Developing a comprehensive bariatric protocol: a template for improving patient care.
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Bariatrics↗
Biomedical subjects
Fran Bartholomeaux
Publications and source records attributed to Fran Bartholomeaux.
Criteria-based protocols and the obese patient: planning care for a high-risk population.
The prevalence of obesity in the United States continues to increase. Well-recognized obesity-related health problems pose many challenges in the acute care facility. These challenges include not only physical barriers and complications, but also concern for the well-being of caregivers. Despite these problems, little pre-planning of resources occurs. Barriers to bariatric protocol development are discussed, and strategies for overcoming these barriers with attention to preventing caregiver injury, optimizing patient care, and limiting associated costs are reviewed. A description of an interdisciplinary criteria-based bariatric protocol is included. With adequate and appropriate pre-planning, the challenge of providing bariatric care can be met.
Clinical Protocols↗
Rapid process redesign in a university-based emergency department: decreasing waiting time intervals and improving patient satisfaction.
Academic emergency departments are traditionally associated with inefficiency and long waits. The academic medical model presents unique barriers to system changes. Several non-university-based EDs have undertaken process redesign, with significant decreases in patient waiting time intervals. This is the presentation of a rapid process redesign in a university-based ED to reduce waiting time intervals. We present the application of a process-improvement team approach to evaluate and redesign patient flow. As a result of this effort, the median waiting room time interval (triage to patient room) decreased from 31 minutes in January 1998 to 4 minutes in July 1998. ED throughput times also decreased, from 4 hours, 21 minutes in January 1998 to 2 hours, 55 minutes in July 1998. Urgent care waiting room time intervals decreased from 52 minutes to 7 minutes and throughput times from 2 hours, 9 minutes to 1 hour, 10 minutes. Patient satisfaction evaluations by an independent institute demonstrated dramatic improvement and establishment of a new benchmark for academic EDs. Process redesign is possible in a busy, complex, tertiary-care ED, with decreases in waiting time intervals and improvement in patient satisfaction. Major sustained support from top-level hospital administrators and physician leadership are fundamental prerequisites. With these in place, a process improvement team approach for evaluating and redesigning the patient care system can be successful.
Academic Medical Centers↗