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JCOM Abstract

J Clin Outcomes Manage 
2011 Jun;18(6):253-258
Implementation of a system-wide quality improvement project to prevent delirium in hospitalized patients
Allen KR, Fosnight SM, Wilford R, Benedict LM, Sabo A, Holder C, Jackovitz DS, Germano SA, Gleespen L, Baum E, Wilber ST, Hazelett S

Abstract Objective: To describe a hospital and health system–wide continuous quality improvement project to improve early detection, treatment, and prevention of delirium. Methods: Protocols were pilot tested then built into daily work processes for all hospitalized medical-surgical patients. All patients admitted to the Acute Care for Elders unit were included in the pilot (n = 102 pre-protocol, n = 97 post-protocol). Results: After implementing the protocols, there was a significant reduction in average length of stay for patients with delirium (7.6 days pre versus 4.0 days post). Decreases were also seen in rates of death (23% vs 9.5%), ICU transfers (18% vs 0%), and 30-day readmissions (31% vs 5%). Conclusions: Implementation of delirium prevention and treatment protocols can decrease the incidence and negative consequences of delirium in the acute care hospital. These protocols are easily incorporated into daily work processes.

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