Our hospital chose the Hospital Elder Life Program (HELP) developed at Yale University as our template for evidence based practice care.  Yale’s research demonstrated a decrease in new onset delirium and functional decline in elderly patients.  Risk factors were identified and strategies were developed to reduce these risks.

Upon adopting the model, we recruited team members from all disciplines to join our efforts.  Team members included nurses, social workers, dieticians, administration, volunteers, physical therapists and medical staff.  The team made rounds, interviewed patients, changed standing medical orders, expanded menu choices, addressed falls, restraints, and Foley catheter use, and improved communication.  We identified areas of needs and developed a Geriatric Clinical Pathway, room specific patient binders, and provided boards for daily orientation.

This transdisciplinary approach proved most successful.  We received positive feedback from patients and families.  As we started on each new unit, the fall rate was noted to decrease.  Foley catheter and adult diaper use decreased and has continued for over 2 years.  With the change in standing medical orders, fewer potentially inappropriate medications were ordered per patient. Patients are out of bed and ambulating more frequently, lowering the risk of functional decline. 

 Because of our early success on one unit, we are currently on five units and the program is being replicated at one of our sister hospitals