Christiana Care Health System (CCHS) is a multisite health system providing care to a catchment area of 1.5 million people. CCHS has 43,000 inpatient discharges, 6500 births, and 114,000 Emergency Department visits annually. Using a FOCUS plan-do-check-act (PDCA) model on the patient education process, a program was developed to improve patient satisfaction and knowledge in three distinct patient groups. The patient groups were selected because they were high volume and/or high risk for complications and in response to unfavorable patient satisfaction data in these groups. Since a large and diverse group of staff-nurses was providing patient education at many sites, the program focused on standardizing the knowledge of staff-nurses regarding patient education and reducing variation in the patient education process. As a result of this program, performance improvements have been made in staff-nurse knowledge, patient knowledge and patient satisfaction.