Caring Across Cultures: Patient Education in Antigua, Guatemala

On each mission trip, we focus on delivering the same care experience for our Guatemalan patients as we do for those at home.

That experience, which often begins months ahead of a patients’ surgical date at home and ends roughly 90 days after surgery, is condensed into just a week of in-person care and a few months of remote touchpoints, facilitated by our medical and surgical counterparts, email, and WhatsApp.

To that end, the team now brings at least five translators on each trip and has a network of local and international students from which to draw to provide a cultural and clinical exchange.

The time in person is the most valuable, not only for patients and their families, but also for our host counterparts to learn and model our clinical orders, behaviors, and education instructions. 

Taking lessons learned from patients at home, we began to focus on how to best prepare patients for surgery.  This began with modeling the same pathway that patients undergo at home--preoperative blood work, history and physical, and education about what to expect and how to prepare.

After developing bilingual order sets, history and physicals, and pre-operative physical therapy materials, our clinical counterparts in Guatemala took control of performing history and physicals and some education prior to our arrival.

During the screening clinic, which is our first touchpoint with patients and only a day or two prior to their surgery, our team reinforced the instructions and further explained why hydration and doing “pre-hab” exercises, for example, are so critical to success postoperatively.  

For the past three years, the team has worked alongside our host team to enhance protocols, instructions, proper use of assisted devices, and other tools rarely used in a country where local doctors report only 100 to 200 total joint replacement surgeries are performed annually. A culturally sensitive, collaborative approach to the teaching experience has led to an improved patient experience, fewer postoperative complications, and a community of happy patients and those who support and care for them.

As we were able to anticipate and overcome barriers more quickly, a key to successfully creating the same patient experience in Pittsburgh and Guatemala was still a major pain point--translators who possessed the cultural sensitivity and clinical knowledge to deliver what would be a 120-plus day patient education pathway in a little over a week.

With an international care team of support, patients can leave the hospital and continue their lives with a renewed outlook and mobility. Year-round collaboration with the Guatemalan hospital team reinforces to patients that they are supported in their recovery process and are never alone.