499-P: Optimizing Diabetes Education before Total Pancreatectomy with Islet Cell Autotransplantation (TPIAT)

Abstract

Background: Caregivers of pediatric recipients of a TPIAT must receive extensive education prior to discharge home. Retrospective review found caregivers were often surprised by the amount of education required and were not prepared to learn while their child was recovering from surgery. Expectations of preparedness were not uniformly reinforced with caregivers, despite available resources. We aimed to provide caregivers with comprehensive education pre-surgery in line with programmatic goals to reduce the inpatient length of stay (LOS) post-TPIAT. Method: We reviewed education time and days for 17 pre-intervention patients (September 2019-August 2020) , and 20 post-intervention patients (August 2020-October 2021) . Diabetes education time was consistently documented in the chart and represented the largest proportion of education needed prior to discharge. Pre-intervention patients received a printed binder of diabetes education and met with diabetes educators at least once in the 6 months prior to surgery. Post-intervention patients received an email with digital links to the timeline and expectations of pre-surgery education, modules for education on diabetes, medication administration, and feeding tube care, and received follow-up phone calls. The intervention was developed using the Plan-Do-Study-Act (PDSA) model of improvement. Results: Prior to the intervention, patients averaged 7minutes of inpatient education spread over an average of 6.4 days. After implementation, patients averaged 575 minutes spread over 4.7 days. There was no cost associated with the development of the intervention. Conclusion: We created our intervention in response to the goal of reducing LOS and adapted it to the low-resource and staffing constraints of a pandemic. We generated a free, sustainable tool that used existing resources. Though our project is ongoing, we are encouraged that inpatient education has been reduced from 7to 575 minutes and from 6.4 to 4.7 days. Disclosure R.E.Ellison: Other Relationship; AbbVie Inc. S.E.Tellez: None.