Make It Stick — Embedding the Sepsis Pathway at Brookfield NHS Trust

A four-round, intermediate healthcare digital-transformation simulation set inside Brookfield NHS Foundation Trust — a 720-bed acute trust in the English Midlands serving 540,000 people on a £610M budget, with a graveyard of 14 clinically promising digital pilots that died at scale once the pilot money or the champion ran out. A clinician-designed digital sepsis-detection pathway has just finished a six-month pilot on two wards (sepsis mortality down 18%, length-of-stay cut 1.4 days). The board gives you, the Clinical Innovation Lead, one chance to embed it trust-wide and make it STICK against the backdrop of those 14 failures. You must: (1) diagnose WHY good pilots die — separating knowledge-translation gaps, structural gaps (no owner, no funding line) and behavioural gaps (the workaround is easier) — and name the sepsis pathway's top sustainability risk; (2) choose an active knowledge-translation bundle within the £1.8M rollout envelope (clinical champions, audit-and-feedback dashboards, EPR forcing-functions, education & simulation training, patient materials) instead of the passive emails-and-guidelines dissemination that killed 11 of the 14; (3) build the board investment case that translates lives saved and freed bed-days into cost-avoidance the board can fund against a £12M deficit, with the case stress-tested at 40% adoption; and (4) routinize the change so it survives champion turnover and the 9-month funding gate (60% adoption or central funding is withdrawn), while handling a senior consultant who publicly disputes the algorithm's false-positive rate. The maths rewards active, socially-anchored, EPR-embedded translation with credible (not champion-dependent) ownership, an adoption-sensitive cost-avoidance case, and engaging clinical resistance as design data — and punishes the five classic errors: passive dissemination, a clinical-benefit-only business case, single-champion dependency, declaring victory at the 9-month checkpoint, and hard-wiring mandatory alerts while ignoring the false-positive concern. Final KPIs track Sustained Adoption (% consistent use), a Sustainability Index (the 24-month survival probability), Clinician Engagement, and the Investment Case strength (£M cost-avoidance vs the £1.8M + £420K/yr ask). Grounded in Oborn's work on knowledge translation and innovation sustainability and in Normalisation Process Theory (May & Finch).