Lessons Learned from Sepsis Microlearning Intervention

Area of Science:

• Healthcare Quality Improvement
• Medical Education Technology
• Sepsis Management

Background:

• Improving early sepsis recognition and treatment is critical for reducing patient mortality.
• Despite quality improvement initiatives, adherence to sepsis best practices in an academic health system remained suboptimal.
• Electronic health record (EHR) systems offer potential platforms for delivering targeted interventions.

Purpose of the Study:

• To develop and evaluate an EHR-embedded microlearning intervention aimed at improving adherence to sepsis care best practices.
• To assess the intervention's impact on reducing antibiotic delay and improving secondary sepsis care outcomes.

Main Methods:

• A randomized stepped-wedge trial was conducted, with randomization at the nursing block level.
• The microlearning intervention was delivered via EHR alerts.
• Antibiotic delay and secondary outcomes were extracted from the EHR and analyzed using mixed models.

Main Results:

• The microlearning intervention did not significantly reduce antibiotic delay (mean difference = 0.71 hours; p = 0.49).
• The intervention, despite over 30,000 alert firings, was viewed only 30 times by nursing staff.
• No significant improvement in sepsis care outcomes was observed.

Conclusions:

• EHR-embedded microlearning delivered through disruptive alerts was not an effective or accessible channel for nursing staff.
• The intervention's content may have addressed knowledge gaps, but the delivery method hindered engagement and impact.
• Future interventions should consider more accessible delivery channels to improve sepsis care adherence.