Educational needs assessment identifying opportunities to improve sepsis care

Area of Science:

• Critical Care Medicine
• Healthcare Quality Improvement
• Medical Education

Background:

• The Centers for Medicare and Medicaid Services (CMS) established the severe sepsis and septic shock (SEP-1) quality bundle in 2015 to standardize care.
• Despite quality improvement initiatives, compliance with SEP-1 measures remains suboptimal nationally and within healthcare institutions.
• This study addresses the critical need to understand and improve adherence to the SEP-1 bundle.

Approach:

• A needs assessment was conducted using a conceptual outcomes framework.
• It involved analyzing national and institutional SEP-1 compliance data.
• A retrospective chart review and focus group were employed to identify care gaps and educational needs.

Key Points:

• National SEP-1 compliance was 51% (2017-2018), while the studied institution achieved only 19%.
• Frequently missed measures included fluid administration, repeat lactate levels, perfusion assessment, vasopressor use, and broad-spectrum antibiotics.
• Focus groups revealed gaps in declarative and dispositional knowledge among clinicians.

Conclusions:

• The needs assessment confirmed substantial deficits in clinician performance, competence, and knowledge concerning the SEP-1 bundle.
• A comprehensive, multifaceted educational program incorporating declarative, procedural, and dispositional knowledge is recommended.
• Strategies such as simulation, point-of-care prompts, and performance feedback are crucial for improving SEP-1 compliance and patient outcomes.