CREATION AND IMPLEMENTATION OF COVID VIDEO DISCHARGE INSTRUCTIONS FOR ADMITTED PATIENTS

ABSTRACT

STATEMENT OF PROBLEM/QUESTION Written discharge instructions about safe COVID practices may not address patients' communication needs, particularly for those with language barriers, necessitating novel means for patient education. DESCRIPTION OF PROGRAM/INTERVENTION We aimed to improve patient comprehension of safe COVID practices by creating patientcentered, language-congruent, and illustrated video discharge instructions (VDI) in English and Spanish. This effort took place in an urban, safety-net hospital, focusing on adult patients in a pilot Med-Surg unit. We assessed patient knowledge with pre- and post-intervention phone surveys. The VDI intervention was launched utilizing a pre-existing television-based patient experience platform. MEASURES OF SUCCESS We used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to evaluate our intervention's impact and sustainability R (number of patients who viewed the VDI);E (changes in knowledge post-intervention);A (number of providers displaying the VDI);I/M (longitudinal tracking to assess continued implementation). We also collected patient feedback on the discharge process and VDI. FINDINGS TO DATE Of 174 pre-intervention subjects, 107 (62%) were COVID-positive (“C+”), and 67 were COVID-negative (“C-”). Predominant preferred languages were English (44%;34 C+, 43 C-) and Spanish (47%;61 C+, 20 C-). 164 (94%) described correct masking technique, and 147 (85%) knew the CDC distancing guideline of 6 feet. Only 31 (18%) could define a close contact. There were no differences based on COVID status. Of the C+ group, 61 (57%) knew their isolation discontinuation date, and only 15 (14%) knew ≥2 of 3 CDC criteria for stopping isolation. There was no difference based on preferred language. Post-intervention surveys and patient feedback collection are ongoing. Early responses have been positive “[I] found it informative, particularly the playby-play with what COVID is and how it is spread.” KEY LESSONS FOR DISSEMINATION Our data reveal a critical knowledge gap in safe COVID practices, suggesting that standard patient discharge education is insufficient. Video, language-concordant education may address this gap. Any innovation adoption requires change management;we use Kotter's 8- Step Process for Leading Change to guide our reflections on this effort. Our project emerged due to the urgency of rising COVID infections (1). With this momentum, we identified collaborators, outlined goals, and rallied staff to execute our multi-phase initiative (2-4). The pandemic's unpredictability and variable day-to-day demands on staff volunteers led to implementation challenges (4). Moreover, fluctuating numbers of COVID cases led to a proportional fluctuation in the sense of urgency for change, impeding implementation. We addressed barriers by meeting with providers and leadership to identify avenues for easing VDI deployment (5). Initial positive responses serve as a motivating short-term win to accelerate implementation, and we solicit additional feedback to promote smooth and standardized implementation (5-7).