Description
- Abstract:
- Abstract of The Acceptability, Feasibility, Adoption, and Fidelity of the “RhodeMap To Sepsis Survival” Implementation Strategy on Inpatient Medical Wards and Its Impact on SEP-1 Bundle Compliance: A Mixed-Methods, Hybrid Type III Implementation Study by Saud Dhillon, Degree: MPH, Brown University, May 2026. Background: Sepsis causes substantial morbidity, mortality, and healthcare utilization. Although the SEP-1 bundle standardizes early sepsis care, compliance remains difficult on inpatient medical wards, where workflow, staffing, monitoring, and uncertainty differ from emergency department and intensive care settings. Methods: This mixed-methods, Hybrid Type III implementation–effectiveness study evaluated “RhodeMap To Sepsis Survival”, a multifaceted strategy to improve SEP-1 bundle compliance among non-ICU, non-ED medical ward patients at an academic tertiary care hospital. Components included performance feedback, sepsis education, infographic posters, a sepsis song, electronic medical record alerts, and a sepsis order set. Quantitative analyses compared SEP-1 compliance (primary outcome, aim-1) and observed in-hospital mortality (secondary outcome, aim-3) during 16-month pre-intervention and 20-month post-intervention periods. Semi-structured interviews with 15 clinicians examined implementation outcomes (primary outcome, aim-2) of acceptability, feasibility, adoption, and fidelity using thematic analysis guided by EPIS framework. Results: Among 147 sepsis patient encounters, SEP-1 compliance increased from 21.8% to 38.0%, an absolute increase of 16.2 percentage points. This improvement was statistically significant (χ² = 4.17, p = 0.041). Hospital mortality decreased from 16.4% to 9.8%, but this difference was not statistically significant. Qualitative findings showed that clinicians generally accepted SEP-1 and RhodeMap to Sepsis Survival, but adoption and fidelity were constrained by workflow fragmentation, cognitive overload, staffing limitations, electronic medical record burden, and execution barriers. The sepsis song was memorable and engaging, but variably used in real-time practice. Conclusions: RhodeMap to Sepsis Survival was associated with improved SEP-1 bundle compliance on inpatient medical wards. Reliable sepsis implementation requires more than clinician knowledge; it depends on workflow design, multidisciplinary coordination, cognitive load, electronic medical record usability, and system capacity. Larger controlled studies are needed to evaluate sustainability, scalability, equity, and clinical outcomes.
- Notes:
- Thesis (M. P. H.)--Brown University, 2026
Citation
Dhillon, Saud Ahmed,
"The Acceptability, Feasibility, Adoption, and Fidelity of the “RhodeMap To Sepsis Survival” Implementation Strategy on Inpatient Medical Wards and Its Impact on SEP-1 Bundle Compliance: A Mixed-Methods, Hybrid Type III Implementation Study"
(2026).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/x4t6-z275
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....