls for patients in the EC and BC interventions for each of the six hospitals. Overall, 72% of patients referred to the TTP were eligible to receive the automated calls. The overall eligibility for the automated post-discharge call was about 13% higher among patients assigned to the BC group when compared to the EC group (78.3% vs. 69.3%), due to the exclusion criteria which, in addition to excluding patients not home discharged, also excluded patients in the EC group who reported not smoking and those who opted-out of the bedside consult.

Of those eligible to receive the post-discharge call, 1,860 patients were reached yielding an overall response rate of 43% with no significant differences between the EC and BC intervention groups. The response rates to the automated calls ranged from 23% to 53% across the six hospitals, with the lowest response among patients discharged from the psychiatric hospital. Among those responding to the automated calls, 1,143 (62%) reported currently smoking, and of these patients, 384 (34%) accepted the offer of a referral to the SCQL with similar rates of acceptance for patients assigned to the EC and BC groups (33% vs 35%). Data received back from the SCQL found of the 384 patients referred to the SCQL, 17% received services from the SCQL. There were different reasons given for failure to provide service to the referred patients, with the most common reasons being inability to reach patients with follow-up calls (45%), patients not interested in the service (19%), and patients 35% deemed ineligible because they had been enrolled in the SCQL within the past year (36%).

Overall treatment delivery

Among 4,337 patients assigned to the EC group, 605 (14%) received a bedside consult and answered the automated post-discharge call; 1,072 (25%) received only the bedside consult; 682 (16%) only received and answered the automated post-discharge call; and the remaining 1,978 (45%) did not receive either a consult or responded to the automated post-discharge call. Among patients in the BC group, 573 (35%) received and answered post-discharge call. Overall, of the 6,000 patients referred to the TTP, 2,932 (49%) received either a beside consult and/or post-discharge call. Treatment delivery varied across the six hospitals as noted above.

Six-week follow-up evaluation survey

Table 5 summarizes responses to questions about smoking status, the use of stop smoking medications, quit attempts, and interest in receiving additional quitting assistance among those who reported that they still smoke. Self-reported smoking abstinence rates were fairly similar across the five hospitals, with 21% reporting not smoking since discharge from the hospital (continuous abstinence), 31% not smoking on the day of the follow-up survey (24-h point non-smoker prevalence), 24% reporting not smoking in the past 7-days (7-day non-smoker prevalence), and 22% reporting not smoking in the past 30-days (30-day non-smoker prevalence). Overall, 41% of patients reported getting stop smoking medications either during their hospital stay, at the time of discharge from the hospital, or after discharge. Getting stop smoking medications during their hospital stay varied across the five hospitals. In general, the patients from the smaller hospitals were more likely to report using stop smoking medications during and after hospitalization. Among the 682 patients still smoking at the time of the follow-up interview 58% ( n  = 394) reported having made a quit attempt since being discharged from the hospital and 43% reported interest in receiving assistance to stop smoking.

This study is unique in that it describes the implementation fidelity of an opt-out TTP in six different hospitals varying in size, rurality, and patient populations. The United States Department of Health and Human Services recently requested information on strategies to broaden the delivery of evidence-based smoking cessation treatments to those who continue to smoke cigarettes [ 23 ]. The findings confirm evidence from other published studies demonstrating the feasibility of using EHRs to efficiently screen patients admitted to the hospital to identify current cigarette smokers and refer them to a TTP [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. In all six hospitals, the vast majority of the patients referred to the TTP were long-term daily smokers, many of whom had tried to quit in the past, with most reporting no prior use of evidence-based smoking cessation treatments. Even in the acute care hospitals, patients identified as current cigarette smokers likely had other psychiatric co-morbidities such as a history of depression, anxiety, and other substance use disorder, especially alcohol use disorder [ 24 ].

Overall, 49% of the 6,000 patients referred to the TTP received some type smoking cessation intervention (i.e., consult or automated post-discharge call). The delivery of smoking cessation treatments was uneven across the six hospitals. The lowest rate of delivery for the bedside consult was in the Charleston hospitals which had a higher average combined daily caseload (6.0 referrals per day) compared to Florence and Marion hospitals (4.9 referrals per day), and Lancaster and Chester hospitals (2.5 referrals per day). Our sense is that a single full-time specialist can comfortably handle about 5 referrals per day which represents an annual referral caseload of between 1,825 patients per full-time specialist.

This study also suggests that providing treatment services to psychiatric patients may require a different intervention model than the one we implemented [ 4 ]. The psychiatric hospital setting brought forth a different set of challenges when attempting to deliver the bedside consult. Most psychiatric patients while admitted are typically following a set, daily schedule and therefore have a higher likelihood of being unavailable for a consult when a specialist is ready to visit their room. In addition, there are a number of patients who are unavailable for medical reasons for extended periods, overall highlighting the continued need to explore effective cessation models that compliment the dynamics within psychiatric settings. A potentially more effective model for delivering cessation support to patients in a psychiatric hospital setting may involve training existing psychiatric staff to provide the care rather than referring patients to a centralized TTP.

