1. Preoperative Education: A Patient-Centered Care Approach Gia Wendt, RN, MSN Improvement Theme: Patient Safety Global Aim: Create a high quality preoperative joint replacement educational presentation in the Arabic language to empower patients with knowledge of mobility pathway, hospital length of stay, home preparation and prevention of postoperative complications. Specific Aim: 80% of Arabic speaking major joint patients meet goal to discharge to safe home environment with support for home care needs in 2.0 days or less by July 1, 2016. CONCLUSIONS REFERENCES PROBLEM METHODS RESULTS OBJECTIVE METHODS (cont.)  It is currently estimated that there are 50,000 to 60,000 Arabic speaking individuals residing in San Diego County (United States Census Bureau, 2015), a patient population served by the healthcare institution, which owns 32% of San Diego’s joint replacement market share (OSHPD, 2013).  The process for delivering preoperative education to the institution’s Arabic speaking joint replacement patient population via a 1:1 educational session using a third party interpreter was ineffective, costly, and time consuming.  Arabic speaking patients were not being provided access to the knowledge needed for setting inpatient expectations, following the major joint mobility pathway, or preparing homes for a safe discharge with support for home care needs in 2 days or less, a target goal set by The Joint Commission.  Arabic speaking patients did not have access to the high quality visual, audible, and written preoperative educational materials provided to English speaking patients which created a healthcare disparity (Darnell & Hickson, 2015). Kotter’s 8-Step Change Model was utilized to propel the project forward (Kotter, 2012).  Using a Root Cause Analysis (RCA), barriers to providing Arabic speaking patients with high quality, cost effective education was identified.  Abbreviated, fragmented preoperative education provided during a 1:1 session using a third party translator was limiting access to information needed by patients to partner in their healthcare, adhere to mobility and clinical pathways, and prepare for a discharge to a safe home environment with support for home care needs in 2.0 days or less.  A SWOT analysis was performed to identify strengths and areas of opportunity to overcome barriers threating successful implementation of the project.  The team investigated technological options for creating a visual and audio preoperative educational video, and the medically certified translation services available to compare quality of resources available and the associated costs.  Through networking, the team identified an Arabic speaking Pharmacist within the institution willing to narrate the educational recording at no charge to the institution’s orthopedic service line.  Narration was created for each slide of the English version joint replacement preoperative educational PowerPoint presentation by the team.  The PowerPoint presentation and narration were sent to the institution’s Multicultural Services Department for translation.  The team partnered with an Arabic speaking Pharmacist within the organization willing to narrate from the translated script to create a PowerPoint with voiceover mp4 file presentation in the Arabic language. A Stakeholder Analysis was performed to clarify team member roles and responsibilities, and to assist with strategic management of the project. A timeline was developed to prevent backward drift, achieve quick wins, build upon the change, and create a new standard of care. (Kotter, 2012). Implementation of this project will provide Arabic speaking patients with high quality visual and audible preoperative education which will be viewed during the group educational session on a laptop using earbuds, and the PowerPoint will be printed, providing patients with written educational materials necessary for partnering in their healthcare and preparing for a 2 day hospital length of stay with discharge to a safe home environment and support for home care needs. Implementation of this project will reduce the cost for educating Arabic speaking patients from $402/patient to $17.75/patient and will reduce costs related to patient education by $19,177 for CY2016 by allowing Arabic speaking patients to attend the group educational class and view the presentation with Arabic voice over narration (Orthopedic Registry, 2015).. Eliminating healthcare disparities will improve the outcomes of all patients served in the community despite lingual and cultural differences, while raising the expectation for providing culturally competent, patient-centered care to all (Darnell & Hickson, 2015). I Plan ID opportunity for improving preoperative education Do Create process improvement plan Study Collect pre- intervention outcome data Act Investigate options for developing preoperative education in Arabic II Plan Identify resources for education delivery Do Present technological options to team Study Compare quality and costs of technological options Act Choose technology to be used for Arabic preoperative education III Plan Implement Arabic PowerPoint w/ voiceover preoperative educational process Do Collect post- intervention outcome data Study Review results and compare to predicted outcomes Act Modify new process as needed to meet desired goal