Weight Loss Surgery at Kettering Medical Center-Sycamore Miamisburg Ohio

| March 25, 2007

 

TELL US ABOUT THE ROLES AND RESPONSIBILITIES OF THE STAFF AT YOUR FACILITY.

Our program, which is a designated ASBS Center of Excellence, has many members that provide care to each patient participating in the program. The program staff works closely with physician office staff. Chris Sexton, BSN, RN, is the program manager; she coordinates the elements for the Weight Loss Surgery team. John Wade, PhD, is the program’s psychologist. He provides psychological support pre and postoperatively. Hilary Cooper is the program office coordinator. Heather Van Pelt and Tavien Feaster are the program’s exercise physiologists. Ann Hunt, RN, MS, Ed, is the educational RN and provides all pre and postoperative patient education. Tamara Johnson, Dawn Noe, and Kristin Flohre are the dietitians, and provide patients with pre and postoperative education. She provides psychological support preoperatively and postoperatively.

WHAT IS THE SIZE OF YOUR FACILITY? WHAT DOES IT PHYSICALLY ENCOMPASS?

Kettering Medical Center–Sycamore is a 176-bed acute care hospital full service campus with the following: Emergency room department (35,000 visits per year), eight operating room suites that are currently under construction to expand and provide integrated, minimally invasive surgical suites, 34 bariatric beds located on a specialty bariatric unit, inpatient/outpatient services, and imaging services tailored to service bariatric patients.

HOW MANY MEMBERS DO YOU HAVE ON STAFF? WHAT ARE THEIR ROLES?

Weight Loss Surgery and Kettering Bariatrics staff are composed of 13 staff members. Dr. Schumacher heads up Kettering Bariatrics at Kettering Medical Center with six staff members, and Chris Sexton is the manager of Weight Loss Surgery at Kettering-Sycamore, composed of nine staff members. Both divisions work closely together to provide quality and seamless care to our bariatric patients. Both staff rely on each other to provide each step necessary to maintain the standard of care that both Kettering Bariatrics and Weight Loss Surgery demand for each patient. Here is a rundown of our staff:

    • David L Schumacher, MD—Medical Director/ Bariatric Surgeon
    • Chris Sexton, RN, BSN—Bariatric Program Manager
    • Ann Hunt, RN, MS, Ed—Bariatric Program Educator
    • Heather Van Pelt—Exercise Physiologist
    • Tavien Feaster—Exercise Physiologist
    • Hilary Cooper—Bariatric Office
      Coordinator
    • Tamara Johnson—Dietitian
    • Kristin Flohre—Dietitian
    • Dawn Noe—Dietitian
    • Jerrod Grogg PA—Physician
      Assistant to Dr Schumacher
    • Mary Steele—Certified Medical Assistant (CMA)
    • Nicole Crase—Office Receptionist
    • Nancy Winfrey—Office Manager
    • Mehul Trivedi M.D—Bariatric Surgeon
    • John Wade, PhD—Psychologist.

HOW IS YOUR FACILITY MANAGED, AND BY WHOM?

Our facility is part of a five-hospital network that falls under one Chief Executive Officer. The network is divided into two sides, and encompasses two osteopathic hospitals that report to one president and our hospital (Kettering Medical Center-Sycamore) plus two other allopathic hospitals that report to our president, Fred Manchur. Kettering Medical Center-Sycamore’s campus leadership is provided by senior executive officer Richard Haas; patient care falls under administrative director Chris Turner; and governance is overseen by chief nursing officer of Kettering Medical Center, Brenda Kuhn.

PLEASE GIVE A GENERAL SYNOPSIS OF PATIENT TREATMENT AT YOUR CENTER.

Each patient attends an educational session preoperatively. Then the patient proceeds to meet with the dietitian, exercise physiologist, and psychologist. The patient also meets with the surgeon for review of history and a physical. The patient goes to the hospital for his or her preadmission testing. The patient then attends a three-hour educational session with the educational RN. Postoperatively, the patient meets with the dietitian at six weeks, 12 weeks, and six months. The exercise physiologist meets with the patient six weeks postoperatively and six months postoperatively. All program staff are available to the patient for a lifetime. The patient must make a commitment to follow up with the surgeon and the program prior to being approved for surgery.

WHAT ARE SOME OF THE NEW EQUIPMENT, DEVICES, AND PRODUCTS YOU UTILIZE?

Kettering Medical Center-Sycamore has two state-of-the-art endosuites for our laparoscopic bariatric procedures. These include Bercholdt ceiling suspended units, suspended HD LCD screens, and Hercules beds, which elevate to 30 degrees and hold 1,000 pounds. Our physicians are currently involved in the evaluation of the On-Q pain bulb with bilateral subcostal placement for postoperative pain relief.

