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Delirium clinical care standard indicators: 1b-Proportion of admitted patients aged >=65 years or >=45 years for Aboriginal and Torres Strait Islander people screened for cognitive impairment using a validated tool within 24hrs of presentation to hospital

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this term1b-Proportion of admitted patients aged 65 years or older or 45 years or older for Aboriginal and Torres Strait Islander people who were screened for cognitive impairment using a validated tool within 24 hours of presentation to hospital
METeOR identifier:Help on this term745810
Registration status:Help on this termAustralian Commission on Safety and Quality in Health Care, Standard 09/09/2021
Description:Help on this term

Proportion of admitted patients aged 65 years or older or 45 years or older for Aboriginal and Torres Strait Islander people, who were screened for cognitive impairment using a validated tool within 24 hours of presentation to hospital.

Indicator set:Help on this termClinical care standard indicators: delirium 2021 Australian Commission on Safety and Quality in Health Care, Standard 09/09/2021

Collection and usage attributes

Population group age from:Help on this term

65 years or older, or 45 years or older for Aboriginal and Torres Strait Islander people

Computation description:Help on this term

For the numerator and the denominator exclude separations where Episode of admitted patient care—admission date, DDMMYYYY is equal to Episode of admitted patient care—separation date, DDMMYYYY.

For the numerator, in the case of patients that initially present to an emergency department, 'within 24 hours of presentation to hospital' should be counted from the time that the patient presents to the emergency department (i.e. rather than be counted from the time that they are transferred to a ward).

The numerator must include screening for cognitive impairment using a validated tool. There are a range of validated screening tools available (ACSQHC, 2021). Examples include:

  • Abbreviated Mental Test Score (AMTS) 
  • 4AT test: screening instrument for cognitive impairment and delirium 
  • Kimberly Indigenous Cognitive Assessment (KICA) tools.

The 4AT has been validated both for screening for cognitive impairment and delirium assessment. Administration of the 4AT meets the numerator criteria for this indicator and for Delirium clinical care standard indicators: 4a-Proportion of admitted patients who screened positive for cognitive impairment on presentation to hospital who were then assessed for delirium using a validated tool.

Both the numerator and the denominator exclude episodes whereby Episode of admitted patient care—separation mode, code NN corresponds to Died, and this occurs within 24 hours of admission.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ Denominator) x 100‚Äč

Numerator:Help on this term

The number of admitted patients aged 65 years or older or 45 years or older for Aboriginal and Torres Strait Islander people who were screened for cognitive impairment using a validated tool within 24 hours of presentation to hospital.

Denominator:Help on this term

The number of patients aged 65 years or older or 45 years or older for Aboriginal and Torres Strait Islander people who were admitted to hospital.

Comments:Help on this term

This indicator is based on the Key Principles for Care of Confused Hospitalised Older Persons (ACI, 2014) and the Ontario Senior Friendly Hospital Strategy Delirium and Functional Decline Indicators (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

Agency for Clinical Innovation. Key Principles for Care of Confused Hospitalised Older Persons. Sydney: ACI, 2014.

Australian Commission on Safety and Quality in Health Care. Delirium Clinical Care Standard. Sydney: ACSQHC; 2021.

Bellelli G et al. 2014. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing 43(4):496-502.

Hodkinson HM 1972. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and ageing 1(4):233-8.

LoGiudice D et al. 2006. Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians. International Psychogeriatrics / IPA 18(2):269-80.

Wong K, Tsang A, Liu B & Schwartz R. The Ontario Senior Friendly Hospital Strategy Delirium and Functional Decline Indicators. Toronto: Ontario Local Health Integration Network; 2012.

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