Of the 45 FCHs that were identified, contact was established with an
individual at 28 hospitals (62%) that could completely answer the questions in our
survey. Of these, 6 were dietitians, 10 were nurses, 7 were physicians, and 5 were a
combination of RN/MD responses. Of the 28 FCHs, 21 (75%) reported having weight
management programs, and 7 (25%) had bariatric surgery programs. From the hospitals
that were not able to complete the survey but provided information via Web sites or
partial contacts, 11 FCHs were identified as having weight management programs, one
of which also had a bariatric surgery program. These 11 institutions were excluded
from further analysis.
Through the simple analysis of the data, our group found that those
institutions with a weight management program but without a bariatric surgery
program are perhaps less prepared for the pediatric patient with severe obesity. Of
the 20 FCHs without a bariatric program, 3 (15%) had made equipment accommodations
in preparation for the care of pediatric patient with severe obesity. In contrast, 5
of 7 (71%) FCHs with a bariatric surgery program had made accommodations with regard
to equipment (). It was also
interesting to discover that not all hospitals that perform bariatric surgery had
created systems or education around the potential resuscitation of these patients.
All other elements of the survey are listed in but follow the same trend of the FCHs without bariatric surgery being
less prepared than those who perform the surgery.
Survey Results Comparing FCHs With and Without Bariatric Surgery
The purpose of collecting survey data from FCHs was to examine the
preparedness of the hospital systems and staff in the event of a pediatric patient
with severe obesity with rapidly deteriorating health. Despite providing medical
services to children with severe obesity, most of those FCHs without bariatric
surgery programs have one or more areas for improvement, with less than 20% having
sufficient readily available equipment and trained staff.
As the numbers of pediatric patients with severe obesity increase, greater
attention to education, equipment, and staff training will be needed. Our original
purpose of initiating the survey was to find resources from other institutions and
therefore only adjust guidelines or policies as they fit our institution. These
survey results suggest that many FCHs are not adequately prepared to care for these
patients and may benefit from the development of institutional guidelines or a
clinical protocol. Our results were surprising and underscored the need for our FCH
to support the development of a Pediatric Obesity Care Guideline (POCG).