Institution Name: Brookwood Baptist Medical Center
Description of Institution: Located in Birmingham, Alabama, Brookwood Baptist Medical Center is part of a private, not-for-profit, faith-based healthcare system. The health system consists of five hospitals, totaling over 1,700 beds.1
Primary Author Name and Title: Lisa H. Griffin, RN, BSEd., CBN
Name of Case Study: As Simple as a Sippy Cup
The #1 reason for ED/readmission during the first 30 days following bariatric surgery was dehydration at our site.
The number of Emergency Department visits and readmissions within 30 days of bariatric surgery had one commonality; The patients were dehydrated. From June 2016 to November 2016, we had an ED/readmission rate for dehydration of 12.05%.
Thirst after surgery was causing our patients to gulp their liquids too quickly. This caused an “overfilling” of their pouch/sleeve which often resulted in vomiting, poor fluid intake, or both. Our ED/readmission rate for dehydration was 12.05%. With introduction of the sippy cup and better instruction on fluid intake, our goal was to reduce this to at least half or 6%.
Planned education and introduction of a sippy cup to patients in preop class began in December 2016. Followed MBSAQIP data for the 6 months following this introduction and reported outcomes.
MBS Direct, MBS coordinator, MBSCR, Dietary, and bariatric floor staff
From December 2016 through May 2017 our ED/readmission rate for dehydration decreased to 5.2%.
Our current ED/readmission rate for 2022–2023 is 1.3%.
One limitation/setback we found was patients would forget to pack their sippy cup to bring to the hospital on their surgery date.
Each sippy cup was approximately $0.88, so about $1 per patient.
Team and Stakeholders’ Perspective on Value
Great outcome with very little expense. This appeared to be a simple fix to what could be a costly problem. The reduction in ED/readmission rates by 7.24% in a 6-month period was great. This simple QI project continues to have great outcomes.
MBSAQIP Database
Sometimes a big problem can be solved with common sense.
Since this project, we have increased our preop education and now have simplistic images of what the postop bariatric stomach looks like with fluids going into it. The visual has really helped our patients understand what happens when they drink too fast or too much.
This project continues to be part of our bariatric plan of care.