Staff education reduces risk of bariatric surgery
In addition to clinical steps necessary to ensure a safe experience for patients electing to undergo outpatient bariatric surgery, it is essential that same-day surgery managers look at staff education, environment, and program marketing to minimize the risk of dissatisfied patients.
"This group of patients are very Internet-savvy and will use chat rooms and public notice boards to express their satisfaction or dissatisfaction with a facility’s service," says Brad M. Watkins, MD, a bariatric surgeon at Northwest Weight Loss Surgery in Kirkland, WA. Because bariatric surgery primarily is self-referral, it is important to establish a reputation as a caring, effective program that produces good results, he says.
One way to establish this reputation is sensitivity training for all staff members, he suggests. "The majority of bariatric surgery patients feel isolated and don’t like being in situations that increase that feeling of isolation," Watkins says. Remove barriers such as counters and desks between the doctor and the patient to establish a more open communication, he adds.
Don’t forget that a patient also may have obese family members who need a comfortable environment in the waiting room, Watkins notes. Avoid chairs with arms, low or soft couches, or other furniture that makes it difficult for them to be comfortable, he suggests.
In addition to training all staff members to be aware of patients’ needs, it is a good idea to appoint one person as bariatric surgery coordinator, recommends Carol Burkhardt, RN, MS, CNP, consultant with the AIG Healthcare Management Division of AIG Consultants in Chicago.
A coordinator can tie all of the different pieces of the program together to ensure that proper pre-op assessments and tests are completed and that all members of the surgery team have communicated with each other, she says. A coordinator also can serve as a resource to all areas of the same-day surgery program, such as the postoperative care unit and pre-admission, when there are questions related to specific needs of a bariatric patient, she adds. For clinical training of nurses, take advantage of some of the home study courses offered by the Association of periOperative Registered Nurses, she suggests.
Be sure you address informed consent early in the process and be prepared to address it throughout the entire process, Burkhardt notes. "While the physician should obtain informed consent prior to surgery, be prepared for questions from the patient that indicate that they may not be fully aware of all risks," she points out.
Be sure the surgeon and anesthesiologist are available and ready to answer questions before the patient goes into surgery, Burkhardt says.
"Your marketing materials should be evaluated carefully because you don’t want to set the stage for unrealistic expectations," she adds. Using terms such as "band-aid surgery" and "minimally invasive" may imply that a lap band procedure has a low level of risk, Burkhardt says. "There are still risks with the surgery, and you need to make sure that you don’t minimize those risks," she adds.
The biggest complaint about bariatric surgery programs is that the program does not offer long-term support that is described in the marketing materials, Burkhardt notes. "If you say that you offer support, be sure to offer it because bariatric patients need follow-up support and dietary support and education to ensure weight loss and good outcomes," she says.
Watkins doesn’t require that his patients attend support groups following surgery, but he strongly encourages it. The group meetings are made fun by keeping them educational and entertaining with speakers or presentations, he says. "We also offer on-line support with message boards that enable patients to offer peer support and encouragement to each other," Watkins adds.
He points out that if you plan your program properly and you select your patients carefully, an outpatient bariatric program can be very rewarding. These are patients who have spent as much as a year researching the procedure and coming to the decision to have the surgery, Watkins says. While a gallbladder patient doesn’t want to be undergoing surgery, a bariatric patient wants to be in the operating room, he says.
"They are ready for the surgery and receptive to instructions on how to improve outcomes," Watkins adds. "It is intensively rewarding to see them change their lives for the better."
In addition to clinical steps necessary to ensure a safe experience for patients electing to undergo outpatient bariatric surgery, it is essential that same-day surgery managers look at staff education, environment, and program marketing to minimize the risk of dissatisfied patients.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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