1. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

2. HELP Project Planning Tool In this section think about….  What qualifications would be required for each of the HELP roles?  What would the job descriptions for each of these roles in your setting be?  What orientation would be appropriate for new HELP employees? The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

3. HELP Staff  Recommended Full Time Equivalents (FTE)  Qualifications  Role Descriptions  Job Orientation  Modifications at HHS The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

4. HELP Staff Program Director Elder Life Specialist Elder Life Nurse Specialist Geriatrician The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

5. Program Director FTE- 0.1 recommended Role Description  Oversees the entire program and is key to provide overall leadership  This role can be assumed by the Geriatrician or HELP CNS  Oversees program metrics Modifications at HHS-  Clinical Manager who manages several Seniors Health services oversees day to day operations including budget, staffing, etc. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

6. Elder Life Specialist (ELS) FTE- 1.0 recommended Qualifications- Bachelor’s Degree -registration in regulatory college  experience with older adult population  supervisory experience  communication skills  organizational skills  computer skills The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

7. Elder Life Specialist Role Responsibilities  Daily interaction with volunteers, patients  Volunteer recruitment, training and mentoring  Linking of patient, health care team and volunteers  Patient screening and enrollment  Reviewing patients’ clinical status  Rounding  Ensuring adherence to volunteer interventions  Tracking of patient data The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

8. Job Orientation (ELS)  Corporate Orientation  Orientation to HELP  Job shadowing of HELP staff  Performing the ELS role with supervision  Shadowing interdisciplinary team members on HELP units (PT, OT, Dietitian, SW, Charge Nurse, Pharmacist, SLP) The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

9. Elder Life CNS  FTE -0.5 recommended  Qualifications  Master’s prepared Advanced Practice Nurse  3-5 years experience with older adult population  Expert clinician in gerontological nursing or willingness to become an expert clinician The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

10. Elder Life CNS Role Description  Reviews patients’ clinical status daily  Collaborates with health care providers  Provides education to patients, families, and nursing staff  Identifies systems issues  participates in quality improvement initiatives  Liaises with community agencies to facilitate discharge planning The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

11. PROGRAM OPERATIONS Record and maintain progress notes Serve as a liaison between the program and nursing administration Track and address quality assurance Provide clinical and administrative support for ELS and volunteers The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

12. Geriatrician FTE- 0.1 recommended Qualifications- Certified Geriatrician Role Description  Participates in HELP rounds  Provides consultation upon request  Provides education to physicians  Serves as liason with hospital medical staff The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

13. Recruitment Training and Retention The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

14. HELP Project Planning Tool In this section think about…. How will you go about recruiting volunteers What qualifications will you set for the volunteer role?(age, personal attributes, previous experience, time commitment, police check, health clearance) How will you go about training the volunteers? What strategies will you use to help retain volunteers? The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

15. Recruitment Work closely with Volunteer Resources -provides volunteer recruitment, screening and general training. They also identify hospital volunteers who seem suited to undertake the additional training to become a HELP volunteer. While the program seeks volunteers of all backgrounds, it has become a sought-after experience for many college/ university students, especially those interested in the health care field. Look for a mixture of different types of volunteers. If you only draw from the student population you will struggle with covering shift during student downtimes like exams The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

16. Volunteer Qualifications Reliable and caring; enjoy working with older people Understand the boundaries of patient /volunteer relationship Mature in judgment Discreet, empathetic behavior and ability to exercise diplomacy Comfortable talking to patients, patient’s family and staff Ability to relate with sensitivity to all patients Ability to work independently and assume responsibility Ability to refer questions to others as needed Minimum time commitment of 1 shift per week for 6 months The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

17. Training Training should be done a minimum of three times a year Volunteers attend 8 hours of classroom training which includes An overview of the Volunteer Manual and HELP videos Guest speakers which could include Physiotherapist, Dietician, Speech Language Pathologist, a member of the Alzheimer Society 12 hours of ward training which includes a detailed tour of the environment-where to find supplies and how to get information shadowing experienced volunteers during their shifts The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

