Mount Sinai Hospital Delirium Program
The Mount Sinai Hospital Delirium Program provides assistance to our medical and surgical care teams by facilitating the early identification and treatment of Delirium in our hospitalized patients. The Delirium Team is comprised of multi-disciplinary medical providers representing various departments, dedicated assessors for delirium, and a volunteer program staffed with extensively trained participants who provide assistance with the care of delirious patients. The Mount Sinai Hospital Delirium Program is based on a unique model which departs the typical personnel heavy multi-component treatment Intervention programs currently used by other institutions focusing on the delirium problem. In contrast, our program relies on a smaller multidisciplinary team backed by innovative technologies developed within our electronic medical records system which provides smart decision support to our team and hospital personnel by using real time patient clinical information. Finally, we are dedicated to the continuous education of hospital staff and patient families in order to enlist the assistance of a vast numbers of people into the treatment of the delirious patient; allowing us to utilize a smaller more efficient team dedicated to the detection and treatment of delirium throughout the hospital.
The Mount Sinai Hospital Delirium Program was developed to assist medical and surgical care teams with the early identification and treatment of Delirium in at risk patients.
Throughout all hospitals nationwide the majority of cases of delirium are missed resulting in increased hospital lengths of stay, poor recovery from acute medical conditions/surgery, increased mortality rates, increased rates of rapid hospital readmission, and increased risk for discharge to skilled nursing facilities instead of home. The target population for the Mount Sinai Hospital Delirium Program the program are hospitalized older adults on general medical units and all post-operative adults patients being cared for in the ICU or on the stepdown units.
The Delirium Team is comprised of multi-disciplinary medical providers representing various departments, dedicated assessors for delirium, and a volunteer program staffed with participants who provide assistance with the care of the delirious patient.
Functions of the Mount Sinai Delirium Program
- Proactively screen all appropriate patients for the presence of delirium or subsyndromal delirium utilizing CAM and CAM-ICU tools adapted for use in Epic (Mount Sinai’s Electronic Medical Records System)
- Automated Epic based algorithms utilizes CAM and CAM-ICU data to diagnose patients with delirium and subsyndromal delirium
- Alert providers and nursing staff of the presence of a delirium or subsyndromal delirium diagnosis in their patients utilizing an Epic-based automated alert system
- Hospital Delirium team provides initial findings and recommendations to assist providers in the care of their delirious patients
- Delirium specific nursing care plans automatically populate the charts of patients identified as delirious and subsyndromally delirious
- Smart decision support for the care of delirious patient is disseminated to providers in pre-formatted Delirium Alert Event Notes which contain details about potential delirium precipitating and perpetuating factors individualized for each patient and derived from automated algorithms in Epic exclusive to Mount Sinai. These algorithms surveys patients’ pharmacy, laboratory and neuroimaging data in order to render relevant recommendations
- Provide sensory support to delirious patients by assessing visual and auditory acuity and providing hearing aids and magnifiers
- The highly trained members of our Delirium Volunteer Program work with delirious and subsyndromal patients daily, utilizing numerous evidence based non-pharmacological interventions to change the patients’ environment to one more to conducive to delirium resolution, provide cognitive stimulation, sensory support, encourage increased mobility, and make detailed observations for the Delirium Team to utilize in ongoing assistance to the primary care teams
- Provide extensive family and caregiver education using a Delirium Education Booklet exclusive to Mount Sinai Hospital, and verbal communication in order to include family members and caregivers actively in the non-pharmacological treatment of delirious patients. Moreover, we provide knowledge to families and caregivers to be utilized after discharge in order to help decrease the likelihood of recurrence of delirious episodes following discharge
- Provide ongoing education to nursing staff and providers through one to one interactions, in-service sessions, grand rounds activities, conferences, and online educational tools available in PEAK