After Adoption: Sustaining the Innovation A Case Study of Disseminating the Hospital Elder Life Program

doi:10.1111/j.1532-5415.2005.53451.x

If you are seeing this message, you may be experiencing temporary network problems. Please wait a few minutes and refresh the page. If the problem persists, you may wish to report it to your local Network Manager.

It is also possible that your web browser is not configured or not able to display style sheets. In this case, although the visual presentation will be degraded, the site should continue to be functional. We recommend using the latest version of Microsoft or Mozilla web browser to help minimise these problems.

Wiley InterScience

Journal of the American Geriatrics Society

Volume 53 Issue 9, Pages 1455 - 1461

Published Online: 20 Jun 2005

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.

Published on behalf of

Go to Society Site

Next Abstract >

Save Article to My Profile Download Citation Request Permissions

Abstract | References | Full Text: HTML, PDF (Size: 110K) | Related Articles | Citation Tracking

After Adoption: Sustaining the Innovation A Case Study of Disseminating the Hospital Elder Life Program

Elizabeth H. Bradley, PhD ^* , Tashonna R. Webster, MPH ^* , Dorothy Baker, PhD, RNCS ^† , Mark Schlesinger, PhD ^*‡ , and Sharon K. Inouye, MD, MPH ^*†

From the Departments of ^*Epidemiology and Public Health and ^†Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut; and ^‡Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey.

Address correspondence to Elizabeth H. Bradley, PhD, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06520. E-mail: elizabeth.bradley@yale.edu

KEYWORDS

Hospital Elder Life Program • diffusion • innovation • geriatrics

ABSTRACT

Objectives: To examine key factors that influence sustainability in the diffusion of the Hospital Elder Life Program (HELP) as an example of an evidence-based, multifaceted, innovative program to improve care for hospitalized older adults.

Design: Longitudinal, qualitative study between November 2000 and November 2003 based on 102 in-depth interviews every 6 months during HELP implementation.

Setting: Thirteen hospitals implementing HELP.

Participants: Forty-two hospital staff members (physician, nursing, volunteer, and administrative staff) implementing HELP, conducted 102 interviews.

Measurements: Staff experiences sustaining the program, including challenges and strategies that they viewed as successful in addressing these challenges.

Results: Of the 13 hospitals studied, 10 were sustaining HELP at the end of the study period; three terminated the program (after 24 months, 12 months, and 6 months). Critical factors were identified as influencing whether the program was sustained: the presence of clinical leadership, the ability and willingness to adapt the original HELP protocols to local hospital circumstances and constraints, and the ability to obtain longer-term resources and funding for HELP.

Conclusion: Recognizing the need for sustained clinical leadership and funding as well as the inevitable modifications required to sustain innovative programs can promote more-realistic goals and expectations for health services researchers, clinicians, and policy makers in their laudable efforts to translate research into practice.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1532-5415.2005.53451.x About DOI