Excellence in Bariatrics

Marianne Aiello, for HealthLeaders Media , February 13, 2012
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Corrective action
The Raleigh Center for Weight Loss Surgery and Provost Bariatrics both have taken corrective measures after noticing irregularities in their outcome quality tracking reports.

Recently, Moran noticed a high number of patients requiring the use of total parenteral nutrition, given by way of IV by providers after the patient has been discharged.

"We investigated the situation and found it was ordered by a physician extender but for the wrong reasons," he says. "We educated the provider and saw our TPN numbers drop back down to a normal level."

It’s incidents like this that have taught Moran that one of the most important steps a bariatric surgeon can do to improve quality is to fully educate the patient and any follow-up care providers.

"You have to give appropriate education, whether it be accomplished with materials provided by surgeons’ offices, dietitians, providers, support groups, or even online programs; that can increase the knowledge base of the patient going into surgery," he says. "This is something bariatric surgeons didn’t do a very good job of 10 or 20 years ago."

Provost had a similar experience when he was conducting a regular review of quality measures and noticed an abnormally high blip in wound infection rates.

Upon further analysis of the data, Provost realized that the infection rate was consistent among all patient groups, indicating that the problem was systemic.

"We looked at other things that have been done to reduce infection rates, and preop cleansing before the patient even comes to hospital has been shown to be effective in cardiac surgeries," Provost says.

He and his team began providing patients with chlorhexidine scrubs to wash their abdomens before coming in for surgery. "And by doing that, we soon saw infection rates decrease," he says.

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