Case Study: Houston Methodist achieves improved recognition of under‑diagnosed delirium with Qstream

Qstream Helps Houston Methodist Staff Recognize Under-Diagnosed Condition

Qstream is a microlearning platform that applies the spacing and testing effects to help clinicians recognize and act on under‑diagnosed conditions such as delirium in older patients—a problem that affects 14–24% of hospitalized patients over age 70 and more than half of some inpatient populations. The challenge is improving real‑world clinician recognition and response to patient‑safety issues within the constraints of busy hospital workflows.

Qstream’s solution delivers short, twice‑weekly case questions that are re‑sent at spaced intervals based on performance, combined with gamified leaderboards and small incentives. In a 267‑nurse VA Boston pilot, 97% participated and 87% completed all 22 questions; nurses reported the program “made learning fun” and improved team building, 90% asked for more training via Qstream, and randomized trials show the method boosts retention for up to two years and produces durable improvements in clinical behavior.

Houston Methodist