Background

While the behavioral health team is often involved in the pre-surgical bariatric surgery process, the empirical literature to date has done little to address the potential role of the behavioral health team post-operatively. A 2018 article by Pearl, Allison, Tronieri, and Wadden suggested that patients may greatly benefit from post-operative engagement with behavioral health providers to address new or persistent barriers to success. Further, the post-operative engagement of psychologists can allow systematic issues that impact patients throughout the recovery process to be identified and assessed via needs assessments and quality improvement projects. At an urban bariatric and metabolic institute affiliated with a 378-bed medical center, a doctoral-level health psychologist, whose primary responsibilities include: completion of pre-surgical assessments, individual therapy, and facilitation of pre and post-operative group-based interventions, is embedded within the clinic. Yet, still a gap in behavioral health care was identified during the time between surgery date and initial follow-up appointment as patients struggled to adjust to the effects of surgery, the magnitude of the lifestyle changes required, and the interference of mental health symptoms with acute recovery. To address this gap, as of January 2018, the primary psychologist completes an inpatient assessment and brief intervention, as appropriate, for each patient one day post-operatively. Overall, patients and staff have been highly receptive to this process, and medical errors have been reduced. Further details regarding the process of developing this form of billable behavioral health rounding within a health care system will also be addressed.