Better healthcare management can reduce the risk of delirium among older adults
New research outlines how those admitted on Sunday and Tuesday are more
likely to develop delirium, a hospital complication

Date:
July 23, 2021
Source:
City University London
Summary:
New research by an Executive PhD Research student at the Business
School (formerly Cass) outlines how elderly patients with
neurological conditions are significantly more likely to develop
delirium shortly after they are hospitalised, and those admitted
on Sunday and Tuesday are more likely to develop the disorder.



FULL STORY ========================================================================== Elderly patients with neurological conditions are significantly more
likely to develop delirium shortly after they are hospitalised.


==========================================================================
A new study has discovered that a delayed transfer to a hospital floor
is associated with greater short-term risk of delirium among patients
aged 65 and over, and for those who arrive to the Emergency Department
(ED) on days with higher risk of prolonged lengths of stay -- found to
be Sunday and Tuesday.

Delirium is an acute cognitive disorder characterised by altered
awareness, attentional deficits, confusion, and disorientation. Current estimates of new- onset delirium highlight the fact that delirium overwhelmingly develops in medical settings (as high as 82 per cent in intensive care settings) compared to the community at large (between one
per cent and two per cent). Research has shown that between 30 per cent
and 40 per cent of all delirium cases are preventable.

Authored by Valdery Moura Junior, an Executive PhD Research student at the Business School (formerly Cass), the study explores whether a combination
of the care experienced at the ED and the delayed implementation of
delirium prevention measures contribute to an increased risk of the
disorder. For example, it is possible that the bright lights and high
ambient noise level of the ED for 24 hours a day will contribute to
increased short-term risk.

The findings showed that of the 858 patients who presented to the ED with
a neurological emergency, delirium was documented in 234 (30 per cent)
patients within the first 72 hours from ED arrival.

This study also found that there was a connection between the onset
of delirium and the day in which the patient arrived in the ED. Those
arriving on Sundays and Tuesdays were more likely to demonstrate symptoms
in a shorter time. Casual factors suggested include fewer hospital beds, delayed floor admission -- a waiting time greater than 13 hours --
and a greater proportion of elective pre- surgical admissions.

Mr. Moura has outlined several measures which can be taken to help
prevent the likelihood of the onset of delirium in these settings, as
well as reduce spending. These include an earlier initiation of delirium prevention measures; a quicker transfer from the ED to the hospital bed;
and improving communication across healthcare managers in primary care, emergency rooms, operating rooms, and post-acute services.

Valdery Moura Junior, who is also computer scientist and technical
leader at the Mass General Brigham, a Boston-based non-profit hospital
and physicians network that includes Brigham and Women's Hospital (BWH)
and Massachusetts General Hospital (MGH), two of the Harvard Medical
School's most prestigious teaching hospitals, said: "New-onset delirium
in older patients alone will mean a high price for the health care
system and poses a global challenge for healthcare managers, providers,
and payors. Managing hospital capacity has been an enormous challenge throughout the pandemic, with many admission processes reviewed as
a result with the goal of improving patient outcomes. Our study may
help to identify feasible targets to improve processes between ED and
the rest of the hospital." Professor Feng Li, Chair of Information
Management at the Business School, said: "This is an excellent example
where routine operational data in a hospital can be used to identify
anomaly and improve patient outcomes.

Valdery's research demonstrated that more systematic use of such data can
lead to significant improvement in the management of hospital capacity
and operational processes, and most of all, quality of patient care." ========================================================================== Story Source: Materials provided by City_University_London. Original
written by Luke Lambert.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Valdery Moura Junior, M Brandon Westover, Feng Li, Eyal Kimchi,
Maura
Kennedy, Nicole M Benson, Lidia Maria Moura, John Hsu. Hospital
complications among older adults: Better processes could reduce
the risk of delirium. Health Services Management Research, 2021;
095148482110287 DOI: 10.1177/09514848211028707 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/07/210723121514.htm

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