Abstract
Delirium has been historically under studied and under appreciated despite its high frequency and profound impact upon outcomes. This reflects failures at all levels from awareness among frontline staff, ownership by specialist researchers, funding from research bodies, and policy making by senior management and politicians. This is reflected in under detection, suboptimal management and a lack of basic mechanisms by which delirium can be documented within health systems activity data. Not surprisingly, the considerable financial implications are poorly acknowledged and reimbursement arrangements sparse. Delirium as an entity has been victim to its unique position at the mind–body interface and occurrence across multiple disciplines such that no one specialty recognizes delirium as its primary responsibility. It is time for the healthcare community to respond to the challenge of delirium.