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Delirium clinical care standard indicators: 7a-Proportion of patients with current or resolved delirium who have an individualised care plan

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 7a-Proportion of patients with current or resolved delirium who have an individualised care plan
METeOR identifier:Help on this term628112
Registration status:Help on this termHealth, Standard 12/09/2016
Description:Help on this term

Proportion of patients with current or resolved delirium who have an individualised care plan.

Rationale:Help on this term

Effective communication between hospital clinicians and ongoing clinical providers is essential for the ongoing care and recovery of patients with delirium (Clinical Epidemiology and Health Service Evaluation Unit 2006), many of whom may have unresolved symptoms at the time of discharge (Wong et al. 2012). Involving patients and carers in the development of the care plan allows treatment goals to be tailored to the patient’s needs and circumstances.

Indicator set:Help on this termClinical care standard indicators: delirium Health, Standard 12/09/2016
Outcome area:Help on this termTransition from hospital care Health, Standard 12/09/2016

Collection and usage attributes

Computation description:Help on this term

Both the numerator and the denominator include patients with delirium that is current or resolved at the time of discharge from hospital.

For an individualised care plan to be included for a patient in the numerator, it needs to be developed collaboratively with the patient’s general practitioner, and involving the patient and their carer. It should be documented, and include the following:

  • a description of the patient’s diagnoses
  • the patient’s goals of care
  • current list of medicines and the conditions for which they are prescribed
  • if prescribed, a plan for ongoing review and withdrawal of antipsychotic medicines
  • any other medicines that have been discontinued and the reasons for discontinuing them
  • any ongoing treatments that the patient needs for delirium and any other health conditions
  • strategies that can reduce the patient’s risk of delirium, or prevent complications from it
  • community support services that the patient is referred to.

It should be provided:

  • to the patient and their carer before they leave hospital; and
  • to the patient’s general practitioner and other ongoing clinical providers within 48 hours of the patient leaving hospital.

Unless explicitly stated in the indicator, all patients with delirium are included in both the numerator and the denominator, not only those where Hospital service—care type, code N[N] = 1 Acute care.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients with current or resolved delirium who have an individualised care plan at discharge.

Denominator:Help on this term

Number of patients discharged with current or resolved delirium.

Comments:Help on this term

This indicator has been sourced from the Key principles for care of confused hospitalised older persons (Wong et al. 2012).

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

Clinical Epidemiology and Health Service Evaluation Unit 2006. Clinical practice guidelines for the management of delirium in older people. Melbourne: Victorian Government Department of Human Services on behalf of AHMAC. Viewed 5 May 2016, http://docs.health.vic.gov.au/docs/doc/
A9F4D074829CD75ACA25785200120044/$FILE/delirium-cpg.pdf
.

Wong K, Tsang A, Liu B & Schwartz R 2012. The Ontario senior friendly hospital strategy delirium and functional decline indicators. Toronto: Ontario Local Health Integration Network.

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