Outcomes of an Interprofessional Team Learning and Improvement Project Aimed at Reducing Post-surgical Delirium in Elderly Patients Admitted with Hip Fracture

Background Healthcare organizations face the challenge of improving the care provided to patients while simultaneously improving the individual and teamwork skills of the personnel who deliver this care. Interprofessional team learning and improvement (ITLI) is a learning format designed to address these objectives. Method Eisenhower Medical Center formed an ITLI team to address the problem of postsurgical delirium among its elderly patients admitted through the emergency department for hip fracture requiring surgical repair. The team was selected from among the professions and disciplines involved in providing care to these patients. The team used a blend of learning and quality improvement processes that included the following activities: reviewing literature, collecting and analyzing data, consulting with a technical expert, planning and implementing interventions designed to improve targeted outcomes, and measuring the effects of these interventions. Results The project was able to reduce the emergence of acute confusion among the targeted population by 64% and the use of restraints by 60% when compared with a historical group of patients with similar characteristics. These outcomes were not statistically significant, probably owing to small numbers. However, staff members perceived advantages to the new approach to patient care and are expanding it to other relevant patient populations. Important professional development outcomes of the project included enhanced knowledge of hospital information technology resources, enhanced quality improvement skills, enhanced interprofessional relationships and teamwork skills, and experience with a new model for organizational problem solving. Organizational outcomes included new technology and clinical infrastructure that will make it easier to measure the effects of future interventions developed for this population, and an overall increased organizational capacity to solve complex problems through interprofessional teamwork. Conclusion ITLI shows promise as a format for improving the quality of care delivered to targeted populations while simultaneously developing individual and teamwork skills of participants.