Start Date
5-15-2025 9:30 AM
End Date
5-15-2025 11:30 AM
Description
Background
Delirium affects 15% to over 50% of patients with hip fractures during their hospital stay (1) and is associated with increased mortality, increased length of hospital stay, poorer functional outcomes, and higher risk of nursing home placement (1,2). However, at Thomas Jefferson University Hospital, the prevalence of documented delirium post-hip fracture is only 5.22%, suggesting potential under recognition. Additionally, at the end of 2025, a new CMS inpatient quality metric will require public reporting on a hospital's capability to provide age-appropriate care for older adults, which can be done by utilizing the 4M framework of age-friendly health care. The 4M framework aims to address mentation, medications, mobility, and what matters most to patients. The goal of our study is to implement a standardized history of physical (H+P), with a specific focus on mentation, and assess whether this intervention improves delirium documentation rates as well as improving the hospital's compliance with the CMS quality metric for age-appropriate care.
Keywords
hip fracture, delirium, older adults, hospitals
Included in
Incorporation of the 4Ms, with a Focus on Mentation, Into the H&P for Older Adults Hospitalized with a Hip Fracture and its Effect on Delirium Documentation
Background
Delirium affects 15% to over 50% of patients with hip fractures during their hospital stay (1) and is associated with increased mortality, increased length of hospital stay, poorer functional outcomes, and higher risk of nursing home placement (1,2). However, at Thomas Jefferson University Hospital, the prevalence of documented delirium post-hip fracture is only 5.22%, suggesting potential under recognition. Additionally, at the end of 2025, a new CMS inpatient quality metric will require public reporting on a hospital's capability to provide age-appropriate care for older adults, which can be done by utilizing the 4M framework of age-friendly health care. The 4M framework aims to address mentation, medications, mobility, and what matters most to patients. The goal of our study is to implement a standardized history of physical (H+P), with a specific focus on mentation, and assess whether this intervention improves delirium documentation rates as well as improving the hospital's compliance with the CMS quality metric for age-appropriate care.
Comments
Presented at the 2025 Jefferson Health Equity and Quality Improvement (HEQI) Summit.