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A Resource to Help Care for Obesity

A Resource to Help Care for Obesity

Few providers have the resources or time to implement guidelines for managing overweight and obese patients, according to Louis J. Aronne, MD, FACP. To overcome this obstacle, Dr. Aronne and other experts in obesity and weight-management care developed BMIQ (www.bmiq.com), a website that allows healthcare providers to add a comprehensive, office-based program to their medical practice. The BMIQ program registers patients during office visits and guides physicians on delivering obesity treatment modules. Patients are then given expanded session materials online and are guided to apply for sessions and plan meals as part of their daily routine. Patients can track their weight, food, and activity goals online. They are also encouraged to schedule their next office visit in order to participate in their next module. Enhancing Implementation “BMIQ can serve as a tool for patients and clinicians to enhance the implementation of evidence-based obesity management,” Dr. Aronne says. “For comprehensive obesity management to be effective, clinicians need a program that is easy to implement, flexible to use, and supports patients outside of the office setting.” The BMIQ Professionals Program accomplishes this mission for a low monthly subscription. Subscribers receive their own branded website along with other program components, such as complete program materials for clinicians and pa­tients, including session guides, patient lessons, and references. They also receive a complete 20-session program that can be delivered individually in the office setting, over the phone, or in a group setting. In addition, subscribers receive video tutorials on getting started and delivering each session as well as comprehensive reports for each patient who completes their online assessment. BMIQ provides integrated patient tracking, which...

Adverse Events in California Hospitals: Look at the Data

According to a Bay Area television station’ s investigative exposé, California hospitals reported 6,282 adverse events to the state over the last 4 fiscal years combined. It sounds like a lot until you realize that there are 410 hospitals in California. That means the average number of adverse events per hospital is only 15.3—fewer than 4 per year. A brief summary of this story appeared on a website called California Healthline. Its lede mentioned the total number and followed it with possibly the understatement of the year “but the number of actual adverse events could be higher.” Ya think? Analyzing data by calculating averages sometimes can be misleading. For example, Stanford Hospital reported a total of 211 adverse events, and the UCSF Medical Center reported 169. That means some hospitals must have reported far fewer than the average number. The NBC article has a handy interactive tool that enables the user to click on the name of any hospital in northern California to see its total number and types of reported adverse events. Use it and note that several hospitals reported only one adverse event over the entire 4-year period. Another interesting statistic is that 3,959 or 63% of the adverse events reported were bedsores. Although bedsores can be serious problems and in most cases preventable, they pale in comparison to death or serious disability associated with the use of restraints or bed rails, operating on the wrong body part, or leaving a foreign body in a patient after surgery. Surgery performed on the wrong body part occurred 140 times. Even one is too many. One California hospital managed...
An Update on Pulmonary Rehabilitation

An Update on Pulmonary Rehabilitation

In 2006, the American Thoracic Society (ATS) and European Respiratory Society (ERS) released a joint statement on pulmonary rehabilitation, a comprehensive, interdisciplinary intervention that had been recognized as a core component in managing patients with chronic respiratory disease. Since that time, there has been considerable growth in the science and application of pulmonary rehabilitation. In the American Journal of Respiratory and Critical Care Medicine, the ATS and ERS updated the 2006 statement, addressing newly gained knowledge surrounding the efficacy and scope of pulmonary rehabilitation. A New Definition A key component of the new statement is an updated definition of pulmonary rehabilitation endorsed by the ATS and ERS based on current insights. It states that “pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies, including (but not limited to) exercise training, education, and behavior changes.” The definition notes that pulmonary rehabilitation is designed to improve the physical and emotional condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors. Bundling Approaches Whereas components of pulmonary rehabilitation can be provided as good medical care, pulmonary rehabilitation combines these interventions. The major components of pulmonary rehabilitation include exercise training and behavioral interventions. Dr. ZuWallack says that, when used as a bundle in pulmonary rehabilitation, these interventions are tailored to the needs and goals of the individual patient. To meet these goals, pulmonary rehabilitation is provided by an experienced and dedicated interdisciplinary team, including a combination of physicians, nurses, nurse practitioners, respiratory therapists, physical therapists, occupational therapists, psychologists, behaviorists, exercise physiologists, nutritionists, and social workers. “Pulmonary rehabilitation programs will vary...
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