Adoption of Delirium Assessment in the Acute Care Setting: A Tale of Two Hospitals

• Published in: Best practices in mental health Vol. 12; no. 2; pp. 81 - 95
• Main Authors: Filinson, Rachel, Clark, Philip G., Burbank, Patricia, Stoukides, John
• Format: Journal Article
• Language: English
• Published: Chicago The Follmer Group 22.09.2016; The Follmer Group, Inc
• Subjects: Acute Care; Analysis; Confusion Assessment Method; Continuing education; Delirium; Evidence-based medicine; Health aspects; Hospitals; Management
• ISSN: 1553-555X; 2329-5384

The aim of this article is to describe the impact of an educational initiative intended to increase adoption of a delirium protocol (the Confusion Assessment Method [CAM]) in the acute care wards of two hospitals. The project embodied the Plan-Do-Study-Act model for improvement of health care delivery, characterized by feedback loops from ongoing evaluation. Continuing education workshops on delirium and focused training on CAM implementation were assessed through pre-/post-test measures. To determine the effectiveness of training, administration of CAM at admission and discharge was tracked for the months preceding training, immediately after training, and during a sixmonth sustainability period in experimental units. Educational programming was well received by staff and increased the use of delirium screening at both hospital sites posttraining, but with declines occurring in the sustainability period at one of the two hospitals. Modifications to the electronic medical record system overcame some obstacles to implementation at the hospital with lower compliance.