Bariatric surgery

DSC_0085cSevere obesity is sharply on the rise and is already the second-leading cause of preventable death in the United States. Some 18 million people in the United States suffer from severe obesity, and the number of weight-loss procedures has increased accordingly, from 16,000 in the early 1990s to 180,000 in 2005.

The Michigan Bariatric Surgery Collaborative was formed in June 2005 to improve the quality of care for patients undergoing bariatric surgery in Michigan. This collaboration between BCBSM, University of Michigan Health System, and 41 hospitals performing bariatric surgery across the state has improved patient care. One hospital in California also participates. There is data on more than 81,000 patients in the registry.

Three times per year the group meets to examine the data and to design and implement changes in patient care that will result in better outcomes for bariatric patients. The project is funded by Blue Cross Blue Shield of Michigan and Blue Care Network and coordinated by the University of Michigan.

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  • Decreased the pre-operative IVC filter placement rate from 7.56 percent to 0.24 percent (2007-2015)
  • Increased compliance with blood clot guidelines to 84 percent (2007-2015)
  • Decreased rates of VTE by 39 percent (2007-2015)
  • Decreased length of hospital stay beyond five days following bariatric surgery by 19 percent (2007-2011)
  • Decreased post-surgical death rates by 50 percent (2007-2015)
  • Decreased readmissions by 38 percent (2007 – 2015)
  • Decreased overall complication rates by 31 percent (2007-2015)
  • Decreased ED visit rates by 7 percent (2007-2015)

Through anonymous review of gastric bypass surgery videos by MBSC surgeons and linkage with outcomes data, a high correlation between surgical skill and positive outcomes has been suggested.  Initial results were published in the New England Journal of Medicine in October 2013.   As a result of this important work, a grant has been received from the National Institutes of Health to develop and evaluate a video-based peer coaching program.