1. Delirium Collaborative

2. Aim  By July 2013, 100% of inpatients 65 years and older in ward 4 of Middlemore hospital will be screened using the Confusion Assessment Method (CAM) tool for 5 consecutive days from admission.  They will have the delirium pathway implemented and documented appropriately to reduce preventable complications associated with delirium. The Counties Manukau Health Delirium Symbol

3. Key Changes  A comprehensive education package regarding an overview of delirium, how to use the CAM and how to implement the intervention package was given to all ward staff.  The adaptation of a robust, easy to use screening tool (CAM) allowing for the increased identification of delirium and detection of a potential delirium developing.  An intervention package which is simple, quick to implement, cost effective, encompasses the multi-disciplinary team and improves patient care through promoting best practice. This includes a patient/family information booklet ensuring education and understanding.  A delirium stamp and computer prompts to encourage diagnosis in the patients EDS.

4. Change Package Education Package Intervention Package Assessment Package Champion Package 1A Delirium Education Spread ppt 2A CAM Presentation ppt 3A Intervention Presentation ppt 1B Delirium Patient Story Video 2B Delirium Project Video 3B CAM Intervention Video 1C 3D’s Handout 2C How to..CAM Tool Practice Session 3C CAM Intervention Sheet & Checklist 2D CAM Tool pdf CMH Guideline 20,000 Days Pamphlet Role of Delirium Champions Delirium A Review pdf Article on Delirium pdf Brief Guide to Delirium pdf 20,000 Days – Delirium Video Delirium Management Pathway CAM Tool Process Map CAM Intervention Check list Placement of CAM tool CAM Compliance Watch Folder Early Delirium Identification & Management - Change Package Patient Room sign Pharmacy review Environment Family Hearing Vision Nutrition/hydration Information Pamphlet for Family CMH Delirium Guideline Communication/ IT/Coding Delirium Coding Stamp Staff Package Version Control Date: 5/6/13 Owner: D Farrell Folder: 20,000 Days/HOP/Delirium/Change Package WiMs Prompt Audit Tool Delirium as diagnosis in EDS iPMs flag Documentation

5. Lessons Learnt  We learnt the importance of keeping our aim in sight to maintain focus.  The importance of reliability to ensure sustainability – this takes time but ensures a stronger change package.  The importance of “champions” to drive a new concept on the ward.  The importance of staff consultation in the improvement of resources.  Implementation of any concept needs to be flexible to allow sustainability in all clinical areas.

6. Health Round Table Innovation Award