{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:39:15Z","timestamp":1780472355349,"version":"3.54.1"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"Curtis Hankamer Basic Research Fund and Chao-Physician Scientist Award at Baylor College of Medicine"},{"name":"National Institute for Aging","award":["1R03AG078943-01"],"award-info":[{"award-number":["1R03AG078943-01"]}]},{"name":"Chao Physician-Scientist Award at Baylor College of Medicine"},{"name":"Houston Veterans Administration Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety","award":["CIN13-413"],"award-info":[{"award-number":["CIN13-413"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Objective\u2003The aim of this study is to understand how emergency departments (EDs) use health information technology (HIT), and specifically the electronic health record (EHR), to support implementation of delirium screening.<\/jats:p><jats:p>Methods\u2003We conducted semi-structured interviews with 23 ED clinician-administrators, representing 20 EDs, about how they used HIT resources to implement delirium screening. Interviews focused on challenges participants experienced when implementing ED delirium screening and EHR-based strategies they used to overcome them. We coded interview transcripts using dimensions from the Singh and Sittig sociotechnical model, which addresses use of HIT in complex adaptive health care systems. Subsequently, we analyzed data for common themes across dimensions of the sociotechnical model.<\/jats:p><jats:p>Results\u2003Three themes emerged about how the EHR could be used to address challenges in implementation of delirium screening: (1) staff adherence to screening, (2) communication among ED team members about a positive screen, and (3) linking positive screening to delirium management. Participants described several HIT-based strategies including visual nudges, icons, hard stop alerts, order sets, and automated communications that facilitated implementation of delirium screening. An additional theme emerged about challenges related to the availability of HIT resources.<\/jats:p><jats:p>Conclusion\u2003Our findings provide practical HIT-based strategies for health care institutions planning to adopt geriatric screenings. Building delirium screening tools and reminders to perform screening into the EHR may prompt adherence to screening. Automating related workflows, team communication, and management of patients who screen positive for delirium may help save staff members' time. Staff education, engagement, and access to HIT resources may support successful screening implementation.<\/jats:p>","DOI":"10.1055\/a-2073-3736","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T23:21:15Z","timestamp":1681428075000},"page":"478-486","source":"Crossref","is-referenced-by-count":12,"title":["Leveraging the Electronic Health Record to Implement Emergency Department Delirium Screening"],"prefix":"10.1055","volume":"14","author":[{"given":"Anita N.","family":"Chary","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States"},{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, United States"},{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Brickhouse","sequence":"additional","affiliation":[{"name":"School of Medicine, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Torres","sequence":"additional","affiliation":[{"name":"University of Texas School of Public Health, UT Health Science Center, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilianna","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Barnes Jewish Hospital, Washington University School of Medicine, Emergency Care Research Core, St. Louis, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States"},{"name":"Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyler M.","family":"Godwin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, United States"},{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aanand D.","family":"Naik","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, United States"},{"name":"University of Texas School of Public Health, UT Health Science Center, Houston, Texas, United States"},{"name":"University of Texas Health Consortium on Aging, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, United States"},{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States"},{"name":"Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1056\/NEJMra052321","article-title":"Delirium in older persons","volume":"354","author":"S K Inouye","year":"2006","journal-title":"N Engl J Med"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.cger.2012.09.005","article-title":"Altered mental status in older emergency department patients","volume":"29","author":"J H Han","year":"2013","journal-title":"Clin Geriatr Med"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/acem.14166","article-title":"Delirium prevention, detection, and treatment in emergency medicine settings: a Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement","volume":"28","author":"C R Carpenter","year":"2021","journal-title":"Acad Emerg Med"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1553-2712.2008.00339.x","article-title":"Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes","volume":"16","author":"J H Han","year":"2009","journal-title":"Acad Emerg Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1136\/postgradmedj-2012-131608","article-title":"Emergency physician recognition of delirium","volume":"89","author":"B Suffoletto","year":"2013","journal-title":"Postgrad Med J"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1067\/mem.2002.122057","article-title":"The prevalence and documentation of impaired mental status in elderly emergency department patients","volume":"39","author":"F M Hustey","year":"2002","journal-title":"Ann Emerg Med"},{"issue":"08","key":"ref7","first-page":"977","article-title":"Prevalence and detection of delirium in elderly emergency department patients","volume":"163","author":"M \u00c9lie","year":"2000","journal-title":"CMAJ"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1046\/j.1532-5415.2003.51151.x","article-title":"Delirium in older emergency department patients discharged home: effect on survival","volume":"51","author":"R Kakuma","year":"2003","journal-title":"J Am Geriatr Soc"},{"issue":"367","key":"ref9","first-page":"1","article-title":"Emergency department visits among adults aged 60 and over: United States, 2014-2017","volume":"367","author":"J J Ashman","year":"2020","journal-title":"NCHS Data Brief"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.annemergmed.2014.02.008","article-title":"Geriatric emergency department guidelines","volume":"63","author":"American College of Emergency Physicians","year":"2014","journal-title":"Ann Emerg Med"},{"issue":"06","key":"ref11","first-page":"1","article-title":"Are geriatric screening tools too time consuming for the emergency department? 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