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A Quality Improvement Approach to Decrease the Utilization of Docusate in Hospitalized Patients.

Kamal A Shair¹, Samantha M Espinosa, Joshua Y Kwon

¹Departments of Internal Medicine (Drs Shair, Kwon, Gococo-Benore, McCormick, Seim, and Cowdell) and Cardiovascular Medicine (Dr Espinosa), Mayo Clinic, Jacksonville, Florida; and Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, Florida (Mr Heckman).

Quality Management in Health Care

|February 22, 2023

Summary

This summary is machine-generated.

Docusate sodium, an ineffective constipation medication, saw a significant reduction in hospital orders. This quality improvement project reduced docusate use without affecting patient length of stay.

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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

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Published on: November 9, 2016

Area of Science:

Hospital Quality Improvement
Evidence-Based Medicine
Pharmacological Effectiveness

Background:

Docusate sodium is frequently prescribed for constipation despite evidence of its ineffectiveness.
Continued use of docusate incurs unnecessary costs and patient risks in hospital settings.
At Mayo Clinic Florida, docusate was ordered for 9.7% of internal medicine patients in January 2020, with an average length of stay of 3.1 days.

Purpose of the Study:

To reduce docusate orders by 50% in internal medicine teaching services within six months.
To implement a quality improvement project addressing the overuse of ineffective medications.
To maintain or improve hospital length of stay (LOS) as a balancing measure.

Main Methods:

A multidisciplinary team of internal medicine residents and pharmacists collaborated on the project.
Six Sigma methodology was employed to devise and implement interventions.
Interventions included educating healthcare professionals and creating process-related barriers to docusate orders.

Main Results:

Docusate orders decreased from 9.7% to 2.4% after five weeks (P = .004).
Hospital length of stay remained largely unchanged, decreasing from 3.1 to 2.7 days (P = .12).
The dual-pronged intervention proved effective in reducing medication use.

Conclusions:

A targeted intervention successfully decreased the use of ineffective docusate in hospitalized patients.
The project demonstrated that medication use can be reduced without negatively impacting patient LOS.
This model can be adopted by other institutions to promote evidence-based medical care.