Here - American Geriatrics Society

P OSTER
A BSTRACTS
satisfaction with the program. COACH is estimated to have saved the
health care system $223,000 in a year by delaying NHP.
CONCLUSIONS
The COACH program reduced NHP in its first year of existence,
while also improving dementia care delivery, caregiver burden
and quality of life. These outcomes were achieved cost-effectively.
The COACH program represents an innovative collaborative care
model for patients with dementia.
B119
Knowledge-To-Action for Delirium Prevention: Diffusion of the
Hospital Elder Life Program (HELP).
T. T. Hshieh, 1 P. Chen, 1 S. Dowal, 2 S. K. Inouye. 1,2 1. Internal
Medicine, Beth Israel Deaconess Medical Center, Boston, MA; 2.
Hebrew SeniorLife, Harvard Medical School, Boston, MA.
Background: Delirium is a common, increasingly prevalent condition
among older hospitalized patients with significant morbidity
and mortality. HELP has been a successful evidence-based model of
care to prevent delirium and functional decline in hospitalized elders,
which has been disseminated widely. Knowledge translation and diffusion
in healthcare is important but often challenging, and theoretical
frameworks to do so effectively are underutilized.
Aim: To evaluate the effectiveness and scope of the HELP diffusion
process (2000-2011), we applied the Knowledge-To-Action
framework (Straus 2009) to determine adherence of HELP diffusion
to best practices in translation and diffusion.
Methods: The Knowledge-To-Action framework consists of 10
phases (3 knowledge creation, 7 action phases), incorporating knowledge
translation into a collaborative, multi-level, systems-based approach.
The 3 knowledge creation phases are: inquiry, synthesis, products/tools.
The 7 action phases are: identify problem/knowledge,
adapt to local context, assess barriers, implement intervention, monitor
use, evaluate outcomes, sustain use.
Results: HELP adheres to all 10 phases of the Knowledge-To-
Action framework (See Table). Many HELP diffusion steps were assignable
to more than one feature.
Conclusions: The HELP diffusion process followed best practices
in translation of knowledge. The steps to evaluate efficacy, costeffectiveness,
adaptations, barriers, and ongoing outcomes may have
helped contribute to its success. We hope this case example may assist
others in developing their own effective knowledge translation programs
for innovations in geriatrics.
HELP Diffusion Adheres To Knowledge-To-Action Framework
B120
Factors associated with Survival after Stroke among Elderly Women
in the WHI.
C. L. Bell, 1 A. LaCroix, 2 S. Smoller, 3 K. Masaki, 1 J. Curb, 1
E. M. Hade, 4 T. Manini, 5 W. Mysiw. 6 1. Geriatric Medicine, University
of Hawaii John A Burns School of Medicine, Honolulu, HI; 2. Fred
Hutchinson Cancer Research Center, Seattle, WA; 3. Epidemiology &
Social Medicine, Albert Einstein College of Medicine, Bronx, NY; 4.
Center for Biostatistics, Ohio State University, Columbus, OH; 5.
Aging and Geriatric Research, University of Florida, Gainesville, FL;
6. Physical Medicine & Rehabilitation, Ohio State University,
Columbus, OH.
Supported By: National Heart, Lung and Blood Institute
Background: Data are limited on factors affecting long-term
post-stroke survival in older women.
Methods: Women’s Health Initiative (clinical trials and observational
study) data on women aged 50-79 and stroke-free at baseline,
with incident stroke prior to 2005, were analyzed for survival through
2010. Prestroke physical function used Rand-36 subscale scores
(range 0-100, higher=better).
Results: Of 3,173 women, 2,062 (65%) survived through 2010;
1,111 (35%) died. On multivariable Cox models, prestroke factors associated
with post-stroke mortality included: older age at stroke
(HR=1.07, 95%CI= 1.05-1.08, p