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Hospitals equip to handle obese@

Published on NewsOK Modified: August 27, 2014 at 5:16 pm •  Published: August 27, 2014
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By Jodie Tillman

c.2014 Tampa Bay Times@

TAMPA — When St. Joseph's Hospital unveiled its new emergency room in July, officials touted its modern additions, from bedside ultrasound machines to cellphone charging stations.

But the new feature that says even more about American health care? A treatment room for obese patients, complete with a larger bed, floor-mounted commodes and scales and a lift that can hoist a person weighing up to 1,000 pounds.

It's the latest example of how hospitals here and elsewhere are investing in design and equipment that can better serve the increasing number of severely obese patients while also protecting health care workers from injury caused by lifting these patients. That also means buying items such as bigger operating tables, recliners and CT scanners and longer needles for drawing blood.

The trend began more than a decade ago when bariatric surgeries to help people lose weight took off and hospitals needed to accommodate those larger patients. In 2010, an industry group published its first set of architectural guidelines that included bariatric design principles — from the width of doorways to the weight capacity of furniture.

Florida requires new hospital projects since March 2012 to incorporate many of these features, including at least one special "bariatric" room in ER projects. A survey of hospitals nationwide, released in February by Texas health care supplier Novation LLC, found a quarter of respondents had invested in physical renovations to accommodate severely obese patients in the past year.

Nearly every hospital has adapted in some way, such as keeping larger blood pressure cuffs on hand or renting heavy-capacity beds if they have time to plan, said Cathy Denning, senior vice president for Novation's sourcing operations. However, it's not unusual for hospitals to still be playing catch up. "Every year we see facilities that recognize their elevators aren't big enough," she said.

For several years, area hospitals, including St. Joseph's and Tampa General, have had beds that support patients up to 1,000 pounds. In its critical care unit, for instance, St. Joseph's has a room that include ceiling lifts capable of moving the heaviest patients from their wheelchairs to the bed. And nurses needing to insert an IV have a special sonogram device that locates veins in patients with excessive body fat.

But finding equipment and beds for severely obese emergency patients can be a scramble, something that should be remedied by the ER's special bariatric room, said Patricia Donnelly, vice president of patient care services for St. Joseph's. The room is being temporarily used for trauma patients until October.

"You make do," she said. "But to be prepared and treat the patient with dignity … is the right thing."

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More than a third of American adults are considered obese, meaning they have a body mass index of at least 30, according to the federal Centers for Disease Control and Prevention. For a 5-foot-8 person, that would be about 200 pounds.

Close to 15 percent of Americans are classified as morbidly or severely obese, which means their BMI exceeds 40. That would be about 260 pounds for a 5-foot-8 person.

Hospitals routinely see patients that large. St. Joseph's Hospital, for instance, typically sees patients weighing more than 400 pounds once a week, said Donnelly. Patients weighing more than 600 pounds are rare.

Every hospital will get these larger patients, either due to an emergency such as a heart attack, or a scheduled admission for surgery, said Dr. Raul Rosenthal, an officer of the American Society for Metabolic and Bariatric Surgery. He is chairman of the department of general surgery at Cleveland Clinic Florida.

"You need to make sure you have the proper equipment and tools to take care of these people," Rosenthal said

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