Identifying and addressing barriers to safe and effective care of bariatric patients in a tertiary trauma hospital

Ms Jacqueline Kay1, Ms Celia Cosgriff1

1Melbourne Health, Parkville, Australia

Aim: The Royal Melbourne Hospital (RMH) has experienced an increase in the number of bariatric patients needing care. RMH commissioned a project to determine the barriers to safe and effective care, aiming to improve patient outcomes and experiences.

Method: The project team, consisting of two staff members with allied health backgrounds, used the lean six sigma methodology to determine the main barriers to care and determine cost effective strategies to address the issues. Staff engagement, from all levels, occurred from the beginning. Bariatric patients and their carer’s were also interviewed to ensure the project would address their concerns and needs. The project team also undertook an extensive bariatric readiness audit of the hospital to identify the physical barriers to access to each ward and procedural area.


The barriers identified fell into three main categories:

  1. Physical space
  2. Staff awareness and attitudes to bariatric patient management and complications
  3. Access to equipment.

These barriers had resulted in bariatric patients being unable to access specialist wards, investigative and procedural services (Theatre, Radiology), poor patient outcomes and increased in length of stay. The bariatric readiness audit provided the project team with a road map for better care of bariatric patients, and has guided the development of Bariatric ‘Kits’ with specific equipment, a Bariatric Management Procedure, and the allocation of bariatric patients to the most appropriate room on the specialist ward.

Significance of findings to Allied Health:

Allied Health can significantly contribute to an organisation-wide project, and implement low-cost changes to ensure improved care and outcomes for bariatric patients.