Embedding consent‑aligned patient education via electronic health record smart phrases to improve preparedness for skin cancer procedures: a quality improvement pilot

Patient efficacy and understanding are linked to increased patient satisfaction and decreased staff workload for outpatient procedures. Patients undergoing skin cancer treatment procedures can have limited understanding of and thus are underprepared for procedures. Underpreparedness increases peri-procedural staff time explaining procedures to patients. Increasing patient understanding, preparedness, and satisfaction increases patient-centeredness and efficiency care. The pilot project implemented two Plan-Do-Study-Act cycles to address the problem of patient preparedness for skin cancer treatment and analyzed results via a 5-point Likert Survey and qualitative interviews with coordinating nurses. The first intervention implemented a focused, paper resource given to patients at their first appointment detailing the purpose, risks, benefits, and alternatives, and follow-up of their proposed procedure. The resource was adapted in the Plan-Do-Study-Act cycle 2 to include the resource as a smart phrase integrated directly in after-visit patient instructions. Patients who received the resource had an increased understanding of every aspect of the procedure listed in the informed consent form when the interventions were implemented. The outcome measure of overall patient preparedness increased from 3.9/5+/-0.93 to 4.5/5+/-0.58. Further, nurses reported shorter length of peri-procedural and scheduling calls with patients to explain procedures and answer any remaining questions. In this quality improvement pilot, providing patients with a procedure-focused resource for educational purposes increases patient preparedness and reduced peri-procedural staff time with patients. Future expanded implementation will enable more robust statistical analyses including subgroup analyses to assess how the intervention performs for across demographic groups.