• Geriatric patients (≥65)

• Patients with 3D syndromes (Delirium/Dementia/Depression)

• Elderly with falls, frailty, incontinence, or malnutrition

• Polypharmacy patients needing medication integration

Facing Taiwan's transition into a super-aged society, the emergency department (ED) is the frontline hotspot for geriatric care. Among geriatric syndromes, delirium poses a severe threat. Once it occurs, hospitalization days and costs double, mortality and complication rates rise sharply, institutionalization risk increases twofold, and dementia risk surges tenfold. However, literature shows universally low ED delirium diagnosis rates; our hospital's early statistics stood at a mere 4.3%. To break this clinical dilemma, our cross-disciplinary team established key care strategies: optimizing cross-team treatment and referral protocols, creating a unique nursing assessment mnemonic ("Pain, Bystander, Side effects, Medication, Hydration, Environment"), providing accessible education leaflets, integrating pharmacist-led medication reconciliation, and initiating immediate physician intervention. The landmark innovation lies in digitalizing the Delirium Triage Screen (DTS) and Brief Confusion Assessment Method (bCAM), embedding them directly into electronic medical and nursing order systems. This technology-integrated, interdisciplinary care significantly improved the delirium diagnosis rate, substantially reducing the 3-day ED revisit rate, 14-day readmission rate, and 1-month mortality rate. The team achieved high patient satisfaction and published results in an SCI journal, setting a new benchmark for geriatric ED quality management in Taiwan.

• Integrating DTS and bCAM diagnostic tools into electronic medical and nursing order systems

• Developing a delirium nursing assessment checklist with a customized mnemonic

• Establishing cross-disciplinary integration among nurses, pharmacists, and physicians

• Providing accessible and patient-friendly health education leaflets

• Successfully improved the delirium diagnosis rate among geriatric patients

• Successfully enhanced patient outcomes for geriatric delirium

• Increased the delirium diagnosis rate from 4.3% to 6.9%

• Reduced the 3-day ED revisit rate from 10.2% pre-intervention to 2.8%

• Reduced the 14-day readmission rate from 14.1% pre-intervention to 7.3%

• Lowered the 1-month mortality rate from 7.8% pre-intervention to 6.0%

• Achieved high overall patient satisfaction

• Standardized delirium intervention protocols

• Conducted monthly interprofessional tracking and reviews

• Improved geriatric delirium diagnosis rates

• Enhanced clinical outcomes for geriatric delirium patients

• Reduced the average length of stay (LOS)

• Lowered average hospitalization costs

• Achieved high overall patient satisfaction

• Earned strong recognition from patients' families

• Secured positive media and academic coverage

• Delirium results published in SCI journal

• First-in-Taiwan ER delirium IT system

• Spearheaded Taiwan's geriatric emergency care policies

• Integrated a cross-team, pharmacist-led medication reconciliation model

• Standardized delirium screening and treatment protocols

• Secured top honors from national healthcare quality awards