The Hospital Elder Life Program (HELP), an effective intervention to prevent delirium among hospitalized elders, has been successfully replicated in a community teaching hospital as a quality improvement project. Now, we report on successfully sustaining the program over 7 years and expanding its scale from 1 to 6 inpatient units at the same hospital. The program currently serves over 7000 older patients annually and is accepted as the standard of care throughout the hospital. Innovations which 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 reduced rate of incident delirium, reduced length of stay, increased satisfaction by patients, families, and nursing staff, and significantly reduced costs for the hospital. The financial return of the program, estimated at over $7.3 million per year during 2008, is comprised of cost savings from delirium prevention as well as revenue generated from freeing up hospitals beds (reduced length of stay in delirious and non-delirious HELP patients). 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 utilize HELP to improve both the quality and cost-effectiveness of care.

HELP can be successfully replicated in a community hospital, yielding clinical and financial benefits.