Pilot implementation of an electronic diagnostic support tool (AiD-DST) designed to identify the cause(s) of delirium

Abstract

Objective(s)

The identification of cause(s) of delirium remains a clinical challenge within medicine. Our group have previously successfully developed and tested the Aetiology in Delirium—Decision Support Tool (AiD-DST). The AiD-DST is designed to help medical professionals close the gap on the detection of cause(s) of delirium. Here, we report on use of AiD-DST in the real-world setting.

Methods

A real-world implementation study of the AiD-DST within a general medical ward of a metropolitan hospital was conducted over a 10-week period. A mixed method evaluation was performed based upon the RE-AIM Framework that incorporates reach, effectiveness, adoption, implementation and maintenance of an intervention.

Results

Reach: fifty-three out of 87 (61%) eligible doctors consented to participation in the study. Effectiveness: A mean of 4.3 diagnoses were generated per patient with no difference in frequency when compared with historical control (z = 1.36; p = .17). Average usability score was 5.86 (SD = 1.15) on a 7-point scale, with 93% of respondents being satisfied with the AiD-DST. Free text feedback comprised themes of accessibility, ergonomics, diagnostic accuracy and applicability of AiD-DST to related conditions. Implementation: Instrument completion rate was 98% (n = 49/50), with a median completion time of 90 s. Maintenance: Sixty-seven % of uses of AiD-DST occurred in the second half of the study (p = .3). Following the initiation period there was an increase in use (r = .79; p = 02).

Conclusion

Proof of principle was demonstrated for local implementation of a diagnostic support tool (AiD-DST).