UC Irvine

Purpose: To improve comprehension and self-efficacy about post-operative care in older adult patients after their Mohs surgery, using multi-faceted education tailored to the individual. Methods: This quality improvement project used a pre- and post-intervention design, following the guidance of the Johns Hopkins EBP Model. The intervention consisted of revised written instructions tailored to the learning needs of older adults, an educational video, electronic health portal access to all materials for home review, and involvement of caregivers in teaching—in addition to standard verbal instruction. Written materials were refined iteratively with provider and clinical team input. A 10-item paper survey assessing knowledge and self-efficacy was administered at the post-operative visit. Primary outcomes consisted of patient knowledge and self-efficacy about post-operative care after Mohs surgery. Secondary outcomes assessed patient preference for educational method, material readability, and clinical team adoption of the intervention. Outcomes from a pre-intervention group were compared with those from a post-intervention group surveyed three weeks after implementation, using descriptive and inferential statistics. Results: Mean knowledge scores increased by approximately 8% following the intervention, although the difference was not statistically significant. Median self-efficacy and readability ratings remained high and unchanged, with identical medians and percentile ranges across groups. Preference for written and verbal instruction were greatest after implementation, highlighting the critical role of verbal instruction in guiding supplemental material use. Clinical team and provider engagement in design and the iterative revision of materials enhanced intervention fidelity and sustainability. Conclusion: A multi-faceted, tailored approach to education of older adults is a feasible, cost-effective strategy to improve post-operative understanding among older adults undergoing Mohs surgery. Continued refinement of materials and evaluation may further improve outcomes.