Reduction of the Inappropriate Use of Stress Ulcer Prophylaxis Across the Health Care System

Inappropriate stress ulcer prophylaxis is a serious problem across the health care continuum. Literature has shown that the overuse of acid suppression therapy, especially proton pump inhibitors, has been associated with an increase in Clostridium difficile, diarrhea, pneumonia, osteoporotic fractures, vitamin B-12 deficiency and inhibition of antiplatelet therapy.

A multimodal approach to reduce the inappropriate use of stress ulcer prophylaxis included the development of evidence-based clinical practice guidelines, educating the multidisciplinary team and changes to the electronic chart order sets and indication-based criteria. This approach was implemented systemwide to promote appropriate prescribing and has successfully reduced acid suppression therapy utilization.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/