Clinical Outcomes picture

Clinical Outcomes

We have rigorous mechanisms in place to ensure that we measure the effectiveness of the treatment and care we provide.

We collect usual national indicators as laid down by The Care Quality Commission, but we also:

  • Use tailor-made bariatric medical and surgical care pathways to record the delivery of clinical care (the only UK weight management provider to do this) – these enable the reporting of unexpected events or where planned outcomes have not been met for whatever reason.
  • Submit data to the National Bariatric database (endorsed by BOMSS and required by bariatric specialised commissioning).
  • Collect our own comprehensive bariatric clinical outcomes and use these as a basis for review and action at our Bariatric Clinical Governance Meetings every 3 months as follows:
Below are just some of the outcomes we measure:
 
SURGERY OUTCOMES
 
Success Criterion
Measure
Data
Quality of life
HADs
Score changes
 
BAROS (modified)
Score changes
Weight
% excess BMI reduction (IFSO Guidelines)
Baseline BMI, Baseline % excess, current % excess
Co-morbidity resolution
Glycaemic control
Fasting Insulin
 
Blood pressure
Systolic, Diastolic
 
Lipid profile
 
 
Resolution of sleep apnoea
Clinical diagnosis
 
Bypass complications
Anastomotic breakdown/Peritonitis
 
Excessive Alopecia
 
Post operative anaemia
 
Vitamin B12 levels below normal reference range
 
Patient demonstrates symptoms indicating Lactose intolerance (diarrhoea after milk/dairy products)
 
 
Patient demonstrates symptoms indicating Tetany (low serum Calcium)
 
Narrowing of anatomises forming symptomatic stricture
 
Intestinal obstruction (confirmed radiologically)
 
Serum Protein deficiency
Gastric Band Complications
Uncontrolled nausea and vomiting post-band insertion
 
Unsuccessful gastric band insertion (technical problems)
 
Port site infection
 
Band incorrectly positioned
 
Sudden onset of dysphagia indicating potential pouch dilatation/band slippage
 
Port inaccessible at time of adjustment (due to movement/patient’s anatomy)
 
Unsuccessful fill – no increase in restriction/weight loss
 
Patient experienced swallowing difficulties post-band inflation
 
Band slippage (confirmed radiologically)
Sleeve Gastrectomy Complications
Anastomotic breakdown/Peritonitis
 
Excessive Alopecia
 
Post operative anaemia
 
Vitamin B12 levels below normal reference range
 
Patient demonstrates symptoms indicating Lactose intolerance (diarrhoea after milk/dairy products)
 
 
Patient demonstrates symptoms indicating Tetany (low serum Calcium)
 
Narrowing of anatomises forming symptomatic stricture
 
Intestinal obstruction (confirmed radiologically)
 
Serum Protein deficiency
Duodenal Switch Complications
Anastomotic breakdown/Peritonitis
 
Excessive Alopecia
 
Vitamin B12 levels below normal reference range
 
Patient demonstrates symptoms indicating Lactose intolerance (diarrhoea after milk/dairy products)
 
 
Patient demonstrates symptoms indicating Tetany (low serum Calcium)
 
Narrowing of anatomises forming symptomatic stricture
 
Intestinal obstruction (confirmed radiologically)
 
Serum Protein deficiency
 
Clinical outcomes for 2009 (Jan-Sep)
 
For all Vita Clinics Patients

Clinical outcome indicator                             

Percentage occurrence                              

Unplanned hospital admissions

1.37%

Unplanned return to theatre

0.55%

Hospital-acquired MRSA

0%

Hospital-acquired Clostridium Difficile

0%

 
 Surgery - For patients operated on in 2009 (Jan-Sep)
 


Clinical outcome indicator

Measure 

Average total weight loss

16.3kg (range 12-21.7)

Average % excess body weight loss

23.4% (range 12.1-38.7)

Average % BMI reduction

12.3% (range 8.2-17.3)

Improvement of type II Diabetes

100%

Resolution of type II Diabetes

100%

Improvement of Hypertension

66%

Resolution of Hypertension

66%

Improvement of Asthma

0%

Resolution of Asthma

0%


MEDICAL WEIGHT MANAGEMENT OUTCOMES
 
Measure
Data
Change in quality of life (HADs) score
% Score changes (reductions)

Weight loss (Kg)

Baseline weight, current weight, average % loss
% excess BMI reduction
Baseline BMI, Baseline % excess, current % excess

Change in waist circumference (cm)

Baseline measure, current measure, average cm reduction

Blood pressure
Systolic, Diastolic
Blood profile

HBA1c, Lipids

Resolution of sleep apnoea
Clinical diagnosis

Change in co-morbidity medication

% dose reduction, % medication cessation

5% weight loss at 3 & 6 months

Baseline weight, % achieving 5% loss at 3 months and 6 months

10% weight loss at 3 & 6 months

Baseline weight, % achieving 10% loss at 3 months and 6 months

 
 Medical weight management - For patients treated in 2009 (Jan-Sep)
 
 

Clinical outcome indicator

Measure 

Average total weight loss

5.96kg (range 3.8-7.4)

Average % excess body weight loss

21.2% (range 16.3-30.4)

Average % BMI reduction

5.56% (range 4.6-6.8)

Improvement of type II Diabetes (% medication dose reduction)

100%

Improvement of Hypertension (% no. of patients with reduction in systolic/diastolic BP) 

100%

Improvement of Asthma

0

% average reduction of HBA1C

Data awaited

% average reduction of serum lipds

Data awaited

Average waist measurement reduction (cm)

10.25 cm (range 7-15)

% achieving 5% weight loss at 3 months

80%

% achieving 5% weight loss at 6 months

Data awaited 

% achieving 10% weight loss at 3 months

Data awaited

% achieving 10% weight loss at 6 months

Data awaited


 
 


 

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