The annual budget for the inpatient TTP across the six hospitals in this study was $380,902. The budget included expenses for three full-time specialist, two part-time psychology interns, clinical oversight, training and equipment for the specialists, and the vendor contract for the Quit Plan Manager™ system which was used for tracking patients from admission to discharge as well as scheduling and executing automated post-discharge calls for patients. With a total of 6,000 patients referred to the TTP over 287 days of the reference period, the average annual number of referrals is estimated to be 7,630 yielding an average annual per patient cost of $51 per referral (i.e., $380,902/7,630 = $51).

The largest barrier we experienced in delivering the bedside consult to patients was actually reaching patients during their admittance. Of the 4,337 patients referred for a bedside consult, 983 (23%) never received a visit from a specialist while hospitalized. Length of hospitalization was strongly associated with who did and did not receive a visit from the specialist. Among those who received a consult visit from a specialist, the average length of stay was longer when compared to patients who did not receive a visit (6.3 days vs 3.3 days, p  < 0.01).Another relatively large group (38%, n  = 1,279) that did not get a consult while hospitalized included patients unavailable for the consult at the time the specialist came to their hospital room. The group of patients unavailable for a consult was overrepresented in our psychiatric hospital which as noted above included many patients who do not stay in their hospital room during the day, and thus were unavailable when the specialist came to visit the patient in their room. Excluding the patients from the psychiatric hospital, among patients who were unavailable for a visit, there was an association with length of hospitalization but in the opposite direction than we observed for receiving a specialists’ visit. Patients in the acute care hospitals who received a visit from the specialist and were unavailable for the consult had an average length of stay of 7.5 days compared to 4.7 days ( p  < 0.01) for patients who did receive the consult. Another factor related to patient unavailability for a consult was how sick/ill patients were during their hospitalization. The Elixhauser Comorbidity Index is a measure of overall severity of comorbidities (range: 0 to 16, with higher scores indicating more comorbidities) and the mean score on this index was significantly higher for patient unavailable for a visit compared to those who received a consult (3.3 vs 3.0, p  < 0.01) [ 25 ]. Among patients who received a consult visit while hospitalized, 86% accepted the consult with only 14% opting out, suggesting that patient resistance to tobacco treatment support is not a significant barrier to treatment delivery. The overall opt-out rate we observed across the five acute care hospitals combined was similar to the rate we reported in our earlier study of the Charleston non-IOP hospital [ 19 ].

The automated calls made to patients 1–2 weeks post hospitalization are a low-cost way to extend smoking cessation services to patients who have relapsed back to smoking after being hospitalized. Forty-three percent of patients were reached with the automated call system using interactive voice recognition. Of those reached, 62% reported that they had returned to smoking within a week or two following their hospital discharge. About one-third of patients who reported currently smoking accepted a referral to the SCQL. Psychiatric inpatients had a lower response to the automated calls, although among those reached, about 25% accepted the referral to the SCQL. A bigger concern with the automated calls was the actual provision of cessation support to patients connected to the SCQL which was much lower than we had expected. Many patients did not answer the follow-up calls from the SCQL or indicated lack of interest in the service after the referral was made, possibly reflecting a lack motivation to quit.

Six-weeks after hospitalization, self-reported smoking abstinence rates ranged from 20–30% depending on how the abstinence rate was defined. Overall, smoking abstinence rates were similar to what we previously reported in our prior study of an opt-out inpatient TTP and were similar across the five acute care hospitals [ 19 ]. On a positive note, among patients who reported that they were still smoking in our 6-week follow-up survey, 43% expressed interest in receiving additional cessation assistance, reinforcing the benefits of using the hospital admission and immediate post-discharge period as an opportunity to support patients in their journey towards smoking cessation. Finding efficient ways to connect patients who return to smoking after hospitalization to treatment resources is an area that is ripe for future investigation.

Quit rates did not differ for patients in the EC and BC intervention groups indicating a need to strengthen the impact of the brief bedside consult. Other studies have shown that the provision of stop smoking medications to patients at the time of discharge from the hospital is a critical component of an effective stop smoking intervention [ 10 , 22 ]. While about 40% of patients did report using stop smoking medications during or immediately after discharge from the hospital, the rate of medication use was lower than we had expected it to be among patients receiving the bedside consult where one of the objectives of the consult was to develop and execute a stop smoking treatment plan for patients. The findings from this study reveal that our tobacco treatment specialists achieved only modest success in getting the medical staff to prescribe stop smoking medications to patients upon discharge from the hospital. Only 16.% of patients in the EC group received medication, even though medication treatment recommendations added to majority of the patient’s medical record as a result of their bedside consult. A recent study found that an EHR hard-stop prompt to clinicians prescribing stop smoking medications to patients at the time of admission and discharge significantly increased medication use by patients and post-discharge quit rates [ 22 ].

