December 29, 2022/Geriatrics/Research

Digital Dashboard Addresses Gaps, Improves Care of Geriatric Patients With Delirium

Accurate, transparent documentation may reduce risks associated with common disorder


Delirium, a common disorder in hospitalized geriatric patients, often heralds poor short- and long-term outcomes. Evidenced by an abrupt change in mental status, the disorder can result in increased length of stay and other complications, including permanent cognitive impairment. Despite its prevalence and substantial risks, however, delirium often goes unrecognized in hospital and post-hospital settings alike.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“Delirium is especially problematic for individuals who already have an underlying cognitive impairment or dementia,” explains Ronan Factora, MD, a physician and researcher in the Center for Geriatric Medicine at Cleveland Clinic. “It’s not unusual for these patients to have trouble bouncing back to where they were before the onset of delirium. As a consequence, they may become more cognitively and functionally impaired, and require a lot more help at home.”

A new project led by Dr. Factora aims to better the outcomes of patients with acute confusion by refining the quality and consistency of their hospital records. Determined to further improve how clinicians diagnose and manage delirium, his team is taking advantage of a digital dementia dashboard used to streamline care and reduce risk.

How it works

Information from electronic health records, including delirium screening results and order sets, are collected in the dashboard, where certain quality indicators associated with delirium, including the patient’s length of stay, can be evaluated. Dr. Factora says the data can help clinicians evaluate the success of their efforts and avoid treatment decisions that could potentially worsen a patient’s symptoms.

The delirium dashboard can also help improve communication between nurses and physicians – an essential component of high-quality care, he explains. “It’s an efficient, transparent way to ensure that every member of the clinical team is on the same page. Not only does the dashboard inform caregivers that a problem is present, it also details the steps that have been taken to address it across the continuum of care,” notes Dr. Factora.

Nurses, who are typically charged with implementing clinical screening throughout the hospital, can administer a set of orders designed to help instruct doctors and other medical providers in the management of delirium. These guidelines include consults with specialists in geriatrics or psychiatry, he says.

Addressing gaps in care

Dr. Factora explains that one of his team’s chief goals is to use the dashboard to help improve documentation and communication – particularly during “transition” periods, when a patient is discharged from the hospital and transferred to a post-hospital setting. Without thorough reporting and clear communication, a patient’s delirium may be overlooked upon discharge and go untreated by subsequent caregivers. Such oversights can lead to serious problems, he says, including the discontinuation of medications prescribed in the hospital for high-risk delirium-related behaviors.


“These patients must be monitored carefully for cognitive decline, even after hospitalization; without appropriate care, their symptoms can worsen,” says Dr. Factora. “When we initiate a handoff to an outside facility, it is critical to communicate the patient’s current delirium status and any treatments they received while in our care. Continuity is a valuable part of any medical plan, but it’s imperative when managing patients with delirium – a disorder that can have grave consequences if not properly addressed.”

Looking to the future, Dr. Factora and his colleagues are working to build a core team to assist in the prioritization of delirium recognition and documentation. “I hope our work can also help improve the ability of our outpatient doctors to recognize delirium and follow their patients longitudinally to ensure that they recover as well as they possibly can.”


Related Articles

October 11, 2023/Geriatrics/Research
Electronic Medical Records May Be Key to Diagnosing Delirium in Geriatric Emergency Patients

Structured data helps identify older adults at risk for poor outcomes, defines patients who require more comprehensive assessments

Telemedicine doctors and patients
January 18, 2023/Geriatrics/Research
Virtual Capacity Evaluations May Provide Distinct Safeguards for Geriatric Patients

Analysis underscores how telehealth can help pinpoint elder abuse

August 25, 2022/Geriatrics/Research
Gun Ownership and Medical Marijuana: Unexpected Barriers to Certain Treatments for Chronic Pain

Clinicians face difficult conversations when drugs and firearms intersect

July 15, 2022/Geriatrics/Research
Speech and Swallowing Issues Often Overlooked in Geriatric Patients Despite Taking a Heavy Toll

New study confirms prevalence, downstream effects of dysphagia and dysphonia

July 5, 2022/Geriatrics/Research
Staff Education Improves Fidelity of Dementia Screening and Early Intervention

Accuracy of Mini-Cog screening tool enhanced by mandatory training

May 9, 2022/Geriatrics/Research
Study Reveals Critical Differences in Older Geriatric Patients with Community-Acquired Pneumonia

Clinicians examine strategies to address unique needs of those aged 85 and older

February 9, 2022/Geriatrics/Research
1-Minute Consult: Should My Older Adult Patients Take Aspirin for the Primary Prevention of Cardiovascular Disease?

Experts examine the dangers and potential benefits of aspirin in geriatric patients

December 20, 2021/Geriatrics/Research
Major Award from NIA and Related Dementia Research Viewed Through Geriatric Prism

Research led by Cleveland Alzheimer's Disease Center could foster collaboration and help identify novel therapies