After adoption: sustaining the innovation. A case study of disseminating the hospital elder life program

J Am Geriatr Soc. 2005 Sep;53(9):1455-61. doi: 10.1111/j.1532-5415.2005.53451.x.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Data Collection
  • Health Services for the Aged* / economics
  • Health Services for the Aged* / organization & administration
  • Hospitalization*
  • Humans
  • Interviews as Topic
  • Leadership
  • Longitudinal Studies
  • United States