6 Monitoring and Evaluating Patient and Program Outcomes

All Bariatric Safe Patient Handling and Mobility (SPHM) Program managers will want to evaluate the program processes and outcomes (Gallagher, 2013). For many years there have been multiple standards that health care facilities have monitored. Until recently, there have been very few that focused on the bariatric population and even fewer evaluating SPHM. As the safe patient handling arena has grown, there is an ever demanding need for program evaluation and outcome measurement. The American Nurses Association (ANA) has recently published the Safe Patient Handling and Mobility, Interprofessional National Standards, with Standard 8 being: Comprehensive SPHM Evaluation Program. In this standard, the employer and health care workers partner to establish a comprehensive system to evaluate the SPHM Program status using staff performance, staff injury incidence and severity, and health care recipient outcome metrics (ANA, 2013).

Program evaluation provides visible results organizations need to ensure successful outcomes. Outcome evaluations are a means of providing documentation that often change clinical practice and/or make a difference in financial, clinical, and/or employee and patient satisfaction. By measuring the status of program elements, leadership will be able to determine if they have partially or fully achieved goals. Analysis of the findings will identify future needs and performance improvement plans that need to be developed. Changes in the Bariatric SPHM Strategic Plan may occur with the findings. Challenges will be encountered, but with persistence and a willingness to take a critical/objective review of the Bariatric SPHM Program, changes can be made to improve employee injury rates as well as the quality of care rendered to the patient.

As in any Ergonomics Program, evaluation is essential to determine if the program is effective in meeting the desired outcomes. Measures for evaluating a bariatric program would include those used in evaluating any safe patient handling program to assess effectiveness in preventing and reducing injuries. Specific data relative to a bariatric program would include patient satisfaction and comfort with technology. To identify technology shortages and predict future needs, the facility may track the number of bariatric admissions and patient demographics. This information may be helpful in identifying future needs for the program and making a business case for additional technology or environmental space design (see Enclosure 6-1 for the Brief Summary - Space and Facility Design Considerations). From time to time there are unforeseen issues specific to the patient size, equipment fit, and/or the task being performed, i.e., a poor sling fit or equipment failure that can cause a poor outcome during a transfer to a chair. These unforeseen events may result in injury to personnel as they exert themselves in attempt to resolve the situation. Collection of injury data should identify patient size and mobility status (Muir & Archer-Heese, 2009).

Enclosure 6-2 provides a performance matrix and monitoring tool for evaluating a Bariatric SPHM Program on a quarterly basis.

6.1. Enclosures

6-1 Brief Summary - Space and Facility Design Considerations

6-2 Bariatric Safe Patient Handling and Mobility (SPHM) Program Key Performance Metrics