Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department

Yale University100 enrolled

Overview

This is an observational study of the pragmatic implementation of an ED screening, outpatient referral, and care coordination process for older ED patients who may have UCID.

Embedded pragmatic, implementation pilot that incorporates training, ED assessment for delirium and dementia risk, referral of ED patients with undiagnosed cognitive impairment and dementia for primary care feedback and care recommendations. This pilot would gather observational data evaluating the feasibility of incorporating cognitive impairment screens into routine ED delirium assessments, and developing optimal work flow for identifying and referring ED patients with suspected (undiagnosed) dementia for confirmatory evaluation and care coordination.

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

Cognitive Impairment Emergency Care Dementia Delirium

Interventions

PD4ED 3-step intervention (ED assessment, outpatient assessment, Brain health plan)DIAGNOSTIC_TEST

1. ED assessment for suspected dementia. 2. positive ED patients referred for outpatient clinic cognitive impairment assessment. 3. positive clinic patients referred to primary care with brain health patient plan.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults age 65 or older * Discharged from the adult ED at YNHH or the ED at NMH Exclusion Criteria: * Documented or known history of dementia * Alcohol/substance intoxication while in the ED * Non-English or Non-Spanish speaking

Locations (2)

Yale New Haven Hospital

New Haven, Connecticut, United States

Northwestern

Chicago, Illinois, United States

Outcomes

Primary Outcomes

Percentage of Patients With Confirmed Delirium or Dementia

percentage of patients discharged from ED positive for delirium or dementia among total number of patients 65+

Time frame: 1 year

Rates of Outpatient Assessment Referral of Patients With Suspected Dementia

number of patients with appointment to Alzheimer's Dementia Centers or geriatrics outpatient clinic / number of patients given information sheet or referred to outpatient clinic

Time frame: 30 days

Number of Participants Diagnosed With Dementia Among Those With Completed Outpatient Assessment

number of patients diagnosed with dementia (all categories) among those that completed the outpatient assessment

Time frame: Up to 100 days from ED discharge

Rates of Connection With Primary Care

number of patients with PCP follow-up about brain health plan of the number of patients with outpatient confirmation of Dementia or MCI

Time frame: 30 days

Data from ClinicalTrials.gov

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