Delirium remains the most common hospital complication. Occurrence rates are set to rise as the population ages and, despite being preventable and treatable, delirium continues to be under-recognised. Given the adverse outcomes associated with delirium and the considerable financial burden, patients with delirium must be considered 'core business' for 21st century hospitals. We propose that the principles of care outlined by the Future Hospital Commission report provide an ideal blueprint for effective, evidence-based delirium prevention and management. In this context, we outline practical advice for clinicians to improve standards of care for patients with delirium in hospitals. Because negative cultural attitudes, coupled with a lack of ownership towards this highly complex group, remain a major challenge, we consider novel educational interventions that empower the multidisciplinary team. Further, improved outcomes for patients with delirium are likely to translate to wider benefits for the hospital population at large.