Table 1.

Comprehensive and Sequential Intervention—Details of Didactic Program

Talk 1: Delirium in older persons: clinical pearls derived from research
Objectives	Session content
1. To understand the key features for recognition of delirium at the bedside	An overview lecture that introduced delirium. It included cases, definitions, pathophysiology, epidemiology, comparison between delirium versus dementia, risk factors for delirium and precipitating factors such as medications, impact of delirium in terms of clinical outcomes and hospital cost, introduction to the CAM delirium screening tool, delirium management, and introduction to the HELP and its effectiveness.
2. To comprehend the multifactorial etiology of delirium and its leading risk factors
3. To learn strategies for the prevention and management of delirium
Talk 2: Recognition of delirium: the Confusion Assessment Method (CAM)
Objectives	Session content
1. To review the development and validation of the CAM	The lecture went into depth on the CAM instrument. It also  included a review of clinical features and significance of delirium identification. CAM development and validation was presented. Much of the lecture was spent on how to use the CAM at the bedside, using examples of each of the four CAM criteria. Clinical cases and videos were used to demonstrate aspects of CAM administration.
2. To understand the key features of the CAM
3. To learn how to rate the key features of the CAM
Talk 3: Improving hospital quality and safety: the HELP
Objectives	Session content
1. To comprehend the perils of hospitalization for older persons	The lecture went into depth on the HELP. Delirium was shown  to be a leading complication of hospitalization as well as a quality indicator. A description of the HELP included the six known risk factors targeted by HELP interventions, implementation of the program by trained staff and volunteers, and processes to identify and manage eligible patients. The impact of HELP on hospital cost-effectiveness and impact on clinical outcomes was presented.
2. To gain knowledge about the interventions of the HELP
3. To review the evidence for effectiveness of the HELP
Talk 4: How to make HELP happen: creating change
Objectives	Session content
1. To review the outcomes and cost-effectiveness of a successful large-scale HELP	The lecture reviewed key features of the HELP and  demonstrated the role of HELP in community hospitals, using a successful example. A focus was on demonstrating economic viability of HELP to hospital Administration. Tools that can be used to demonstrate HELP success were presented, as were possible metrics to track. In addition, HELP can favorably impact Center for Medicare and Medicaid Services “no-pay” conditions, such as falls.
2. To understand how HELP sites create system change and sustain it
3. To learn about the impact of HELP on Medicare no-pay conditions, such as falls

CAM = Confusion Assessment Method; HELP = Hospital Elder Life Program.