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Michael Garron Hospital (MGH) was proud to welcome the Delirium Awareness Flag of Ontario to our campus, in recognition of our teams’ dedication to safer, compassionate care for our East Toronto community. The flag is part of the Regional Geriatric Program of Toronto’s campaign to raise awareness about delirium prevention across Ontario’s healthcare system.
“Delirium is a serious medical condition that needs urgent attention, as it’s often characterized by a sudden change in a patient’s thinking and awareness,” shares Raychel Moore, Nurse Practitioner (NP) in Geriatric Medicine Service and the NP Director of Senior’s Strategy at MGH. “It can develop quickly – sometime over hours – and often caused by a treatable issue. Older adult patients are particularly vulnerable to developing delirium due to age-related physiological changes, multiple chronic illnesses and the stress of a hospital environment.”
“Delirium prevention is therefore critical. Delirium can have profound effects on patient health and lead to complications and longer hospital stays. Effective delirium prevention and management is a cornerstone of high-quality senior care because it protects the two things older adults value most: their cognition and their independence.”
Delirium Awareness Safer Healthcare (DASH) is a multi-year initiative by Ontario Health (OH) to reduce incidence of delirium in senior patients during hospital stays. MGH is proud to have been an early adopter of the strategies outlined in the initiative.
In the day-to-day, DASH and delirium prevention require practical steps from clinical staff. “Delirium prevention is a collection of small, consistent, everyday actions built into routine care. In practice, it looks like implementing strategies to improve sleep, supporting mobility, ensuring glasses and hearing aids are used, reducing high-risk medications, attending to toileting needs and keeping patients oriented and well-hydrated,” says Raychel.
“The DASH campaign strengthens this work by making delirium awareness a routine part of team huddles, standardizing best practices and empowering staff to act earlier and more consistently,” she continues.
Raychel shares an example of how early intervention makes all the difference. A geriatric patient with no next of kin and very limited social support came to the hospital with cellulitis. The team’s early detection of delirium and prompt treatment of the underlying cause prevented what could have been a cascade of negative outcomes, particularly functional and cognitive decline. “As a result, the patient was able to return to their community with the same level of independence and received education around support available to them in future,” shares Raychel.
“As part of our Seniors Strategy, we are focused on improving safety, dignity, and outcomes for older adults across the continuum of care,” says Kevin Edmonson, Executive Vice President, Clinical Programs and Quality at MGH. “DASH aligns strongly with these goals by embedding evidence-based, patient-centred practices into daily care, supporting staff capability and reducing avoidable harm for older adults while they are hospitalized.”
A key part of MGH’s success with DASH has been comprehensive staff training. Raychel, working with the Regional Geriatric Program of Ontario and the Toronto Academic Health Science Network, has developed training modules that have helped spread and scale delirium prevention practices across the organization.
“We’ve already seen greater engagement and confidence from staff in caring for older adult patients,” says Mikki Layton, Vice President, Professional Practice, Programs, Scholarship and Chief Nursing Executive at MGH. “Other healthcare organizations are now adapting her training modules for their own use.”
MGH’s surgical teams have also implemented a range of measures to prevent delirium in older adult patients. Some of these include minimizing opioid use, early geriatric consultations for fracture patients, early mobilization, timely medication review, and engagement by the Hospital Elder Life Program (HELP).
A future initiative to be implemented is “Sip to Send” for patients having hip fracture surgery. Rather than following traditional fasting protocols, older adult patients will be given fluids up until surgery time. Dehydration can be a trigger of delirium, and by keeping patients hydrated right up to surgery, clinical teams are addressing one of the key risk factors.
As MGH continues to refine its approach to DASH implementation, the hospital’s work is drawing attention from the wider healthcare community. Jennifer Sampson, Director of Seniors and Aging and Transitional Care at MGH, shared MGH’s experience as an early adopter of DASH at the 2026 DASH congress, showcasing how the hospital has innovatively applied DASH principles across clinical units.
“Looking forward, our focus is on spreading and sustaining delirium-prevention practices across more units, strengthening measurement and evaluation and further integrating delirium prevention into broader seniors-friendly initiatives at MGH,” concludes Kevin.
