Area hospitals, clinics adapt to larger patients

As America’s obesity problem grows, hospitals and clinics are making changes to accommodate the needs of heavier patients.

Everything from the size of patient exam rooms to the width of waiting-room seating to selection of sturdier toilets has influenced health care facilities’ decision-making and planning.

For example, exam rooms are 10-by-12 feet in Altru Health System’s $13 million clinic project set to open soon in Devils Lake, said Leah Hummel, Altru architect.

“It’s up from what the standard used to be,” she said. “The size is increasing by 150 percent.”

Instead of individual chairs, the new clinic will feature 48 inch-wide benches “that will accommodate larger patients, or a mother and child, and offer more flexibility,” she said.

Industry standards that guide health care facility planning call for seating to be at least 40 inches wide, Hummel said, noting that the federal Americans with Disabilities Act requires that width to be 36 inches.

In Altru’s waiting rooms system-wide, loveseats are replacing chairs, she said. “They are wider and work out better than oversized chairs.

“We’ve made efforts to put seating of that type in every waiting room. And that is the standard going forward.”

Janet Shreier, coordinator of Altru’s Bariatric Center, said these changes matter to people who are dealing with obesity.

“As you look at the patient experience, patients may wonder, ‘Does this facility meet my needs?’”

‘Welcoming atmosphere’

Changes being made to accommodate these patients “are creating a more welcoming atmosphere” at Altru, she said. “It’s not much fun for people that struggle with appropriate seating to go to a clinic for their health care and can’t find adequate seating.”

By meeting these patients’ needs, “it’s a good direction to be moving,” she said.

Americans’ growing girth is causing a dramatic increase in diabetes, hypertension and other chronic diseases. It’s also forcing hospitals and ambulance crews to make systemic changes in the treatment and transport of patients and to invest in expensive equipment and special training for the staff.

Obesity has risen rapidly nationwide — 13 percent of adults were obese in 1987, compared with 35.7 percent today. Some 10 million Americans are more than 100 pounds overweight and considered morbidly obese.

Design changes, special equipment

At the new Altru Specialty Center on South Washington in Grand Forks, three hospital rooms feature bigger beds, a lift system for larger patients, specialized equipment for eating and larger showers.

Altru hospital beds are designed for patients up to 350 pounds, Hummel said. But other beds, for heavier patients, are available, as needed.

For those patients, mobility becomes an issue, she said.

Equipment designed for heavier patients help make the patient and staff more comfortable, said Schreier, and prevent skin issues.

The hospital has also added new seating in patient rooms and can provide special bariatric chairs, similar to recliners, for when the patient is able to get out of bed and move around, Hummel said.

A couple of rooms in Altru’s rehabilitation facility are scheduled for remodeling next year in a plan to include lift systems that can transfer patients up to 1,000 pounds, she said, estimating the weight capacity.

And there’s bathroom “seating.”

“The typical porcelain toilet doesn’t accommodate the bariatric patient,” Hummel said. “They need the new stainless steel ones which are much more heavy duty.”

Because Altru has had problems with wall-mounted toilets, the health care provider is looking to new designs, with extra bracing underneath.

“Our new standard is floor-mounted toilets,” she said.

Increased costs

These changes are expensive — and drive up health care costs. In a national survey, hospitals reported spending up to $1.5 million last year on equipment and other needs of obese patients, according to Novation, a national health care supply company.

At Altru, changes brought on by an increase in the ranks of larger patients have “added considerable expense to the cost of constructing new facilities,” Hummel said, “but we do it because it’s best for our patients.

“It’s important that we accommodate all of our patients.”

The rising incidence of obesity leads directly to more hospital stays and higher health care costs because it increases demand for treatment of heart disease, diabetes, stroke and many other illnesses.

The medical costs of obesity are staggering — $147 billion in 2008, according to the federal Centers for Disease Control and Prevention. On average, annual health care costs for the obese patient is $1,429 more — 42 percent higher — than the annual cost for patients of normal weight.

Hospitalizations among obese children increased 75 percent nationally from 2001 to 2005, and the costs of caring for them doubled to $267.6 million, the American Hospital Association reported last year.

Mary Jo Layton of The Record (Hackensack, N.J.) contributed to this report. Call Knudson at (701) 780-1107; (800) 477-6572, ext. 1107; or send e-mail to pknudson@gfherald.com.

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