Banner receives grant for innovative diagnostic tool

Algorithm in electronic medical record helps diagnose delirium

 1/4/2025

Banner Health is one of seven health care systems in the nation to be awarded a $100,000 grant by the Institute for Healthcare Improvement to support the implementation of a new diagnostic tool used to detect delirium in patients at Banner – University Medical Center Phoenix. The Diagnostic Excellence – Age-Friendly Health Systems Seed Grant program, supported by the Gordon and Betty Moore and The John A. Hartford foundations, seeks to test innovations supporting age-friendly diagnostic practices.

Known as NOVAD (Neurological Orientation and Verbal Response Assessment for Delirium), Banner’s tool uses data from the electronic medical record to tell medical staff if a patient is at high risk for delirium, which is a serious change in mental abilities that results in confusion and lack of awareness.

As the population in the United States gets older, the importance of quality geriatric care in hospitals remains essential. Arizona is home to more than 1 million residents aged 65 and older, making up almost 18% of the state population. This population often requires a higher, more specialized level of care during inpatient hospitalizations due to increased risks for complications in an acute care setting. As an age-friendly healthcare system, Banner – University Medical Center Phoenix has implemented measures to improve the quality of care for its aging patients, such as the acute care for elders unit and the HOPE Oral Care Program.

In tandem with the age-friendly guidelines set by the Institute for Healthcare Improvement, the NOVAD tool will help provide better care for older patients through its ability to warn staff early of possible delirium cases.

Research shows that the prevalence of delirium in hospitalized patients is about 30%, but many cases are often missed or unconfirmed. If not diagnosed early, delirium has the potential to affect patients’ ability to eat and swallow and increases their risk of infection, which may lead to increased length of stay and even mortality. NOVAD will play a key role in identifying these cases early—without any additional work from medical staff—and alerts providers when necessary.

“Our ultimate goal with this tool is to create a better standard of care that will drastically improve delirium treatment at Banner – University, and eventually across all Banner Health hospitals,” said Dr. Nimit Agarwal, chief of geriatric medicine at Banner – University Medical Center Phoenix. “We hope NOVAD will prove to be an invaluable asset in helping us give the best care possible to patients, especially our older patients.”

To detect delirium, NOVAD analyzes observations that have already been documented by nurses in the electronic medical record.

“This grant allows us to take another step in the right direction as a leading health care system for geriatric care in the Southwest,” said Dr. William Holland, senior vice president of care management and chief medical informatics officer for Banner Health. “Implementing this new diagnostic tool closely aligns with Banner’s High Reliability Organization goals by aiming to reduce harm in the hospital setting.” The project recently started in the acute care for elders unit and will expand throughout the hospital. The tool is the first of its kind that does not add any new steps in nurses’ workflows and can be easily scalable in most electronic health record systems.

“Data and analytics play a massive role in how we practice medicine now more than ever,” said Dr. Sumit Agarwal, director of analytics for Banner Health. “Harnessing these through new, innovative tools like NOVAD will be pivotal in how we provide quality, personalized care to everyone.”