Implementing delirium screening in the emergency department: a quality improvement project

Area of Science:

• Geriatrics
• Healthcare Quality Improvement
• Emergency Medicine

Background:

• Delirium is prevalent in older adults within acute care settings.
• Clinical guidelines mandate delirium screening for older patients.
• An institutional audit revealed only 16% of emergency department patients were screened for delirium.

Purpose of the Study:

• To increase delirium screening rates in the emergency department.
• To implement Lean Six Sigma (LSS) methodology for quality improvement.
• To utilize a multidisciplinary approach to address screening deficits.

Main Methods:

• A 12-week project employing LSS tools and methodology in the emergency department.
• Root cause analysis to identify barriers to delirium screening.
• Implementation of a multifaceted intervention: education, audits, feedback, documentation changes, and team huddles.

Main Results:

• Delirium screening rates increased to 82% at 5 weeks post-intervention.
• Screening rates further improved to 92% at 17 weeks post-intervention.
• Demonstrated significant improvement from the baseline of 16%.

Conclusions:

• Lean Six Sigma (LSS) methodology drives significant healthcare quality improvement.
• Multifaceted interventions effectively enhance delirium screening in emergency departments.
• Education, documentation adjustments, and team huddles are key components for improving screening rates.