Improving Preoperative Education for Patients Receiving Thumb Basal Joint Arthritis Surgery: A Quality Improvement Project

Abstract

Basal thumb joint arthritis is a disabling, loss of function to the afflicted hand resulting in weakness in grasping and holding. Patients preparing for surgery aim to improve function and current practice is to provide verbal postoperative self-care information to the patient by the surgeon at the orthopedic hand clinic in Northern California. Hand therapy and orthopedic hand surgery collaborated to develop postoperative self-care management videos and handouts for patients in an effort to improve postoperative expectations, satisfaction, and self-care confidence. The videos have been available for a year and only one patient has provided feedback to hand therapists. The quality improvement project aimed to improve preoperative education by 75% in four-weeks after implementation of the video and handout. The quality improvement project integrated the Institute of Medicine’s (IOM, 2001) six aims for improving healthcare and utilized The Model for Improvement with the four-stage cycle to test a change (IHI, 2018, API, 2018). Data revealed barriers to implementation of the video during a thirty-minute focus group session with the quality improvement team. The quality improvement team selected dissemination of the video and handout to patients scheduled for basal thumb surgery. Data extracted at the end of four-weeks was completed according to Safe Harbor method. One Plan Do Study Act (PDSA) test cycle was completed. Significant barriers to the project include inaccessible videos and inadequate patient engagement to view the videos pre-operatively. However, stakeholders are dedicated to promoting the self-care videos and plan to implement the educational material at a surgery center for the next PDSA cycle.