Data collection began in 2009 and is expected to be completed in 2012.The control cohort of 70 patients has been recruited, and 45 patients have been accrued to the intervention group to date.
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These eight units are implementing the intervention in a successive order that will be determined at random.
The incidence of delirium, the primary outcome, will be measured with the Confusion Assessment Method (CAM).
Patient data are collected at baseline, discharge, and 6 months post-discharge from an inpatient rehabilitation program.
Evaluations include mobility, physical function, and living arrangement.
Staff data are collected at baseline and one year after implementation of the model to determine change in staff knowledge and attitudes toward patients with hip fracture and CI.
Bi-monthly semi-structured interviews with unit managers have been conducted to examine factors and barriers influencing the model implementation.
Evaluation of this model of care is timely given the increasing proportion of persons with cognitive impairment and hip fractures.
The study is registered at Identifier NCT01566136.
The stepped-wedge design was chosen for ethical, practical and statistical reasons.
The study results will be generalizable to the Dutch hospital care system, and the proven cost-effectiveness of HELP will encourage the spread and implementation of this program.
A multiple baseline approach (also known as a stepped-wedge design) will be used to evaluate the (cost-) effectiveness of HELP in a cluster randomized controlled study.