Why should hospitals, medical offices, and especially bariatric and cardiac clinics offer better accommodations to larger sized patients? What can be done to improve accommodations? And how can offering better, more bariatric-friendly services and amenities have a positive effect on a healthcare business’s bottom line?
Obesity has evolved into a major issue worldwide, especially in developed nations. In “Essentials of a Bariatric Patient Handling Program,” Certified Occupational Health Nurse Marylou Muir writes that more than a billion people in the world today are overweight, with 300 million meeting the criteria for obesity.
Patients with a Body Mass Index (BMI) over 30 are considered obese. People with BMIs above 40 are severely obese. The typical bariatric patient is 100 to 200 pounds overweight. Except in extreme cases, such as athletes or bodybuilders, most people over 300 pounds are overweight.
Unfortunately, patients who are significantly overweight (approximately 37 percent of the U.S. population) have problems performing simple tasks that others take for granted, such as sitting in a blood draw chair or lying on an exam table. These issues are why hospitals and medical facilities are striving to design facilities with bariatric patients in mind.
What Goes Into Bariatric Design?
As average weights in America continue to climb, the number of weight-related health problems also increases. Hospitals and medical clinics are finding that ever-growing numbers of patients are obese. They are continuously implementing changes to accommodate bariatric patients and keep both them and facility care teams safe.
Healthcare facilities consider several important design guidelines when making changes to their accommodations and amenities. According to the white paper “Bariatric Design 101 – An Introduction to Design Considerations,” bariatric-friendly conveniences should include the following elements:
- Pain reduction
- Slip/fall risk reduction
- Improvements to patients’ sleep
- Patient stress reduction
- Depressed mood reduction
- Spatial disorientation reduction
- Improvements to patient privacy and confidentiality
- Social support
- Staff injury reduction
- Staff stress reduction
- Increased staff effectiveness
- Increased staff recruiting and retention
“The core goal of bariatric care revolves around maintaining patient dignity,” says American Institute of Architects member (AIA) Joan Suchomel in “Weighing The Cost of Care: How Hospitals Accommodate Obese Patients” on Becker’s Hospital Review. “…It’s part of doing business. [Obese] patients are going to show up, and you have to be ready for them.”
Healthcare providers wishing to renovate facilities to better accommodate the bariatric community need to consider the entire patient experience, both through the eyes of the patient and from the viewpoint of their staffs.
Waiting areas, hallways, patient rooms, seating and other furnishings, bathrooms, operating rooms and therapy centers must be designed to make patients feel more comfortable and less isolated. Those areas also need to have room for any necessary equipment, including bariatric Hoyer lifts, wheelchairs and gurneys.
“If patients feel isolated, or that they are drawing attention to themselves or are not being accommodated, they are less likely to return to the facility. And that, of course, affects the hospital’s bottom line,” AIA members Monte Hoover and Keith Smith explain in “Accommodating The Bariatric Patient” in Healthcare Design Magazine. “…Designers should strive to keep patients from feeling alienated or restricted as they move through spaces during testing and treatment.”
What Specific Accommodations Are Suggested For Bariatric Patients?
Suggested design specifications differ from facility to facility, often depending on the type of care provided. Emergency rooms and intensive care units tend to see high numbers of bariatric patients, so designing or renovating ERs and ICUs can make a significant difference in patient comfort.
Healthcare providers who deal with heart conditions/disease, diabetes, chronic pain, respiratory issues, sleep apnea or arthritis, and facilities dedicated exclusively to bariatrics are also likely to see a higher percentage of bariatric patients.
The International Health Facility Guidelines section on bariatric design highlights several design specifications and guidelines that facilities should plan to meet or exceed when considering bariatric accommodation:
- Reception/Waiting Rooms – Seating should be made available for bariatric patients and their (potentially) obese family members. Spaces for wheelchairs should also be included, along with power outlets for recharging electric units. A full 20 percent (and as much as 50 percent for cardiac and bariatric units) of waiting area seating should be designed to seat obese patients comfortably.
- Patient Bedrooms/Inpatient Areas – Bedrooms should be large enough to fit more than one caregiver while still allowing for equipment movement. A minimum of about 5 feet should be clear to the front and sides of the patient’s bed. Ceiling-mounted lifts should be installed in 50 percent of patient rooms. Bariatric seating is also necessary for inpatient lounge rooms, and should also include wheelchair space and power outlets.
- Ensuites/Bath/Shower Rooms – Properly fixed and reinforced grab rails, toilets, vanity anchoring and lifters must be in place for bariatric ensuites. Toilets should be securely anchored to the floor and capable of supporting nearly 1,000 pounds. Showers should be approximately 4 feet by 6 feet in size, and the entire bathroom should have enough space to accommodate a wheelchair.
- Gymnasiums/Therapy Centers – Gym and physical therapy equipment should be capable of supporting at least 550 pounds. Equipment may include everything from stationary bikes to rowing machines, treadmills, strength training equipment, examination couches and group training areas. Ceiling-mounted lifts are also highly recommended.
- Staff Areas – Healthcare facility staff members may be obese as well, which means that meeting rooms, storage closets and break rooms should be designed with their needs in mind.
Additional considerations that could make a huge difference to patients’ comfort levels, Hoover and Smith note, include scales recessed into the floor or designed to weigh patients in wheelchairs (not too long ago, bariatric patients were weighed in truck loading docks, which was understandably embarrassing for them), and supplies such as blood pressure cuffs, bedpans and imaging equipment that accommodate their size.
In essence, equipping a medical facility to accommodate larger sized patients is both a wise business decision and a compassionate way to recognize the difficulties faced by those who suffer from weight problems. And while these patients seek to attain a healthier weight, they will appreciate the feeling of inclusion afforded them at hospitals and clinics that incorporate bariatric design elements.
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