“…Our goal for the 5D Project was to achieve practice changes in the evaluation of delirium, dementia, and depression. Yet effecting and documenting Level 3 uptake of improvements into clinical practice is a perennial challenge (Davis et al, 1999;Kulier et al, 2010;Oxman, Thomson, Davis, & Haynes, 1995;Takayesu, Nadel, Bhatia, & Walls, 2010). Past research has indicated that using multifaceted educational approaches, such as practice-based tools, quality improvement data, and using opinion leaders to influence practice behaviors, have the most success in effecting practice changes (Bradley et al, 2004;Gifford et al, 1999;Grol & Grimshaw, 2003;Vickrey, 2005).…”