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Bariatric Friendly Hospital Initiative

Caring for patients with obesity in the hospital setting

Background

Bariatrics is the branch of medicine that deals with the study and treatment of obesity. Bariatric care encompasses all aspects of the healthcare of individuals living with obesity. As of October 2015, the Canadian Medical Association classifies obesity as a chronic disease.

The continuing rise in obesity is a global health issue. Approximately 28% of adult Albertans have obesity. Patients living with obesity coming into health care settings are at significantly higher risk for complications arising from skin conditions and injury, due to inadequate facility design, equipment, or lack of staff competencies in their care. Many health care providers lack the knowledge of the complex nature and causes of obesity; and believe that if a person exercises more and eats less, they can lose weight (which is not true). Weight bias generally refers to negative attitudes toward a person because he or she has obesity.

Marty Enokson is a patient advisor. Listen to his perspective on living with obesity, and the biases he has encountered. Watch the video – Living with obesity and biases  3 minute clip | full length.

The Initiative

The Bariatric Friendly Hospital Initiative   focuses on implementing standards and guidelines for a bariatric friendly care hospital environment within AHS facilities, in alignment with AHS Patient First and Our People Strategies.

This initiative will support health care providers to become more knowledgeable about the complexity of obesity, and to be aware of their own personable biases and how they may be impacting patient care. It supports them to develop competencies in safe patient handling, as well as the unique care needs of patients with obesity, and to work effectively and compassionately with this patient population. It focuses on timely access to proper equipment to safely manage lifting and transferring patients with bariatric care needs.

This quality improvement initiative is being led by the DON SCN, in collaboration with South Zone leadership, Dr. Mary Forhan, Faculty of Rehabilitation Medicine, University of Alberta, and Obesity Canada .It will take Dr. Forhan’s key research findings, and implement these into clinical practice.For more information about the University of Alberta bariatric care and rehabilitation research group (BCRRG), contact Dr. Mary Forhan, forhan@ualberta.ca  or visit BCRRG.

The Goal

To improve and standardize how patients with obesity are cared for in Alberta’s hospitals. Medicine Hat Regional Hospital is the initial demonstration site.

Provincial working groups have identified and agreed upon seven standards in the following four areas:

  • Health Provider Professional Competency
    Education to support healthcare providers to become more knowledgeable about obesity and work effectively and compassionately with patients with obesity, including:
    • Obesity as a complex chronic health condition with many causes and contributing factors.
    • Weight bias and its impact on health and access to care.
    • Unique care needs of patients with obesity
  • Patient and Provider Safety - Safe patient handling
    Ensuring that staff have the timely access to proper equipment to safely manage lifting and transferring patients with bariatric care needs. The DON SCN is partnering with Workplace Health as well as Patient Safety.
  • Transitions in Care
    Identification of important information to share when patients with bariatric care needs are transferred between departments in the hospital. (eg. when going for an x-ray or physiotherapy)
  • Data, Evaluation and Monitoring
    Building a data infrastructure and identifying required electronic metrics to support patients in hospital, and also our healthcare system to care for patients with obesity.

This initiative is not focused on treatment interventions for obesity, and therefore weight loss interventions are not included as a "bariatric care need".

For more information about the bariatric friendly hospital initiative email diabetesobesitynutrition.scn@ahs.ca

Additional Learning

Weight Bias

Negative attitudes toward a person because he or she has obesity can be manifested in different ways, leading to prejudice and discrimination. Patients experience weight bias resulting in avoiding accessing healthcare services.

Weight bias prevents healthcare providers from delivering optimal care, and increases patient risk for psychological distress and delays patients in seeking appropriate screening/ treatment.

Webinar: Weight Bias. What is it, and is it impacting your practice?

Complex Nature of Obesity and Weight Loss

TED talk: How to Lose 50 Pounds and Keep Them Off  (YouTube)