EP466 - Redefining Outpatient Surgical Care: Implementation and Satisfaction of a Culturally Tailored Colorectal Surgery Clinic

ePoster Presenter(s)

• PP

  Prabh R. Pannu, MD

  General Surgery Resident
  Beth Israel Deaconess Medical Center - Harvard Medical School
  Beth Israel Deaconess Medical Center
  Boston, MA, United States

  Disclosure information not submitted.

Author(s)

• 

  Pia Canal Zarate, MD (she/her/hers)

  Research fellow
  Bieth Israel Deaconess Medical Center
  Boston, MA, United States

  Disclosure information not submitted.
• DF

  Deric J. Fernandez, n/a

  Undergraduate Student
  Beth Israel Deaconess Medical Center
  Randolph, Massachusetts, United States

  Disclosure information not submitted.
• 

  Alexander A. Xu, MD, MS (he/him/his)

  Fellow
  Beth Israel Deaconess Medical Center
  Boston, MA, United States

  Disclosure information not submitted.
• DW

  Daniel Wong, MD MHS

  Assistant Professor
  Beth Israel Deaconess Medical Center, Harvard Medical School
  Boston, Massachusetts, United States

  Disclosure information not submitted.
• KC

  Kristen Crowell, MD

  Assistant Professor
  Beth Israel Deaconess Medical Center, Harvard Medical School
  Harvard Medical School
  Boston, MA, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• TC

  Thomas E. Cataldo, MD

  Assistant Prof of SUrgery
  Harvard Medical School
  Boston, Massachusetts, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• 

  Evangelos Messaris, MD

  Division Chief
  Beth Israel Deaconess Medical Center - Harvard Medical School
  Boston, Massachusetts, United States

  Disclosure information not submitted.

Senior Author(s)

• 

  Ana Sofia Ore, MD MSc MPH (she/her/hers)

  Colon & Rectal Surgery Fellow
  Mayo Clinic Rochester
  Mayo Clinic - Rochester
  Rochester, Minnesota, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: The necessity of providing culturally tailored care for surgical patients to improve patient satisfaction and ensure equitable care can't be overstated, especially for at-risk groups such as patients with limited English proficiency (LEP). The objective of this study was to evaluate the 2-year implementation of a culturally tailored Latinx Colorectal Surgery clinic and evaluate patient satisfaction.

Methods/Interventions: The Latinx Colorectal Surgery Clinic was established as a monthly clinic in a Northeastern hospital staffed by a multidisciplinary team, including bilingual Spanish-certified patient navigators, nurses, surgical trainees, and trained interpreters supporting non-Spanish-speaking colorectal surgeons. All adult patients (>18 years) who primarily spoke Spanish and required colorectal surgical care were offered appointments. Patient instructions were tailored in real time to individual health literacy levels with the support of AI-based tools. Patient demographics collected included self-reported ethnicity, primary language and highest level of education completed. The Newest Vital Signs (NVS) test was utilized to evaluate patients' health literacy with scores (0-6) correlating a high likelihood limited (0-1), possible limited (2-3) or adequate (4-6) level of health literacy. The Patient Satisfaction Questionnaire Short Form (PSQ-18) was administered via telephone at 1-2 weeks following the clinic visit to evaluate patient reported satisfaction outcomes.

Results/Outcomes: A total of 92 patients, some with multiple patients visits participated in the Latinx Colorectal Surgery Clinic. Study cohort included patients from over 12 different countries, with Spanish as primary language for 92.5% patients. 76.1% patients presented for assessment of benign anorectal diseases (hemorrhoids, fistulas, fissures) followed by 20% for benign abdominal processes (diverticulitis, IBD) and remainder 4% for colorectal cancers. Utilizing NVS scoring, only 12% patients demonstrated adequate health literacy. There was a significant association between adequate health literacy and level of education (χ² 18.5, p< 0.001) Notably, 92% patients reported feeling more comfortable receiving care in Spanish. Patient satisfaction was evaluated using PSQ-18 survey with high overall general satisfaction (4.3) for the clinic. Communication (4.3), interpersonal manner (4.1) and technical quality (4.2) were among the highest scored patient satisfaction categories. Interestingly, a significant association was seen between patients with low healthy literacy (low NVS scores) and high patient satisfaction (χ² 4.7 p< 0.001).

Conclusion/Discussion: This study demonstrates the implementation and feasibility of a culturally tailored colorectal surgery clinic with high patient satisfaction. This model provides the framework to establish a comprehensive, sustainable and culturally tailored clinic model for surgical patients, taking into consideration their health literacy, cultural beliefs and language preferences, with the potential for broad implementation across different cultures and practice models including multidisciplinary cancer care.

Redefining Outpatient Surgical Care: Implementation and Satisfaction of a Culturally Tailored Colorectal Surgery Clinic