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We just started doing pre-op class last

week. Myself and the exercise physiologist team teach it. It lasts 60 minutes

(30-ntr, 30-exer) and we give them goals to start working on at the class –

general goals like eat more fruits/veggies, drink water, etc. Then they have

logs that they fill out reporting on their ntr and exer goals. 3-4 weeks later

they meet with us one-on-one for 30 minutes, where we assess the pt as far as

candidacy for surgery in terms of our scope, and individualize their plan. We

have 12-16 people per class and we teach it every week. Once they have

approval for surgery they come to a pre-op class for surgery – currently it

is 2 hrs but will probably decrease some since we have added the initial

education class. It includes info from ntr, exer, nursing, and psych. We ask

that the pt bring their support person to this class and we offer this class

every other week. The number depends upon the number of surgeries for the next

2-3 weeks. But usually ranges between 8 and 15 patients I think.

Hope this helps.

K. Mackie, MS, RD, LDN

Southeast Bariatrics, P.A.

2300-A Randolph Road

Charlotte, NC 28207

(704) 347-4144 x 214

hmackie@...

www.southeastbariatrics.com

From:

[mailto: ] On Behalf Of Theresa

Sent: Thursday, October 02, 2008

3:00 PM

To:

Subject:

group classes

The dietitians with our bariatric program currently

meet with pts

individually to assess and teach the diet pre-op. Our administration

would like us to consider group classes. For those of you that do

group classes, how many classes do you do pre-op and how often do you

teach them, how long are they, do you limit the number of pts at each

class.

Thanks in advance for any and all help.

Theresa Wehrly

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We just changed to 4 preop group classes this week (we used to have 12 classes offered and wrote a paper on it actually persons who attended 6 or more classes lost almost 10% more EBW in 6 months than not) but downsized now to 4 for ease of surgery.

I (as the RD and group fitness instructor) teach 3 classes (Basic Nutrition, Exercise, and Postop Course/success stories) and the psychologist teaches 1 (Mindful Eating).

We have about 30-40 per class and 3 classes per week; we also offer post op classes and support group 1x/month.

Hope this helps!

PS I have attached our link to the paper; also Jamal et al (SOARD 2006) wrote a good paper on preoperative dietary counseling.

McCarthy, M.S., R.D., L.D.N.Registered Dietitian

Center for Lap-Band Surgery

Mercy Hospital2525 S Michigan Ave, Chicago, IL

office: 312-567-8793

cell: 773-307-3160

mccarthy112781@...

From: Kennedy <hmackie@...>Subject: RE: group classes Date: Thursday, October 2, 2008, 2:19 PM

We just started doing pre-op class last week. Myself and the exercise physiologist team teach it. It lasts 60 minutes (30-ntr, 30-exer) and we give them goals to start working on at the class – general goals like eat more fruits/veggies, drink water, etc. Then they have logs that they fill out reporting on their ntr and exer goals. 3-4 weeks later they meet with us one-on-one for 30 minutes, where we assess the pt as far as candidacy for surgery in terms of our scope, and individualize their plan. We have 12-16 people per class and we teach it every week. Once they have approval for surgery they come to a pre-op class for surgery – currently it is 2 hrs but will probably decrease some since we have added the initial education class. It includes info from ntr, exer, nursing, and psych. We

ask that the pt bring their support person to this class and we offer this class every other week. The number depends upon the number of surgeries for the next 2-3 weeks. But usually ranges between 8 and 15 patients I think.

Hope this helps.

K. Mackie, MS, RD, LDN

Southeast Bariatrics, P.A.

2300-A Randolph Road

Charlotte, NC 28207

(704) 347-4144 x 214

hmackie@southeastba riatrics. com

www.southeastbariat rics.com

From: BariatricNutritionD ietitians [mailto:BariatricNu tritionDietitian sgroups (DOT) com] On Behalf Of TheresaSent: Thursday, October 02, 2008 3:00 PMBariatricNutritionD ietitiansSubject: [bariatricNutrition Dietitians] group classes

The dietitians with our bariatric program currently meet with ptsindividually to assess and teach the diet pre-op. Our administrationwould like us to consider group classes. For those of you that dogroup classes, how many classes do you do pre-op and how often do youteach them, how long are they, do you limit the number of pts at eachclass.Thanks in advance for any and all help.Theresa Wehrly

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  • 10 months later...

We use groups alot and have great success (there is always somebody who needs more attention, but overall it works well for us). We do not charge for RD visits (sad I know, I could go on about why, but basicially my salary is coming from a different area than where our clinic receives payment), so I cannot answer about reimbursement.

