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Appl Clin Inform 2025; 16(04): 1165-1171
DOI: 10.1055/a-2677-6012
Special Issue on CDS Failures

Lessons Learned from Sepsis Microlearning Intervention

Authors

  • Eduardo R. Osegueda

    1   Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
    2   Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
    3   Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, United States

  • Ben Webber

    4   Department of Hospital Medicine, School of Medicine, University of Minnesota, Minneapolis, Minnesota, United States

  • Tanvi Mehta

    5   Division of Biostatistics & Health Data Science, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States

  • Deborah L. Pestka

    3   Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, United States
    6   Department of Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota, United States

  • Joseph S. Koopmeiners

    3   Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, United States
    5   Division of Biostatistics & Health Data Science, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States

  • Ivana Ninkovic

    7   Fairview Health Services, Minneapolis, Minnesota, United States

  • Genevieve B. Melton

    3   Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, United States
    6   Department of Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota, United States
    8   Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, United States

  • Timothy J. Beebe

    1   Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
    3   Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, United States

  • Michael G. Usher

    3   Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, United States
    9   Division of General Internal Medicine, School of Medicine, University of Minnesota, Minneapolis, Minnesota, United States
    10   Indiana University School of Medicine, Indianapolis, Indiana, United States

Funding This research was supported by the Center for Learning Health Systems Sciences, which is a collaboration between the University of Minnesota School of Public Health and University of Minnesota School of Medicine. The effort of Eduardo Osegueda was supported by Award Number T32HL150452 (PI: Diane Neumark-Sztainer) from the National Heart, Lung, and Blood Institute (NHLBI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHLBI or the National Institutes of Health.
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Abstract

Background

Improving early recognition and treatment of sepsis is key to decreasing patient mortality. A large academic health system implemented several quality improvement initiatives, yet monthly compliance with sepsis best practices remained low.

Objective

Develop and evaluate an electronic health record (EHR)-embedded microlearning intervention to address suboptimal adherence to sepsis care best practices.

Methods

We conducted a randomized stepped-wedge trial of our microlearning intervention with randomization done at the nursing block level. Antibiotic delay and secondary outcomes extracted from the EHR were analyzed using mixed models to account for intracluster correlation.

Results

The microlearning intervention did not reduce antibiotic delay (mean difference = 0.71 hours; p = 0.49). Despite the alert firing over 30,000 times during the study period, the microlearning intervention was viewed only a total of 30 times.

Conclusion

Our microlearning intervention did not improve sepsis care outcomes. We believe that although the content addressed key knowledge gaps, delivering the intervention through disruptive EHR alerts was not an accessible delivery channel to the nursing staff we targeted.

Keywords

sepsis - inpatient care - evidence-based medicine and nursing - inpatient - quality - quantitative

Protection of Human and Animal Subjects

The University of Minnesota Institutional Review Board deemed this study exempt from full review (Study 00014216).


Supplementary Material



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Eingereicht: 23. Dezember 2024

Angenommen: 05. August 2025

Artikel online veröffentlicht:
26. September 2025

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