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Equipment
Quality Improvement
Complications
MBS Committee
Grab Bag
100

Describe two different ways toilets can be mounted to accomodate 1000 lbs. and which are available on your unit.

1. Floor Mounted

2. Supported with a toilet support

100

Name the methodology used for our quality projects

DMAIC

  • Define
  • Measure
  • Analyze
  • Improve
  • Control
100

Describe the symptoms of an anastomotic leak

Tachycardia, fever, nausea, vomiting, pain, and leukocytosis

100

what is the frequency the MBS Committee meets

Quarterly

100

Name the handout used to educate patients on center's volume specific to each procedure, the expected outcomes, risks, benefits and alternatives to each procedure.

Procedures at a Glance

200

Describe the process for ordering weight appropriate furniture that is not available onsite

1. Order on the procedure booking sheet

2. Ask the unit clerk to initiate an order with the rental company

200

Name two of the bariatric quality projects that have been initiated

  • 2021 – 2023: Decreasing the Incidence of Adverse Events and Mortalities from Postoperative DVT/PE
  • 2022 – 2023: Curbing Bleeding w/in 30 Days of Bariatric Surgery
  • 2022 – 2024: Decreasing Readmissions Due to Nausea/Vomiting, Fluid, Electrolyte or Nutritional Depletion
  • 2023 – 2025: Progress Note Standardization for Complete MBSAQIP Quality Database Entry
  • 2024 – 2025: Decreasing ED visits due to avoidable causes primarily abdominal pain and nausea, vomiting, fluid, electrolyte or nutritional depletion
200

Describe the protocol that is followed when a patient with a history of bariatric surgery presents to the ED.

  • We have a policy called: Monitoring ED and Readmission Protocol that we follow.
  • The ED notifies the attending bariatric surgeon
200

Name 4 bariatric surgeons in our facility AND which one is the MBS Director

Drs. GF, AUE, AA, FC

Dr GF

200

Name the two designated Bariatric Units

1. PACU

2. 4800

300

Where can I find the weight capacity of the equipment in our facility (be specific)

What is Ellucid>Bariatric Policy & Procedure Manual>Facilities, Equipment and Furniture Resources>

300

Name 3 reasons a patient would be excluded from having bariatric surgery.

  • Pregnancy at surgery
  • Uncontrolled major depression
  • Uncontrolled psychiatric disorder
  • Active alcoholism or drug abuse
  • Untreated or recent history of eating disorder
  • Uncontrolled, severe psychiatric illness 
  • Terminal illness
  • Acute systemic infection
  • Uncorrectable coagulopathies
  • Any condition, in the judgment of surgeon puts patient at undue risk
  • Lack of commitment to diet modification or lifelong vitamin/mineral supplementation
  • Lack of comprehension of risks, benefits, expected outcomes, alternatives, and required lifestyle changes
300

Describe the symptoms that would raise concern for BOTH:

1. DVT

2. PE

1. DVT=Pain, swelling, tenderness, discoloration, or redness, warm skin

2. PE=SOB, CP, tachycardia, anxiety, hypoxia, or fever

300

What does the role of the MBSCR (metabolic and bariatric clinical reviewer) AND name one of our MBSCRs

Abstracts and enters all bariatric data into the MBSAQIP data registry.

DP or BK

300

Name 3 required bariatric education modules in Focus.

1. Sensitivity Training

2. Patient Transfer and Mobilization

3. Signs and Symptoms of Postoperative Complications.

400

What is the maximum weight of a patient who can have bariatric surgery at our facility?

500 lbs

400

Describe two ways your team works together to care for bariatric patients

MBS Committee Meetings:  Held Quarterly

Departmental Rounds

Shift Huddles

Bariatric Inservicing to Departments

Bariatric Equipment Rounds

Standard Progress Notes

Standard Orders

Support groups

400

There are 5 reasons in the standard order sets to call the surgeon.  Name 3.

  • SBP>140 or DBP>90
  • HR>100 or <55 BPM
  • RR>22 or <10 breaths/min
  • Temp >100.6F
  • Urine output<30ml
400

Describe the purpose of the MBS Committee

a confidential setting for sharing best practices, responding to adverse events and fostering a culture to improve patient care

400

Name 3 bariatric pathways

1. Preoperative

2. Perioperative/Intraoperative

3. Postoperative

500

A patient is about to sit in a chair that cannot accommodate their weight.  What do you say to them?

Let me get you a more comfortable chair (or something similiar)

500

What is the SAR and what happens if our site is found to be a high outlier in a particular category of the SAR

1. Semiannual Risk-Adjusted Report

2. High outliers must develop a QI initiative to address the high outlier status.

500

A patient presents to the ED with intermittent abdominal pain.  What could be the reason for this?  Name one test would you order to help diagnose the problem?

Internal Hernia

Bowel Obstruction

Appendicitis

... and many more!  

Testing: Labs, CTAP, 


500

Name 3 standard agenda items in the MBS Committee Meeting

Procedure Volumes, Adverse Event Review, Pathway Review, Quality Projects, Compliance with MBSAQIP Standards, Research Update

500

Describe the education the patient receives before, during or after surgery.

  • Preoperative Medical Packet
  • Preoperative Nutrition Packet
  • Care Companion
  • Discharge Summary