ICOUGH and reducing pulmonary complications
Starting in October 2016, the consortium has partnered with Boston Medical Center to implement the ICOUGH bundle to reduce peri-operative pulmonary complications, including pneumonia, ventilator dependence and unplanned intubation. The bundle includes:
I - Incentive Spirometry
C - Cough and Deep Breathing
O - Oral Care
U - Understanding ICOUGH practices
G - Get out of bed and walk
H - Head of Bed greater than 30 degrees
This program promotes patient compliance through audit and feedback and implements an innovative process improvement by transparently sharing outcome data, process measure compliance, and institutional barriers and successes.
The Challenge
In 2017, the opioid epidemic was declared a public health emergency. According to the CDC, overdose deaths are a leading cause of injury-related deaths in the U.S. with rates still on the rise. In 2021, more than 220 people died each day from an overdose death. Opioids can be effective for managing post-operative pain, but overprescribing and misuse can lead to opioid dependence and addiction.
Our Solution
The Pennsylvania-New Jersey Surgical Opioid Stewardship (PENNJ-SOS) program is a collaborative of surgeons and surgical teams dedicated to developing and implementing strategies to prevent opioid use disorder while effectively managing post-operative pain.
To aid in opioid stewardship education and communication, PENNJ-SOS created multiple health-literate resources for both patients and clinicians.
In addition to the resources and program activities, a key component of PENNJ-SOS is data collection. Using a national registry (National Surgical Quality Improvement Program), hospitals collect perioperative data on surgical patients related to opioids, which provides surgical teams with benchmarking for quality improvement and research purposes. Findings, best practices, and innovations are shared at quarterly regional collaborative meetings.