Date of Degree
Fall 2025
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Melanie Brewer
Second Advisor
Dr. Claudette Chin
Third Advisor
Dr. Kristie Lowry
Abstract
Problem: Sepsis is a life-threatening condition with high readmission risk, threatening patient recovery and survival. In the managed care organization (MCO) where this DNP project was implemented, sepsis ranks among the top five readmission diagnoses. The organization's 30-day readmission rate of 15.5% is substantially higher than the benchmark of 9.29%, highlighting a clinical quality issue, a strain on patient outcomes, and a strain on healthcare resources.
Aim of the Project: This quality improvement (QI) project aimed to reduce sepsis readmissions by embedding a sepsis questionnaire into case management workflows to identify clinical risks and social determinants of health, improve transitions, and support post-discharge recovery.
Review of the Evidence: Sepsis survivors face a high risk for rehospitalization, with one in 21 adults readmitted within 30 days. Evidence supports case management interventions as effective strategies for improving stabilization and reducing readmissions. Although research on MCO-driven strategies is limited, emerging studies show MCO interventions can also reduce readmissions.
Project Design: The Institute for Healthcare Improvement Model, incorporating iterative Plan-Do-Study-Act (PDSA) cycles, was utilized to guide the project. The OhioHealth Change Management Model tools and methods were utilized during the implementation process to assess readiness and sustain adoption. As a QI initiative, IRB approval was not required.
Intervention: The questionnaire was embedded into case management workflows, with a 50% adoption goal. PDSA cycles and change management surveys guided refinements during the 12-week pilot.
Significant Findings/Outcomes: The adoption of the questionnaire increased from 78% to 85%. Readiness surveys showed a 25% increase in staff confidence, a key factor for sustainability.
The sepsis analysis demonstrated a reduction in inpatient admissions (1.34 to 0.29), ER visits decreased (1.31 to 0.76), and Provider visits increased (4.07 to 5.28), indicating a shift from acute to outpatient care. Additionally, readmissions decreased by 34%, and paid claims declined by 34%.
Implications for Nursing: The QI project highlights the crucial role of the advanced practice nurse in advancing the AACN Essentials by implementing evidence-based interventions. Embedding the Sepsis Questionnaire into managed care workflows demonstrates nursing’s leadership in driving the Quadruple Aim and provides a scalable model for payer-driven quality improvement.
Recommended Citation
Kelley, Vernita L., "Implementing a Sepsis Questionnaire to Reduce Readmissions…A Health Plan’s Experience" (2025). Doctor of Nursing Practice (DNP) Scholarly Project. 41.
https://fuse.franklin.edu/dnp-project/41
Rights
Copyright, all rights reserved
Included in
Bacterial Infections and Mycoses Commons, Infectious Disease Commons, Other Nursing Commons
