Becoming a COE, Continuum of Care

In this presentation, Dr. Balibrea reviews the basic aspects of one of the pillars for becoming a center of excellence in bariatric surgery: the continuum of care (ensuring continuity of treatment by standardizing the largest possible number of procedures/actions). For many scientific societies this is an indispensable requirement, and it has become one of the standards for the American College of Surgeons and the ASMBS in order to ensure correct clinical management in centers dedicated to the surgical treatment of obesity. The continuum of care consists of several distinct parts on which the team of healthcare professionals must work, establishing clear protocols that can be recorded in various formats (paper, online, etc.) Thus, the continuum of care comprises protocols for patients, guidelines for action during the perioperative period, follow-up standards, and rules for the establishment of patient support groups.

These protocols cover the entire period of patient care: from candidate identification and preoperative education to long-term follow-up, including all details related to the surgical process. These recommendations are regarded as dynamic and should be reviewed on a regular basis or if the results obtained by the center are not those expected. Recently, the possibility of protocolizing the referral of patients with complications to centers of reference/excellence has started to be considered under the concept of "sectorization of bariatric surgery".

The presentation discusses the current role of Telemedicine in the implementation of all these types of measures, especially after the COVID-19 pandemic. In summary, a comprehensive and updated review of how to develop one of the fundamental tools to provide the best care for patients who are candidates for bariatric surgery.