In summary, the findings from this descriptive study demonstrate the broad real-world reach and impact of implementing an opt-out TTP in a diverse set of hospitals spread out geographically across the state of South Carolina. Despite these strengths, there are important limitations to this study that should be noted. First, our system of referring patients to the program was restricted to patients classified as currently smoking cigarettes which undoubtedly excludes patients who had recently stopped smoking or are using other types of non-cigarette tobacco products. Second, referrals are based on self-reported smoking status as recorded in the EHR which is not always accurate. Of 3,354 patients in the EC group who were contacted by a specialist, only 3% reported not smoking (i.e., false positives). However, we acknowledge that a likely greater number of patients will fail to accurately report their true current smoking status (i.e., false negative) [ 26 ]. Biochemical validation of smoking status represents a potential solution to improving the accuracy of smoking status assessment but was not done as part of screening process because it would have added additional costs to the program [ 27 ]. That said, the screening process we employed allowed for repeat checking of a patient’s self-reported smoking status every day while hospitalized so that someone previously screened as not smoking could have their smoking status updated to currently smoking if a change in status was recorded in the EHR. Third, the post-discharge smoking cessation outcomes reported in this paper are based on self-report and only for those who participated in our follow-up survey. If one assumes all non-responders to the follow-up survey were still smoking, the reported quit rates will drop to a range of 6.4% to 9.3% which would markedly reduce the estimated population impact of the program. That said, the same type of limitation would apply to population surveys which are also based on self-reported smoking status assessed at the time of interview (point prevalence) and which also fail to adjust for non-responders [ 28 ].

Despite these limitations, this descriptive paper illustrates the feasibility of implementing an opt-out TTP for patients seen in a diverse set of hospitals at a relatively low cost per patient referred. Overall, patient acceptance of TTP was high although the impact of the EC intervention was less than we had expected. Our analysis found elements of our treatment delivery can be improved upon through better patient-to-staffing ratios, improved systems to get stop smoking medications prescribed for patients, and improvements in linking patients to stop smoking services after hospital discharge.

Availability of data and materials

A de-identified dataset, data dictionary and copy of our REDCap survey are available upon request made to lead author (K. Michael Cummings, [email protected]).

Abbreviations

Tobacco Treatment Program

South Carolina Quitline

Joint Commission

Electronic Health Record

Association for the Treatment of Tobacco Use and Dependence

Tobacco Treatment Specialist

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Acknowledgements

We would like to acknowledge Martha Dunlap who assisted with data collection for the patient follow-up survey, and Amanda Palmer, Brandon Stanford, Stan Flowers, Mathew Gregoski, PhD, who provided input and analytic support for the quality improvement study.

This work was funded in part the South Carolina state tobacco fund earmarked to the MUSC Hollings Cancer Center. Dr. Brownstein received additional support from the South Carolina Clinical and Translational Science (SCTR) Institute at MUSC. The SCTR Institute is funded by the National Center for Advancing Translational Sciences of the National Institutes of Health (grant UL1TR001450).

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TelASK Inc, Ottawa, Canada

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University of Pikeville, Kentucky College of Osteopathic Medicine, Pikeville, USA

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Department of Public Health Sciences, Medical University of South Carolina, Charleston, USA

Naomi C. Brownstein, Alana M. Rojewski & Benjamin A. Toll

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Stephanie Stansell, Demetress Adams-Ludd & Bridget Harris

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Contributions

Conceptualization of the study – KMC and BAT; Securing funding KMC; Analysis plans and execution – KMC, VT, AR, NCB; Data collection – VT, SS, DAL, BH, AAB, EL; Administrative oversight – KMC, BAT, AMR, DL, EM, EZ; Lead on writing of the manuscript – KMC; Manuscript editing – BAT, VT, NCB, AAB, AR, EL, SS, DAL, BH, EM, RZ, DL, AMR.

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Correspondence to K. Michael Cummings .

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Ethics approval and consent to participate.

This research study was reviewed and approved with respect to the study of human subjects by the Medical University of South Carolina’s Institutional Review Board-I, Study Protocol #107000, under expedited review procedures. A HIPAA Waiver of Authorization for Research was requested and subsequently approved due to the study involving no more than minimal risk to the subject, thus satisfying Privacy rule 45 CFR 46.110 and 21 CFR 56.10. We requested a waiver of consent due to the high volume of patients who reside geographically across the state of South Carolina. Obtaining written authorization for home, often-ill discharged patients would increase the loss of confidentiality and could not practically be conducted. Consent occurred in two ways: 1) Limited PHI Data request; and 2) Verbal consent for the 6-week follow up survey. All methods were carried out in accordance with relevant guidelines and regulations.

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Competing interests

VT is employed by TelASK the vendor hired by MUSC to operate the Quit Plan Manager™ system used for patient tracking. KMC and BAT both have received payments as expert witnesses in litigation filed against the tobacco industry. All other authors have no conflicts to report.

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Cummings, K.M., Talbot, V., Roberson, A. et al. Implementation of an “opt-out” tobacco treatment program in six hospitals in South Carolina. BMC Health Serv Res 24 , 741 (2024). https://doi.org/10.1186/s12913-024-11205-7

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Received : 01 September 2023

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DOI : https://doi.org/10.1186/s12913-024-11205-7

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