Ninh T. Nguyen, Nance Hove, C. M. Stevens, Candice Moore, UCI Medical Center, Orange, CA, University HealthSystem Consortium, Oak Brook, IL

INTRODUCTION: With the development of laparoscopic bariatric surgery, there is a high demand for development of bariatric surgical practices. Inadequate hospital facilities and inexperienced surgeons/personnel managing the morbidly obese can lead to worker's compensation and malpractice claims. We surveyed participating institutions of the University HealthSystem (UHC) Consortium to examine the current practice of bariatric surgery and its associated risk management at academic centers. METHODS: A bariatric surgery survey was sent to all participating UHC institutions. The survey questioned 1) the availability of bariatric equipment, 2) credentialing and reappointment process of bariatric surgeons, 3) the availability of outcome measures, 4) risk management data (worker's compensation and malpractice claims related to the care of bariatric patients), and 5) suggested improvement in their bariatric surgery program. RESULTS: Seventeen UHC institutions participated in the survey. 82% of the organizations performed bariatric surgery. More than a quarter of the institutions do not have appropriate bariatric equipment such as bedside commodes, gowns, high weight scales, beds, OR tables, surgical instruments, and radiologic equipment capable of handling the morbidly obese. 38% of institutions have had accidents or equipment problems related to bariatric equipment and 55% of institutions had worker's compensation claims due to care for bariatric patients. Only 60% of institutions require a minimum number of procedures to be performed by surgeons prior to granting privileges; 80% of institutions use bariatric surgical outcome measures to evaluate a surgeon's competence for reappointment; and 92% of institutions track complication rates. 62% of institutions had claims related to the care of bariatric patients and 53% of the claims were related to surgical complications of the procedure. Suggested improvements included more bariatric equipment, establishment of a comprehensive bariatric program, development of a specific unit to specialize in bariatric surgery, and enhance the educational training of all members of the bariatric surgical team. CONCLUSION: The results from this survey demonstrated that the practice of bariatric surgery is suboptimal in more than a quarter of institutions performing bariatric surgery with regard to availability of bariatric equipment and credentialing of surgeons. Inadequate practice of bariatric surgery can lead to high worker's compensation and malpractice claims.