HOW IS SCHEDULING HANDLED AT YOUR CENTER?

Procedures are scheduled through Central Scheduling at Kettering Medical Center (our largest hospital in our network). We are converting to PICIS, a new software package, to enhance scheduling for the network. Time in the operating room is allocated based on historical usage by the physician, and block time is adjusted quarterly. Turnover and on-time start is monitored monthly; the surgeon will maintain his or her block time according to timeliness and turnover time. This data is reviewed with an affected surgeon on a regular basis. Each surgeon is given this information on a monthly basis.

HOW HAS MANAGED CARE AFFECTED YOUR FACILITY AND THE CARE THAT IT PROVIDES PATIENTS?

The driving force of managed care is to reduce healthcare costs for Medicare and commercial insurance companies. This means lower reimbursements to hospitals. It has forced a reduction in the average length of stay of inpatients and switched many hospital visits to an outpatient setting. This has resulted in higher acuity on our nursing units.

Managed care has created compliancy issues that require additional focus on patient stays. In addition to compliance issues, many procedures and tests require pre-certification or notification before treatment, resulting in payers denying payment if all the complex rules are not followed. Managed care contracts for commercial payers are becoming more and more complex. Rates are only a small portion of the contract negotiation.

Reduction in physician reimbursement has also affected how we do business. There are fewer doctors to fill physician vacancies. Physician recruitment is often difficult and can be very expensive.

HOW DOES YOUR FACILITY DEAL WITH THE ISSUE OF PATIENT SAFETY AND STAFF SAFETY?

Safety of our patients and staff is of primary importance to Kettering Medical Center-Sycamore. We have fostered a “no-blame culture” for error reporting. We voluntarily participate in the Centers for Medicare and Medicaid Services’ demonstration project for quality and in the Institute for Healthcare Improvement’s (IHI) 100,000 Lives Campaign, and have an active patient safety committee to evaluate patient outcomes, risks, and interventions. We also follow strict protocols for lifts and transfers of patients.

PLEASE DESCRIBE YOUR PATIENT EDUCATION PROGRAM.

Patient education begins with a three-hour educational session upon entering the program, in which the patient meets with each discipline of the program preoperatively. We implement postoperative follow-up with all disciplines. The patient also receives a manual written by the program staff and surgeon emphasizing the education the patient has received throughout the preoperative process. The patient has complete access to the program staff pre and postoperatively for any questions or needs. We hold a monthly bariatric support group, lead by our program manager and psychologist, to encourage compliance, follow-up, and ongoing patient education.

HOW MANY PATIENTS DO YOU TREAT ANNUALLY?

* Females Males Avg Age *Admit date is between October 1, 2005 and September 30, 2006.
Inpatient 6,222 4,150 64
% Male/Female 60% 40%  
Bariatric 365 108 47
% Male/Female 77% 23%  
Outpatient 78,569 55,349 51
% Male/Female 59% 41%  
Total 84,791 59,499 52
% Male/Female 59% 41%  

The table above illustrates our patient statistics.

WHAT LONG-TERM FOLLOW-UP MEASURES ARE PRACTICED AT YOUR FACILITY?

We have in place a five-year minimum follow-up plan for all bariatric patients. Our goal is a lifetime of follow-up for each patient. We use the tracking system Exemplo as our bariatric database. This database supports our efforts to ensure that no patients fall through the cracks.

WHAT QUALITY CONTROL ASSURANCE MEASURES ARE PRACTICED IN YOUR FACILITY?

Kettering Medical Center-Sycamore tracks infection rates, return to surgery, leaks, DVTs, pneumonias, unplanned re-admits within 30 days, ICU days, and deaths. This is done through our Exemplo bariatric database, and information is reported to the hospital’s Quality Committee and Weight Loss Surgery’s medical director’s.

WHAT TRENDS DO YOU SEE EMERGING?

We see a significant trend in the number of laparoscopic adjustable gastric bands being performed in ambulatory centers. Patients’ BMIs are increasing at an alarming rate. We believe the use of laparoscopic gastric sleeves will accelerate as both a staging procedure and a primary procedure. Our surgeons perform intraoperative endoscopies on all of our patients. We would like to see the practice adopted routinely by others in an attempt to limit postoperative complications.

WHAT MAKES YOUR FACILITY UNIQUE?

We are one of five ASBS Centers of Excellence for bariatric surgery in Ohio. We provide a full-service bariatric program with a dedicated bariatric unit and staff. We also have a bariatric surgical team with state-of-the-art minimally invasive operating room suites. Kettering Medical Center-Sycamore has been awarded the JD Power Award three years in a row for “Outstanding Patient Experience.”

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Category: Bariatric Center Spotlight, Past Articles

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