Ward rounds by psychiatric liaison team for early detection and intervention of delirium can decrease length of hospital stay

<p>Background: Delirium is a common, severe and costly problem that worsens patients’ prognosis and increases length of stay (LOS). However, many delirious patients are undetected, and few studies have demonstrated how to decrease LOS. The primary aim of this study is to clarify whether ward rounds decrease LOS of delirious patients. Methods: An Interdisciplinary team made weekly ward rounds for early detection and intervention of delirious patients in general medical wards between April 2014 and September 2015. In advance of the rounds, the team screened patients suspected of delirium by referring to pharmacists for information about the prescription of high-risk drugs for delirium on admission and the use of pro re nata antipsychotics in general medical wards. On the rounds, the team received reports from ward nursing staff about the screen-detected and other suspected patients and advised them on the spot to deliver pharmacological and nonpharmacological intervention or to refer to psychiatrists as needed. The delirious patients who were referred to psychiatrists from April 2013 to September 2015 were eligible for enrollment in this analysis. The endpoints were the number and LOS of the referred delirious patients. We compared the endpoints in post-implementation with pre-implementation of the rounds. Findings: The delirious patients of the 2nd year implementation were referred significantly more than those in pre-implementation (ratio to all inpatients: 1.60 % vs. 0.64%; p<0.001). The former had significantly shorter LOS (median 28.5 days vs. 42.0 days; p<0.01) than the latter. Interpretation: The rounds may be effective and feasible in detecting more delirious patients and decreasing LOS.</p>