Senior residents Educating about Hospitalized Olders at risk for Delirium (SEHOD): A 6-months follow up

Introduction:The Huron internal medicine residency program developed the Ohio Resident Chapter of Geriatric Medicine(ORCGM).The ORCGM conducted a randomized controlled trial to validate a new geriatric educational module(delirium)for medical residents.

Methods:A total of 272 patients, age 65 or older admitted to a general medical floor were enrolled.107 patients in intervention group(SEHOD I) were assigned to new interns that received regular bedside teaching from senior residents in order to recognize the risk factors for delirium and manage delirium appropriately.165 patients in control group(SEHOD II) were assigned to new interns that did not. Medical residents in both groups were taught about delirium in hospitalized patients through e-mail and lectures. The primary outcome was the rate of delirium. The secondary outcomes were length of stay(LOS) and total costs. The patients were followed up for 6 months.

Results:There was no statistical difference of age(p=0.818) and Charlson's co-morbidities index scores(6.66 vs.6.56,p=0.592) between SEHOD I and II. The rate of delirium was 26.17% of SEHOD I, and 38.18% of SEHOD II (Relative Risk 0.69,p=0.040). The SEHOD I reduced LOS 2.70 days compared to SEHOD II(SEHOD I=5.89 days,SEHOD II=3.19 days,p<0.001). SEHOD I reduced total costs 32% than SEHOD II. In 6 months' follow up, frequencies of Emergency Department visits and Re-Hospitalizations(ED/RH) were decreased 23% in SEHOD I(1.33) compared to SEHOD II(1.72)(p=0.089).

Conclusion:New interns receiving regular bedside teaching from senior residents could reduce the rate of delirium, LOS, and costs for elderly patients admitted to a regular medical floor. This intervention could avoid unnecessary acute care in 6 months.