Publications by authors named "Sarah Dowal"
Background: Postoperative delirium and postoperative cognitive dysfunction share risk factors and may co-occur, but their relationship is not well established. The primary goals of this study were to describe the prevalence of postoperative cognitive dysfunction and to investigate its association with in-hospital delirium. The authors hypothesized that delirium would be a significant risk factor for postoperative cognitive dysfunction during follow-up.
View Article and Find Full Text PDFThe Hospital Elder Life Program (HELP) can prevent delirium, a common condition in older hospitalized adults associated with substantial morbidity, mortality, and healthcare costs. In 2011, HELP transitioned to a web-based dissemination model to provide accessible resources, including implementation materials; information for healthcare professionals, patients, and families; and a searchable reference database. It was hypothesized that, although intended to assist sites to establish HELP, the resources that the HELP website offer might have broader applications.
View Article and Find Full Text PDFImportance: Delirium, an acute disorder with high morbidity and mortality, is often preventable through multicomponent nonpharmacological strategies. The efficacy of these strategies for preventing subsequent adverse outcomes has been limited to small studies to date.
Objective: To evaluate available evidence on multicomponent nonpharmacological delirium interventions in reducing incident delirium and preventing poor outcomes associated with delirium.
The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom developed guidelines for the diagnosis, prevention, and management of delirium in July 2010 that included 10 recommendations for delirium prevention. The Hospital Elder Life Program (HELP) is a targeted multicomponent strategy that has proven effective and cost-effective at preventing functional and cognitive decline in hospitalized older persons. HELP provided much of the basis for seven of the NICE recommendations.
View Article and Find Full Text PDFArticle Synopsis
- Clinical geriatrics programs are struggling financially, with lessons from successful programs not clearly applicable to those facing closure.
- This study examines failed programs, particularly the Hospital Elder Life Program (HELP), which operated successfully at numerous sites before encountering issues.
- Analysis of interviews with administrators at six closed HELP sites reveals that financial crises removed key support figures and shifted focus to revenue-generating initiatives, exposing existing vulnerabilities like lack of physician and nursing support.
- To avoid closure, geriatrics programs should secure broad support from senior leadership, especially in nursing and medicine, to navigate potential crises effectively.
Article Synopsis
- The study investigates how the Hospital Elder Life Program (HELP) justifies its operations to decision-makers in hospitals, focusing on its effectiveness in improving care for older adults.
- Researchers conducted 62 in-depth interviews with HELP staff and administrators across 19 sites in North America to identify successful strategies for securing funding amid financial pressures.
- Three key strategies emerged: meaningful engagement with decision-makers, documenting operational successes with relevant metrics, and gaining support from influential hospital staff, all crucial for sustaining the program’s operations.