Advisor(s)
S Hernandez
Committee Member(s)
Allyson Hall
Larry Hearld
S Hernandez
William Rice
School
School of Health Professions
Document Type
Dissertation
Department (new version)
Administration/Health Services
Date of Award
6-3-2025
Degree Name by School
Executive Doctor of Science (DSc) School of Health Professions
Abstract
ORGANIZATIONAL FACTORS THAT IMPACT EMERGENCY ROOM SEPSIS BUNDLE COMPLIANCE IN U.S. HOSPITALS JASON L. KIMBRELL HEALTH SERVICES ADMINISTRATION ABSTRACT This in-depth study examines the organizational factors within U.S. hospital emergency rooms (ERs) that impact care teams’ adherence to established, time-sensitive sepsis protocols. The regression analysis revealed a concerning trend: for each 1% increase in annual patient walk-out rates, compliance with sepsis protocols declines by 2.10%. Additionally, the impact on poor ER throughput where the ESI level 3 length of stay increases by 1 minute, a hospital's compliance with the 3hr POA sepsis bundle decreases by .08%. These findings underscore the need to optimize ER processes aimed at throughput and operational performance. The research pointed to the adverse effects of low engagement levels among ER RNs linked to higher turnover rates. Increased RN engagement is associated with improved collaboration with physicians. This suggests disengaged staff contribute to rising walk-out rates, negatively affecting compliance with the three-hour present-on-admission (POA) sepsis bundle. Elevated RN engagement correlates with better ER throughput, as indicated by shorter lengths of stay for patients classified as Emergency Severity Index (ESI) Level 3. This highlights the crucial role of employee engagement in staff retention and the hospital’s effective implementation of vital medical protocols. This study emphasized the significant impact of hospital management practices on employee engagement and patient outcomes. It advocated for a focused effort to enhance staff involvement to improve compliance with critical medical procedures and elevate the overall standard of care. The management implications of the research are vast and elevate the critical role that hospital culture has on quality and clinical outcomes, where people are foundational difference-makers.
ProQuest ID
Recommended Citation
Kimbrell, Jason Lee, "Organizational Factors That Impact Emergency Room Sepsis Bundle Compliance In U.S. Hospitals" (2025). All ETDs from UAB. 7312.
https://digitalcommons.library.uab.edu/etd-collection/7312
