Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 59, Issue 2, Pages 359-365Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1532-5415.2010.03243.x
Keywords
delirium; Hospital Elder Life Program (HELP); intervention; prevention; hospital care; sustainability
Categories
Funding
- National Institute on Aging [K24AG00949]
- Retirement Research Foundation [2007-225]
- Alzheimer's Association [IIRG-08-88737]
- Aging Brain Center, Institute for Aging Research, Hebrew Senior Life
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The Hospital Elder Life Program (HELP), an effective intervention to prevent delirium in older hospitalized adults, has been successfully replicated in a community teaching hospital as a quality improvement project. This article reports on successfully sustaining the program over 7 years and expanding its scale from one to six inpatient units at the same hospital. The program currently serves more than 7,000 older patients annually and is accepted as the standard of care throughout the hospital. Innovations that enhanced scalability and widespread implementation included ensuring dedicated staffing for the program, local adaptations to streamline protocols, continuous recruitment of volunteers, and more-efficient data collection. Outcomes include a lower rate of incident delirium; shorter length of stay (LOS); greater satisfaction of patients, families, and nursing staff; and significantly lower costs for the hospital. The financial return of the program, estimated at more than $7.3 million per year during 2008, comprises cost savings from delirium prevention and revenue generated from freeing up hospital beds (shorter LOS of HELP patients with and without delirium). Delirium poses a major challenge for hospital quality of care, patient safety, Medicare no-pay conditions, and costs of hospital care for older persons. Faced with rising numbers of elderly patients, hospitals can use HELP to improve the quality and cost-effectiveness of care.
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