18. Retention Consistent and ongoing support and mentorship from HELP staff Volunteer Recognition The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

19. http://www.hospitalelderlifeprogram.org The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

20. Central Website Overview of delirium and the HELP program for Older Adults/Caregiver and Clinicians New sites can apply for access into the HELP Private site (there are instructions on the website regarding how to apply) The private site holds all of the HELP materials including manuals, instructional videos, tools and resources On the private site there is also instructions on how to join the HELP Google Group The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

21. Hamilton Health Sciences HELP Resource Website http://www.hhsc.ca/body.cfm?id=1015 Includes extra resources that have been developed over the years for the program at our site Some examples are Volunteer Assignment sheet Sample Volunteer Training Schedules Sample Patient Education Handouts The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

22. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

23. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

24. The Organizational and Procedural Manuals: Overview & Structure Manual This manual gives a broad understanding of the program, the key elements of the program, and how they connect Goals of the program Description of staff – their qualifications, FTEs Program costs Administrative structure Quality Assurance Procedures – Working Group; Staff Performance Check; Patient/Family Survey; HELP Outcomes; Intervention adherence The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

25. Overview & Structure Manual cont’d Volunteer Component: Role, position description Training Volunteer retention Case Scenarios with suggested responses The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

26. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

27. Organizational and Procedural Manuals: The Clinical Process Manual This manual is the “heart of HELP”, in that it contains the activities from screening through discharge MMSE – ensure that your organization has permission to use the MMSE (at HHS, we utilize the SMMSE) Overview of cognitive screening instruments Screening and enrollment procedures Patient enrollment form Structure of patient assessment; includes scripts for ELS/ELNS The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

28. The Clinical Process Manual cont’d ELS Scope of Responsibilities Volunteer coordination Patient care Program operations Patient information package Evaluations to identify risk factors Confusion Assessment Method ELS/Volunteer Intervention Summary Chart The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

29. The Clinical Manual cont’d Geriatric Nursing Assessment and Interventions ELNS Protocols (Delirium, Dementia, Psychoactive Meds) ELNS Scope of Responsibilities Patient care Staff education Program operations Additional areas of ELNS assessment (i.e. anxiety, continence, skin) List of top 10 Drug Interactions Beers List The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

30. The Clinical Process Manual cont’d Interdisciplinary Interventions Rounds Geriatrician consults Community links Interdisciplinary consultations Discharge & Post-Discharge Planning Patient/family satisfaction surveys The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

31. The Clinical Process Manual cont’d Educational interventions to improve geriatric expertise References and resources for all protocols Chaplaincy protocol The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

32. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

33. The Database Manual Sample forms and worksheets for ELS Patient Enrollment Form – see our version in package ELS intervention worksheet Patient care plan Volunteer assignment form – see our version in package ELS Daily Evaluation Form The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

34. The Database Manual cont’d Tracking adherence of volunteer interventions Master tracking log (worksheet) Adherence codes Tracking adherence of nursing interventions Daily assessment (ELNS Patient Profile Sheet) ELNS Interventions Master Tracking Log and Intervention Codes The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

35. The Database Manual cont’d Discharge Evaluation Patient discharge assessment form Patient/family satisfaction survey ELNS telephone follow-up Samples of completed forms The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

36. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

37. The Volunteer Training Manual Overview – program structure chart Program goals Role of the volunteer Training process – classroom and shadowing Separate sections cover each protocol Expectations of the volunteer Importance of documentation The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

38. The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH

39. The Business Tools Manual Introduction Executive Summary Background research & outcomes Program design & tools Program results – Clinical & Quality; Economic Summary of Potential Business Impact Overview of Potential Cost Savings Financial worksheets Data Collection Questionnaire Power Point Slide Presentation Evaluating the Volunteer Model – value of volunteer time The Hospital Elder Life Program © 2000, Sharon K. Inouye, MD, MPH