We do coordinate our groups w/the MD/APN appointments. Basically, we do diet and exercise visits 2 afternoons/week - we see up to 10 patients in 1 group...5 see the APN before group, the remaining 5 see her afterwards. We also offer the pre-op surgery appointments 2x/wk...the surgeon meets with the patients individually to go over his part, then he meets w/all the pre-op pt in a group to sign consents, then I see them to go over pre and post op diets. We also use group classes for post op visits.

As far as for patients coming in from out of town, or patients w/a hectic, less flexible schedule...this sounds harsh, but we stick to our clinic schedule, so the patient is responsible for making arrangements to be in clinic when expected. It's funny how patients can make things happen when they are determined! We have created a template in our scheduler and stick to that...it's so much more effecient for us.

As far as keeping track of who comes to class, I make a chart note for everyone I see, and if they don't show up, it is their responsibility to reschedule. We use Remedy for our charting and part of every patient's chart includes a task list...we use this list to check off completion of initial eval, diet and exercise, pre op visit, etc, so this helps us see where a patient is in the process. Our APN sends out a letter to encourage follow up for patients who miss their appointment.

I don't have any powerpoints slides, but I use the same handouts I used when I saw patients individually.

Hope this helps! Anne

Anne Marquart, MS, RD, LD / Bariatric Dietitian / Roller Weight Loss Institute - Northwest Health System / 609 W. Maple Ave. Suite 101 / Springdale, Ar 72764 / (479)757-3182 / Fax: (479)757-2935 / amarquart@... / www.rollerweightloss.com

-----Original Message-----From: le [mailto:dfalk0222@...]Sent: Thursday, August 13, 2009 12:18 PM Subject: group classes

I am a bariatric dietitian for Univerity of Minnesota Medical Center Fairview. Due to our increasing volume of patients and increasing pre-op insurance requirements for dietary visits, we are looking into starting group pre-op and post-op classes. Do all insurance companies cover these visits? How many sessions should be offered per month? How do you coordinate these sessions with the physician visit (post-op).What about out-of-town patients who cannot attend some/all sessions? How do you track who comes to the classes? Does anyone have any outlines/power points of classes they currently run?I apologize for all the questions, but I am new to this class idea. We currently see everyone individually. Thank you,le Falk RD,LD

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Thank you !!

>

> We use groups alot and have great success (there is always somebody who needs

more attention, but overall it works well for us). We do not charge for RD

visits (sad I know, I could go on about why, but basicially my salary is coming

from a different area than where our clinic receives payment), so I cannot

answer about reimbursement.

>

> We do coordinate our groups w/the MD/APN appointments. Basically, we do diet

and exercise visits 2 afternoons/week - we see up to 10 patients in 1 group...5

see the APN before group, the remaining 5 see her afterwards. We also offer the

pre-op surgery appointments 2x/wk...the surgeon meets with the patients

individually to go over his part, then he meets w/all the pre-op pt in a group

to sign consents, then I see them to go over pre and post op diets. We also use

group classes for post op visits.

>

> As far as for patients coming in from out of town, or patients w/a hectic,

less flexible schedule...this sounds harsh, but we stick to our clinic schedule,

so the patient is responsible for making arrangements to be in clinic when

expected. It's funny how patients can make things happen when they are

determined! We have created a template in our scheduler and stick to that...it's

so much more effecient for us.

>

> As far as keeping track of who comes to class, I make a chart note for

everyone I see, and if they don't show up, it is their responsibility to

reschedule. We use Remedy for our charting and part of every patient's chart

includes a task list...we use this list to check off completion of initial eval,

diet and exercise, pre op visit, etc, so this helps us see where a patient is in

the process. Our APN sends out a letter to encourage follow up for patients who

miss their appointment.

>

> I don't have any powerpoints slides, but I use the same handouts I used when I

saw patients individually.

>

> Hope this helps! Anne

>

> Anne Marquart, MS, RD, LD / Bariatric Dietitian / Roller Weight Loss Institute

- Northwest Health System / 609 W. Maple Ave. Suite 101 / Springdale, Ar 72764 /

(479)757-3182 / Fax: (479)757-2935 / amarquart@... / www.rollerweightloss.com

>

>

> group classes

>

> I am a bariatric dietitian for Univerity of Minnesota Medical Center Fairview.

Due to our increasing volume of patients and increasing pre-op insurance

requirements for dietary visits, we are looking into starting group pre-op and

post-op classes.

>

> Do all insurance companies cover these visits? How many sessions should be

offered per month? How do you coordinate these sessions with the physician visit

(post-op).What about out-of-town patients who cannot attend some/all sessions?

How do you track who comes to the classes? Does anyone have any outlines/power

points of classes they currently run?

>

> I apologize for all the questions, but I am new to this class idea. We

currently see everyone individually.

>

> Thank you,

>

> le Falk RD,LD

>

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