How They Did It
Stanford's bariatric teams launched a "readmission bundle" that included common sense care coordination, like good preoperative education, giving prescriptions in advance so patients could fill them before surgery, and explaining expectations for their stay in the hospital. Other actions included assuring same-day physician appointments, coordination with patients' families, and explaining what patients should eat and drink and what specific number they should call if they need help.
Morton relates Stanford's experience to show the benefits of quality measurement under the new Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program or MBSAQIP (don't try to pronounce it), which launched a year ago.
This week, MBSAQIP issued its first requirements for accreditation in a 60-page document. Morton was one of the writing committee's co-chairs.
Two Accreditation Programs Merge
The MBSAQIP melds two accreditation programs that had been operated separately, one by the American College of Surgeons (which accredited about 550 hospitals, and the other by the American Society for Metabolic and Bariatric Surgery, which accredited 150 hospitals. Under the new combined program, hospitals will all have a specially trained nurse reviewer, "a person outside the direct medical practice" to independently and accurately collect 100 or more patient variables abstracted manually from charts.
Lab values that give a sense of a patient's severity of illness include, comorbidities, complications, reoperations, time in the operating room during surgery, amount of blood loss, and who assisted the procedure.