The Hospital Elder Life Program at the Jewish General Hospital

Study Overview
=================
Brief Summary
-----------------
Older patients (i.e.; ≥ 65 years) with a hip fracture, and who are admitted to orthopedics for surgery are particularly at risk of adverse health events such as delirium, recurrent falls and prolonged hospital stay caused by their frailty status. The Hospital Elder Life Program (HELP) is a comprehensive inpatient-care program that ensures optimal care for older adults in the hospital and, thus, might reduce the incidence of postoperative adverse health events. The overall objective of this study is to examine in a quantitative fashion the effects of the HELP program on adverse health events in geriatric inpatients admitted to the orthopedic ward at JGH for surgery after a hip fracture.

Detailed Description
-----------------
Delirium and mobility impairment with high risk of falls are important medical complications after a hip surgery. More than 95% of hip fractures are caused by falling and the risk of a new fall after a hip surgery may be up to 50%. Both postoperative delirium and fall are associated with increased length of stay and high perioperative mortality. The Hospital Elder Life Program (HELP) is a comprehensive inpatient-care program that ensures optimal care for older adults in the hospital. The primary goals of the HELP program are: Maintaining cognitive and physical functioning of high risk older adults throughout hospitalization, maximizing independence at discharge, assisting with the transition from hospital to home, and preventing unplanned hospital readmissions. These goals have been accomplished using a multicomponent intervention strategy. In addition to targeted interdisciplinary geriatric assessment, the program uses an innovative volunteer model to provide personal, supportive attention to vulnerable older inpatients.

Official Title
-----------------
A Measure of the Effects of the Hospital Elder Life Program at the Jewish General Hospital: a Pre-post Intervention Study

Conditions
-----------------
Delirium, Fall Injury, Mortality

Intervention / Treatment
-----------------
* Other: Inpatient-care program


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: age 65 and over admitted to orthopedic ward for hip surgery after a fracture Exclusion Criteria: younger than 65 years of age palliative care

Ages Eligible for Study
-----------------
Minimum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Interventional<br>The HELP Program is a comprehensive inpatient-care program that ensures optimal care for older adults in the hospital by using trained volunteers that do specific activities to help prevent or maintain functional decline. | Other: Inpatient-care program<br>* Patients enrolled in the Hospital Elder Life Program can receive four types of personalized volunteer-led interventions based on the needs identified by the care team. These interventions include: Daily orientation and visiting program Basic active movements Meal assistance Recreational activities<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of delirium after a hip surgery | As measure will be used the CAM ( Confusion Assessment Method) | 24 hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of falls before having a hip fracture | The number of falls are recorded in medical chart | Up to one month | 
| In-hospital mortality | Mortality during hospitalization. | Up to one month | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
older, hospital, program