1. The Hospital Elder Life Program ABC Hospital
Annual Report
1/1/2014 – 12/31/2014

2. The Hospital Elder Life Program (HELP)
Comprehensive, evidence-based model of care that improves outcomes for older adults
Targeted interventions completed by interdisciplinary staff and trained volunteers
Primary goals:
Maintain cognitive and physical functioning
Maximize independence at discharge
Assist with transition from hospital to home
Prevent unplanned hospital readmissions

3. 2014 Goals of HELP at ABC Hospital
Outcome
Increase ELNS position from 0.6 FTE to 1.0 FTE by 9/30/14
Accomplished 11/15/14
Expand HELP to Rehab Unit 1 by 12/1/14
Will complete by 6/30/15
Recruit at least 10 new volunteers with summer availability by 4/30/14
11 volunteers recruited between Feb and Apr, 10 staying past the summer
Enroll 1500 patients in HELP during this reporting period
1507 patients enrolled
85% of patients will report satisfaction with their care during this reporting period
92% of patients reported satisfaction with their care
Achieve adherence rate (complete and partial) of 85% during this reporting period
Achieved adherence rate of 90%

4. HELP at ABC Hospital HELP Staff
1.0 FTE Elder Life Specialist (John Doe, BSW)
0.9 FTE Elder Life Nurse Specialist (Jane Jones, MSN, RN)
0.1 FTE Geriatrician (Sally Smith, MD)
0.1 FTE Program Director (Jane Jones, MSN, RN)
HELP Units: Medical Unit 1, Medical Unit 2, Surgical Unit 1, Surgical Unit 2
Patients Enrolled: 1507
Volunteers: 55 volunteers, 5500 volunteer hours

5. HELP Patients at ABC Hospital (Total enrolled = 1507)
Characteristic
Age, mean (range)
78 (70-88)
Female, N (%)
995 (66)
Non-White, N (%)
256 (17)
Hispanic, N (%)
90 (6)
Length of stay in days, mean
9.2

6. Adherence Rates of Interventions by Admission (N=1716 admissions of 1507 patients)
Adherence rate1 patient-days, N(%)
Complete Partial Non-Adherence
Intervention assigned
(# patient-days)
Orientation
8272 (83)
1288 (13)
389 (4)
9949
Therapeutic Activities
6760 (68)
2246 (23)
948 (10)
9954
Sleep Enhancement
136 (10)
826 (61)
390 (29)
1352
Early Mobilization
4469 (46)
4168 (42)
1171 (12)
9808
Vision Protocol
879 (90)
31 (3)
65 (7)
975
Hearing Protocol
824 (80)
139 (13)
71 (7)
1034
Fluid Repletion
120 (46)
78 (30)
65 (25)
263
Feeding Assistance
1692 (45)
1260 (33)
844 (22)
3796
Overall
22152 (60)
10036 (30)
3943 (11)
37131
1. Adherence rates calculated as adherence recorded for each patient-day/total number of patients-days intervention was assigned

7. Reasons for Non-Adherence (N = 3943 non-adherent patient-days for all interventions)
Lack of availability of staff/volunteers
1262 (32)
Patient refusal of intervention
1025 (26)
Medical contraindication
867 (22)
Patient unavailable (e.g., off floor for procedure)
513 (13)
Other
276 (7)

8. HELP Outcomes by Admission (N = 1716 admissions in 1507 patients)
Admissions (N=1716)
Change in SPMSQ score from admission to discharge
Same or improved, N (%)
Decline, N (%)
1028 (92)
86 (8)
Change in ADL score from admission to discharge
969 (86)
153 (14)
LOS, days
Mean ± SD
Median (range)
9.2 ± 8.7
7 (1-163)
Discharge destination, N (%)
Home, no services
Home, with services
Skilled nursing facility
Short-term
Long-term
Not specified
Deceased
Other2
489 (29)
470 (27)
248 (15)
147 (9)
115 (7)
50 (3)
157 (9)
Fall rate (falls per 1,000 patient days)
3.2
Delirium rate, N (%)
189 (11)
30 day unplanned readmission rate, N (%)
137 (8)
1. SPMSQ = Short Portable Mental Status Questionnaire, ADL = Activities of Daily Living, LOS = Length of hospital stay, SD = standard deviation
2. “Other” category includes: hospice, transfer to acute rehabilitation unit, assisted living, rest home, and unknown

9. Comparisons over time of patient outcomes
Patients enrolled in HELP vs.
Eligible patients not enrolled in HELP

16. Patient/Caregiver Satisfaction (1280 surveys completed, 85% completion rate)
Question
“Agree” or “Strongly Agree” N(%)
Volunteers were helpful during my hospitalization
1216 (95)
HELP staff explained the program in a way I could understand
1165 (91)
Overall, I was satisfied with the care I received in the HELP program
1178 (92)
1. Answer choices: strongly disagree, disagree, neutral, agree, strongly agree

17. Patient/Caregiver Quotations
“Brought me magazines, took me for walks, and also we did exercises while in bed. So yes, I do believe this Hospital Elder Life Program is very, very helpful to the patient and gives them something to look forward to.”
“Thank goodness for HELP! With the volunteers my husband was much improved from his last hospital stay, where he went into acute delirium.”

18. Staff Satisfaction (200 surveys completed, 87% completion rate)
Question
“Agree” or “Strongly Agree” N(%)
The HELP staff are supportive
HELP is a useful resource at ABC Hospital to support elder care
My job has been more satisfying due to having assistance from the HELP volunteers and staff in caring for older patients
1. Answer choices: strongly disagree, disagree, neutral, agree, strongly agree

19. Staff Quotations
“The positive feedback from patients and staff is so powerful – that convinces our administrators and anyone else who might have doubted it. In fact, nurses on other floors are asking, ‘Why can’t we get HELP on OUR floor?’”
“The patients said that the HELP Program was the best part about their stay.”