Hospitals Upgrade Equipment to Better Treat Obese Patients

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We often discuss the impact that high-obesity rates are having on hospitals and their budgets and quality scores. However, an article by Shari Rudavsky in The Indianapolis Star focuses on another area in which these rates are affecting hospitals—equipment.

“Hospitals are getting super-sized,” Rudavsky reports. Everything from waiting-room chairs to wheelchairs, beds, doorways, and toilets are being upgraded and reinforced to support the excess weight that many patients are bringing with them.

In fact, Novation found out in its annual report on the costs of bariatric care that hospitals are spending upwards of $5 million on these updates and more than 33 percent of U.S. hospitals are investing in upgrades for the purpose of treating obese patients.

These numbers have seen a steady increase over the past four years.

The last thing hospitals and healthcare facilities want to do is turn away obese patients. It’s a conversation that is incredibly hard to have, hospital executives say. This trend in upgrading equipment to better treat obese patients can be traced back about 10 years, Rudavsky writes, “when bariatric surgery took off in popularity and the American public began ballooning in weight.” In an interesting plot twist, the equipment used in bariatric surgery has proven itself useful for treating the general needs of obese patients.

According to Rudavsky, “Vein viewers can locate veins in patients whose fat obscures their vascular access; they’re also useful in patients with difficult-to-find veins. Scanners need wide enough holes and strong enough tables to accommodate larger patients; patients with claustrophobia may also appreciate them.” Furthermore, she adds, doctors will use longer needles for thicker arms and “special surgical equipment that let the surgeon reach deeper inside a patient’s abdominal cavity.”

Still, just how bad is this obesity rate among patients?  Using a local hospital as an example, Rudavsky writes that St. Vincent Indianapolis’ Dr. Hubert Fornalik encounters an average BMI of 38 from his patients when normal BMI should be 18.5 to 24.9. One of his patients includes a 5-foot-2-inch patient with an 83 BMI, weighing more than 400 pounds. In fact, 30 percent of Indiana’s population suffers from obesity.

On top of making these equipment changes, the manner in which these changes are made is a delicate matter. Most of the equipment, like the waiting-room furniture, “should blend into the environment.” As one hospital administrative director told Rudavsky, “You don’t want to say, ‘Hey go get the big wheelchair for this patient.’ We want to do everything to make sure that they are not identified as an obese patient through their whole journey.”

To avoid discrimination, some organizations are asking the vital question, “If a thin person came in with these issues, what kind of treatment would you recommend?”

This topic seems unlikely to go away, especially as obesity continues to spread throughout generations. How do you and your organization care for obese patients? Have you had to make any equipment upgrades? Have you ever had to turn an obese patient away for treatment because of their obesity?

-by Pete Fernbaugh

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Fred Benjamin February 4, 2014 at 12:57 pm

Thank you Mr. Fernbaugh and Ms. Rudevsky for highlighting this issue. As the COO of a regional chain of Skilled Care and Assisted Living facilities I can tell you that we are also dealing with the implications of the Obesity epidemic. Additional issues that we encounter include the need for more lifts to assist staff in moving and transferring larger patients from bed to wheelchair or to toilet. Sometimes patient room doorways have to be enlarged to accommodate larger beds. Further, these patients may be at increased risk for skin breakdown and therefore the staffing and supply costs associated with providing care for these individuals can be dramatically higher than for non-obese people. In this highly cost sensitive era, where healthcare providers are often required to provide services for fixed fees that many times do not cover actual costs, this issue will become increasingly prominent in the news.

Thanks again for this excellent article.


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