AAMHP

Background
Staff members experience with bariatric patients presenting to hospital is identified within their own departments and work roles. The commonality of issues and needs related to patient handling and transfers are not readily identified across the hospital.

Study design and methods
This qualitative action research study used staff interviews, patient journey mapping, and patient feedback interviews. Rural Australian experience in a single facility is compared with the five generic risks categories in bariatric patient pathways of the British study by Hignett etal (2007)1. Essomenic Patient Journey Modelling software for health care settings by Curry (2010)2 was used to analyse processes, with focus group input for proposed changes and an improved model of service delivery.
 

Results
Content analysis of six key staff interview transcripts and the patient journey modelling of four inpatient pathways identified obstacles across the five generic risk categories of equipment/patient factors/building and design/communication/organisational factors. A report of 12 key recommendations in action plan format and a proposed bariatric patient model was provided to the health facility.
 

Discussion
Recommendations include improving communication through advanced notice and patient alerts, reporting of bariatric patient issues and incidents; providing resources to support management of bariatric patients and training in consistent safe patient handling techniques. A range of improvements in equipment were identified including the need for visible Safe Working Load. The research demonstrated obstacles to safety with bariatric patients who are normally independently mobile.
 

Conclusion
It is beneficial for health facilities to identify their own specific obstacles regarding patient handling safety with bariatric patients to see what happens across the journey and facilitate targeted intervention strategies. The research also demonstrates Essomenic Patient Journey Modelling as a useful tool for diagrammatical analysis of patient journeys and generating an improved model of care.