Each year, as part of Brigham and Women’s Faulkner Hospital’s ongoing commitment to providing the safest, highest quality care to our patients, departments across the hospital are charged with developing and implementing their own Quality Assurance Process Improvement (QAPI) plan. This year, the 7 South team, led by Nurse Director Mary Anne Barry, MBA, BSN, RN, and Chief PA for Surgery Meaghan Klempa, MMSc, PA-C, is focused on reducing the length of stay for post-operative bariatric patients.
Reducing length of stay is a hospital-wide goal. For patients recovering from laparoscopic sleeve gastrectomy for weight loss, the goal is for them to be discharged after just one night in the hospital, which allows them to finish recovering in the comfort of their own home. “It’s so much healthier for patients to recover at home,” explains Barry. “They get more rest at home and then they can jump right into their new life and new routines and ultimately have a much better result after their surgery.”
On 7 South, the team aims to discharge 80 percent of their post-operative bariatric patients on post-op day one (the day following surgery). “When a patient comes up to the unit after their surgery, we introduce their diet, which initially is liquids. The next step is to get them out of bed. On the night of their surgery, we want them to walk a bit before bed. When the next day rolls around, they get education from our dieticians. Then, if they are medically cleared and able to tolerate enough liquids, they are able to go home that day,” says Barry.
It sounds simple, but there are many factors outside of the care team’s control that can impact a patient’s length of stay—many of them exacerbated by the COVID-19 pandemic. “We are seeing a lot of weight loss surgery patients who have been home and sedentary throughout the pandemic and just aren’t physically strong enough to go home on post-op day one,” explains Barry. “Some have had their surgery delayed because of the pandemic and are that much more deconditioned. And some have nausea that is hard to control and prevents them from drinking their shake and hydrating appropriately.”
That’s why the team has chosen to focus on the things they can control, like mobility, nutrition/hydration and controlling pain, as part of their QAPI project. “Our next step is to create some patient education materials that reinforce the information they are provided during their pre-operative visits with their surgeon. We hope it serves as a reminder about how important mobility, nutrition/hydration and pain control are in speeding recovery. We hope to follow that up with a discharge survey to measure how we’re doing,” says Barry.
To learn more about weight loss surgery and the role both patients and their care givers play in its success, click here.
Reminder! QAPI plans for 2022 are due by the end of September. If you are a department head and have not done so, please review your QAPI plan with your Senior Leader and submit the final plan to Caitlin Manca by Friday, September 30.
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