Bradley and colleagues29 and Inouye and colleagues28 also examined factors that led to the success of the HELP program. Factors that were deemed essential to the success of the HELP program in various hospitals included the work of dedicated clinician leaders to champion the cause and internal support from multiple departments.28 and 29 Allowing flexibility to adapt the HELP program to meet the individual needs of the hospital was also necessary to the success of HELP in different hospital settings.28 and 29 Adaptations included changing some forms to decrease repetitive documentation, decreasing the frequency of some interventions, allowing flexibility for the intensity of the interventions.28 and 29 Quality assurance procedures (such as staff meetings, patient satisfaction surveys, and monitoring the performance of volunteers) were not always implemented.28 and 29 There were no reports examining whether adaptations affected the fidelity of the HELP program.