{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:42:04Z","timestamp":1789497724807,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100018858","name":"International Society for Advancement of Cytometry","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG071744"],"award-info":[{"award-number":["R33AG071744"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delirium is a common complication of hospitalization and is associated with poor outcomes. Multicomponent delirium prevention strategies such as the Hospital Elder Life Program (HELP) have proven effective but rely on face\u2010to\u2010face intervention protocols and volunteer staff, which was not possible due to restrictions during the COVID\u201019 pandemic. We developed the Modified and Extended Hospital Elder Life Program (HELP\u2010ME), an innovative adaptation of HELP for remote and\/or physically distanced applications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>HELP\u2010ME protocols were adapted from well\u2010established multicomponent delirium prevention strategies and were implemented at four expert HELP sites. Each site contributed to the protocol modifications and compilation of a HELP\u2010ME Operations Manual with standardized protocols and training instructions during three expert panel working groups. Implementation was overseen and monitored during seven learning sessions plus four coaching sessions from January 8, 2021, through September 24, 2021. Feasibility of implementing HELP\u2010ME was measured by protocol adherence rates. Focus groups were conducted to evaluate the acceptability, provide feedback, and identify facilitators and barriers to implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 106 patients were enrolled across four sites, and data were collected for 214 patient\u2010days. Overall adherence was 82% (1473 completed protocols\/1798 patient\u2010days), achieving our feasibility target of &gt;75% overall adherence. Individual adherence rates ranged from 55% to 96% across sites for the individual protocols. Protocols with high adherence rates included the nursing delirium protocol (96%), nursing medication review (96%), vision (89%), hearing (87%), and orientation (88%), whereas lower adherence occurred with fluid repletion (64%) and range\u2010of\u2010motion exercises (55%). Focus group feedback was generally positive for acceptability, with recommendations that an optimal approach would be hybrid, balancing in\u2010person and remote interventions for potency and long\u2010term sustainability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HELP\u2010ME was fully implemented at four HELP sites, demonstrating feasibility and acceptability. Testing hybrid approaches and evaluating effectiveness is recommended for future work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18212","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T13:39:19Z","timestamp":1673617159000},"page":"935-945","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Modified and Extended Hospital Elder Life Program: A remote model of care to expand delirium prevention"],"prefix":"10.1111","volume":"71","author":[{"given":"Tamara G.","family":"Fong","sequence":"first","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"},{"name":"Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Albaum","sequence":"additional","affiliation":[{"name":"Biochemistry Program Vassar College  Poughkeepsie New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly L.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Maine Medical Center  Portland Maine USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara G.","family":"Cohen","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Sutter Health  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shauni","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Primary Care Institute Allegheny Health Network  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5438-5087","authenticated-orcid":false,"given":"Mark A.","family":"Supiano","sequence":"additional","affiliation":[{"name":"Geriatrics Division University of Utah School of Medicine and University of Utah Center on Aging  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip E.","family":"Vlisides","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Michigan Medicine  Ann Arbor Michigan USA"},{"name":"Center for Consciousness Science University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harley L.","family":"Wade","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Maine Medical Center  Portland Maine USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyn","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Primary Care Institute Allegheny Health Network  Pittsburgh Pennsylvania 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