Journal article
Electronic Health Record Tools for the Detection, Management, and Monitoring of Delirium in Emergency Departments: Examples from Five Healthcare Systems
Delirium Communications
08/08/2025
DOI: 10.56392/001c.142177
Abstract
Background
Delirium is a state of acute brain failure causing confusion, reduced focus, and changes in alertness. It is common in older patients, occurring in 6-38% of older emergency department (ED) patients. Evidence suggests that systematic screening improves detection rates and early detection, management and reporting are critical. However, examples of operationalizing this in clinical non-research care are scarce.
Objective
To describe and disseminate examples of best practices for delirium screening, management, and monitoring within the ED.
Methods
A group of emergency physicians interested in geriatric emergency medicine (GEM) and evidence-based medicine gathered monthly to discuss ways of implementing delirium care. Members were asked to submit any electronic health record (EHR)-based interventions for delirium in current use at their institutions. One group member categorized the EHR tools by their use for screening, prevention, management, and monitoring of delirium. As a group, categorizations were reviewed and agreed upon and similarities, differences and themes were identified.
Results
Current EHR interventions from 5 EDs were included. We found that: 1) Screening for delirium in EDs is challenging due to the nature of the environment and the variety of tools available. 2) Prevention tools included order sets. 3) Management was accomplished with best practice alerts and order sets to help screen, prevent, address underlying causes, and manage agitation. Delirium prevention order sets emphasize optimizing patient mobility, comfort, and communication. Assessment order sets include routine labs and consultations, while management order sets for agitation provide safe medication options considering older adults’ unique physiology. 4) Utilizing dashboards for compliance monitoring offers real-time feedback, and provides an overview of adherence to clinical guidelines, regulatory standards, and patient safety protocols.
Conclusion
These real-world examples can be used in EDs implementing delirium programs. Further studies on how EHR interventions impact screening, diagnosis, and treatment of delirium in the ED are needed.
Details
- Title: Subtitle
- Electronic Health Record Tools for the Detection, Management, and Monitoring of Delirium in Emergency Departments: Examples from Five Healthcare Systems
- Creators
- Anita Chary - Baylor College of MedicineLauren Southerland - The Ohio State UniversityMaura Kennedy - Massachusetts General HospitalAri B. Friedman - University of PennsylvaniaSangil Lee - University of IowaRachel Skains - University of Alabama at BirminghamAnnika Bhananker - Baylor College of MedicineAlex Peebles - University of IowaKatherine Schneider - University of IowaFernanda Bellolio - WinnMedShan W. Liu - Massachusetts General Hospital
- Resource Type
- Journal article
- Publication Details
- Delirium Communications
- DOI
- 10.56392/001c.142177
- ISSN
- 2959-104X
- eISSN
- 2959-104X
- Language
- English
- Electronic publication date
- 08/08/2025
- Academic Unit
- Emergency Medicine; Injury Prevention Research Center
- Record Identifier
- 9984946843102771
Metrics
2 Record Views