a senior-friendly initiative which aimed to better addressthe in-hospital care of elders. This initiative stresses the importance of keeping lengths of stay as short as possible for older adults and presents various methods to preventdelirium. Every hospital in the province has implementedthese guidelines at different levels. However, our results show that over 4 years postimplementation, ED lengths of stay for older patients are still quite significant in Quebec,increasing their risk of developing delirium according to previous studies. Our results also clearly confirm the fact that patients with incident delirium have longer hospitalLOS, making them more at risk for further complications.We also recorded an important difference in incidentdelirium across the four study sites, varying from 8.3% to20%. Although intersite comparisons were not poweredby our sample size, many factors could have explainedthis difference. The different level of implementation ofthe provincial senior-friendly guidelines at each site couldbe a possible cause.