The Ontario Bariatric Network "OBN" is comprised of 4 surgical centres of excellence and regional assessment and treatment centres "RATC". RATC's provide surgical assessment and post-operative support closer to home. The OBN consists of a centralized provincial referral portal. Patient referrals are processed centrally and transferred to the closest centre. The Sudbury RATC provides service to those living in North Eastern Ontario or Local Health Integration Network (LHIN) 13. LHIN13 covers 400,000 sq km and has a culturally diverse population of 570,000. One third of its population lives in rural areas compared to 15 per cent provincially. Twenty five per cent of residents are Francophone while 10 per cent are aboriginal. Establishing a new bariatric clinic servicing a large rural geographical area has its rewards but many challenges. Some were known in advance, some were discovered along the way, and others came as a surprise. Challenges with professional staff availability and recruitment were expected but required ongoing creativity. Breaking the barrier of negativity and myths around gastric bypass and involving patient's primary care providers from the first day has been instrumental in improving patient care in both the pre-op and long term post-op period. Developing program protocols and clinic flows that balanced patient and clinicians needs and surgical funding targets was more complex than expected requiring significant clinician input change and flexibility. Moving into our in to our second year of operation we had to evolve our processes to meet the needs of our patients many of whom traveling is physically difficult. To better meet our patient's needs we are continuing to expand and develop our outreach using Telemedicine in creative ways allowing for access to care closer to home.
MacKinnon, B. (2013). Establishing a Regional Bariatric Surgical Program in North Eastern Ontario. Canadian Journal of Diabetes, 37, S247. https://doi.org/10.1016/j.jcjd.2013.03.384