Another bariatric excellence award for Fresno Heart & Surgical

In the three years since its inception, Fresno Heart & Surgical Hospital’s bariatric surgery program has received 5-star (or top) ratings from HealthGrades® and been designated as a center of surgery excellence by insurers Blue Cross, Blue Shield, Aetna and Health Net. But the biggest honor yet is the recent mark of approval from the American Society for Metabolic and Bariatric Surgery (ASMBS), said Dr. Kelvin Higa, the program’s medical director.

“When you get an ASMBS designation as a Center of Excellence, you can be assured that this is not just a program, this is a whole hospital that is dedicated to bariatric patients,” Dr. Higa said. “You have to have surgeons with experience and expertise and a hospital facility and hospital staff that’s dedicated to support the service.”

Wanda Holderman, the hospital’s chief executive officer, called the ASMBS recognition a “remarkable achievement.” She said, “This was a result of devoted, compassionate and motivated staff and affiliated physicians. To obtain and maintain this distinction is a tribute and reflects excellent performance, quality outcomes, detailed data collection and reporting, and an adherence to strict protocols and clinical pathways. It has raised the bar to continually dedicate energy and focus to the bariatric program at Fresno Heart & Surgical.”

Dr. Keith Boone, the hospital’s medical director and a bariatric surgeon, said Fresno Heart & Surgical had been working three to four years toward this achievement. “We had to get Joint accreditation first and then put in 24-hour hospitalist care. And there was a tremendous amount of education for staff. We’ve been doing excellent quality work for 10 years and that’s been recognized by the public and referring physicians in town and also by HealthGrades … But this is definitely a feather in our cap.”

Unlike other ratings organizations that look at just surgical outcomes or infection/complication rates, Drs. Higa and Boone said, ASMBS is also looking for hospitals with specialized equipment designed for larger patients and for all hospital personnel to receive ongoing and specialized education plus sensitivity training.

The metabolic and bariatric society explained its criteria: “Psychosocial challenges and the uncontrolled complications of morbid obesity require highly competent and compassionate support. Furniture, hospital equipment, instruments and imaging resources must be suitable to deal with patients who often exceed their ideal body weight by 100 pounds. Especially important is a well-trained staff, capable of dealing with the physical and emotional demands of the morbidly obese.”

Robin Ryder, registered nurse, bariatric program coordinator at Fresno Heart & Surgical, said it was a challenge to include all staff, no matter where they worked or what patients they normally saw. “Education was the largest piece of getting this designation and probably the most exciting piece,” Ryder said. “We wanted everyone to understand what needs to happen from the time a patient makes that first phone call, to the first time they walk into our facility, through surgery, discharge, to a year later and then to the patient’s whole life afterwards.”

ASMBS also scrutinizes the patient experience, but Ryder said this was an area where Fresno Heart & Surgical already excelled. “We have exceptional customer service throughout the whole facility and it’s just the way the whole hospital has been designed,” she said. “That was the easy part for us. That's the hospital-wide culture here.”

Dr. Higa said while such Center of Excellence designations reassure patients of top care, Fresno Heart & Surgical’s collaboration with ASMBS elevates care for patients nationally by sharing data on what improves the procedure and the recovery process. “It’s the whole idea that we’re making surgery safer, more effective and more cost-effective for patients and improving it for all,” Dr. Higa said.

This story was reported by Erin Kennedy. She can be reached at ekennedy@communitymedical.org.

Monday, November 09, 2009