Optimizing sepsis care within a learning health system: qualitatively examining the perspectives of those involved in...

Improving early recognition and treatment of sepsis is key to decreasing patient mortality. The current study investigates barriers and facilitators to timely and appropriate sepsis care from the perspectives of care team members across different roles at a large academic health system.

We held focus groups with frontline staff involved with sepsis care grouped by roles, including nurses, physicians, residents, pharmacists, laboratory staff, and members of an interdisciplinary sepsis rapid response team. Surveys were distributed to participants unable to attend a focus group session. Two researchers independently coded interview transcripts and survey responses, and mapped codes onto the Consolidated Framework for Implementation Research.

Twenty-two frontline staff participated in seven focus groups; six others completed supplementary surveys. We identified eighteen factors influencing sepsis care across four themes: (1) sepsis detection; (2) approach to sepsis care; (3) team dynamics; (4) awareness of sepsis protocols, best practices, and performance.

This study adds important insights on how team dynamics and environmental pressures affect sepsis care delivery. By including multiple roles in our sample, this study provides unique insight regarding how the lack of shared mental models troubles sepsis care delivery.

Future efforts to optimize sepsis care should focus on assessing team dynamics and developing interventions to improve these shared understandings and communication across roles.