On Fire with the Delirium Prevention Project

Dr. Amos puts out firesWell, to my amazement, I had time to attend the Delirium Early Detection and Prevention Committee last Friday. Usually I’m too busy putting out fires all over the hospital in my role as psychiatric consultant, which me reminds of something a former president of the Academy of Psychosomatic Medicine once said:

“A consultation service is a rescue squad.  At worst, consultation work is nothing more than a brief foray into the territory of another service…the actual intervention is left to the consultee.  Like a volunteer firefighter, a consultant puts out the blaze and then returns home… (However), a liaison service requires manpower, money, and motivation.  Sufficient personnel are necessary to allow the psychiatric consultant time to perform services other than simply interviewing troublesome patients in the area assigned to him.”—Dr. Thomas Hackett.

I was excited about it because I wanted to see if we could pick up some momentum after a hiatus and put out that raging fire of delirium .

Anyway, I’m on fire again about the project again. The meeting agenda included:

  • Delirium Order Set: We’re going to try the screensaver reminder for this in which all the workstation computers in the hospital will carry a message about the availability and practical usefulness of the Epic Delirium Order Set.
  • Delirium Observation Screening Scale (DOSS): We may need to light a fire under some nurse champions who will help encourage a culture of persistence in screening with the DOSS and ensuring that doctors listen to them and act when they get positive screens.DOSS
  • Delirium Educational Handout for Families: We’re going to give the educational handout to family members and there’ll be a research assistant who will distribute surveys to them so that we can get their feedback on the handout and improve it.Delirium Guide for Families pg 1Delirium Guide for Families pg 2
  • Intensive Care Unit Screening for Delirium: We’re going to redouble our efforts to persuade, cajole, threaten the critical care unit personnel to use the Confusion Assessment Method-ICU (CAM-ICU) to screen for delirium consistently.
    Altered Consciousness CAMICU
    Altered Consciousness CAMICU
    The ASE auditory version CAMICU
    The ASE auditory version CAMICU

    Disorganized thinking CAMICU

  • American Delirium Society Annual Meeting in June 2014: I’m afraid I’ll miss the annual meeting of the American Delirium Society in Baltimore. It promises to be another outstanding educational event. They will light another fire nobody can put out.mount-and-blade-with-fire-and-sword-soundtrack-available-for-free

Save_the_Date ADS in Baltimore 2014


Author: Jim Amos

Dr. James J. Amos is Clinical Professor of Psychiatry in the UI Carver College of Medicine at The University of Iowa in Iowa City, Iowa. Dr. Amos received a B. S. degree in Distributed Studies (Zoology, Chemistry, and Microbiology) in 1985 from Iowa State University and an M.D. from The University of Iowa in Iowa City, Iowa in 1992. He completed his psychiatry residency, including a year as Chief Resident, in 1996 at the Department of Psychiatry at The University of Iowa. He has co-edited a practical book about consultation psychiatry with Dr. Robert G. Robinson entitled Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry. As a clinician educator, among Dr. Amos’s most treasured achievements is the Leonard Tow Humanism in Medicine Award.