Recruitment difficulties and bad data quality

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.

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.

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