An Electronic Alert to Reduce Postoperative Delirium in the Older Adult

Older adults frequently experience delirium after surgery, contributing to a decline in quality of life, increasing morbidity and mortality rates, and adding significant costs to the healthcare system. The Beers Criteria was developed by the American Geriatrics Society and lists medications correlated with a decline in cognition among older adults. These medications are commonly administered in the perioperative period by anesthesia practitioners. At a large university hospital, an educational video was distributed, followed by the launch of an electronic health record alert advising over 300 anesthesia practitioners to reduce dosing or omit Beers Criteria medications in patients aged 70 or older. The total administration and total mean dosage of Beers Criteria medications administered were measured across four study periods: pre-educational video/pre-alert, post-education/pre-alert, and at two post-education/post-alert time points in select surgeries. This quality improvement project demonstrated significant reduction in Beers Criteria medications administered to patients 70 years or older to reduce rates of cognitive decline.