NAME: Carter Baumgartner

Assignment: Needs Statement Development

Part 1: Observations:

NAME: Carter Baumgartner

NAME: Carter Baumgartner

1. Translate problem into a need statement:
Problem: cost of the procedures is too dam high
Need Statement: Need for a cheaper alternative to the already present surgeries.
Verify accuracy of Need statement against problem:
accurate need statement toward the problem
Confirm that need is solution independent:
in no way implies a solution
Validate that the scope of the need is appropriate:
because more than a third of the population is affected providing a procedure that will be used by even
some of them will be some cool cash
Define need criteria and classify need:
Need Criteria: people want a cheaper alternative
Classify Need: blue sky in that it will need the development of an entirely new surgery.
2. Translate problem into a need statement:
Problem: faster the procedure the less bleeding there will be, some way to sew up and patch together
faster. The tool they used to stitch the stomach and intestine together worked really well.
Need Statement: Need for a faster stitching method.
Verify accuracy of Need statement against problem:
need statement appropriately respects the problem
Confirm that need is solution independent:
no solution implied
Validate that the scope of the need is appropriate:
with less bleeding the patient could get out earlier and feel better when they woke up and if it could be
used outside of gastric procedures then it would revolutionize surgery.
Define need criteria and classify need:
Need Criteria: maybe it wouldn't make that big of a difference to decrease the time by a few minutes
Classify Need: incremental, it may affect many things but it would have to be an amazing leap in
stitching technology to make a big enough difference to do much.

NAME: Carter Baumgartner

III.1 Disease State Fundamentals:
A. Normal physiology:
The normal function of this organ is to have a large pouch that runs into the small intestine as a straight
line with no obstructions. The stomach will start the digestion but is more used as just a staging area to
regulate the flow of food into the intestine via valves.
B. Pathophysiology:
Disease Function: In cases of extreme obesity the patient may not be able to lose the weight without
help, the procedure is designed to make it easier on the patient and speed up recovery. Being overweight
comes with a huge amount of problems including heart disease diabetes and even higher incidence of
some cancers. The extra weight also adds stress to joints and can cause chronic pain around the knees
and spine.
Causal Factors: Obesity is caused by consuming an excessive amount of calories over what is used
through activity. Some foods influence more than others with sugar being the main culprit of the
worldwide epidemic. The replacements first world countries have for sugar are being found, more and
more, to be worse than the natural thing and that they (namely high fructose corn syrup) are cheap
makes gaining weight easier for more people than ever before.
Disease Progression: Obesity usually progresses throughout a lifetime and it's affects won't be felt into
the victim's 40s or 50s. Although the most serious of symptoms do take a long time to come to fruition
the less severe forms of the disease come with their own problems as well.
C. Understand Clinical Presentation: (Profile the patient state associated with a disease)
As stated above the usual patient will be older and have had a sedated lifestyle with little to no activity
and have had plenty of access to food high in sugar.
D. Assess Clinical Outcomes (Elaborate on the morbidity and mortality rates associated with the disease)
Morbidity: the pain in their joints and decrease in the ability to move cause many life problems and
increases the severity of the disease, thus obesity fuels itself. Readmission rate of the band is 13%.
Mortality: from 112,000 to 365,000 deaths per year in the USA. .05% mortality for gastric band
procedure.
E. Gather Epidemiology Data: (Outline the incidence and prevalence of the disease, as well as dynamics in
the area)
Incidence: in 2009 the incidence of obesity was 4% of the American population and was .7% for
extreme obesity.
Prevalence: over a third of the adult population at 36%
Geographical Target: tends toward the deep south and around the great lakes with the upper north east
and the west having much less incidence.
F. Economic Impact:
with no insurance backing the patient up they will have to pay the 10-30 thousand dollars out of pocket
and with so many people being affected by the disease the cost toward the American people is very high,
an astonishing 190 billion dollars yearly.

NAME: Carter Baumgartner

III.2 Treatment Options:
A. Develop an Overview of Treatment Options:
1.
Bypass: cut the stomach to make a small pouch and then bring part of the small intestine up to
connect that pouch with the rest of the digestive tract.
2.
Band: use a flexible band to constrict the stomach so there is a small pouch on top that will do
the job of the stomach and hold the food to make the patient feel full without having to eat so much.
3.
Lifestyle changes: if the obesity isn't so bad that the patient cant move than a non surgical way of
fixing the problem is preferred. This includes eating better and exercising regularly.
B. Evaluate Clinical Treatment Profiles
1. Bypass: used in the more extreme situations and has a better impact on the patients weight with 65% of
the patient's body weight being lost. By far the most risky and it can't be undone.
2. Band: although the bypass is often the recommended surgery due to the severity of the disease
progression the band is used when the patient opts for the less invasive procedure. It is possible to undo
and it cheaper than the bypass alternative.
3. Lifestyle changes: easily the cheapest in that it is free, exercise and diet will do wonders for those who
catch obesity early enough to be able to make those changes.
C. Analyze Economic Treatment Profiles:
1. Bypass: most expensive surgery (and maybe not coincidentally the most recommended) the bypass
surgery is the hardest and the most invasive, however it also shows the best results the quickest.
Although the cost will differ based on the hospital it ranges from about $10,000 to $30,000. Because
insurance will not pay for any of these procedures as they are optional the cost is very important to
making the surgery work.
2. Band: a cheaper alternative to that above (around $10-15 thousand) and the ability to revert to normal
function seems to make this the preferred procedure for all but the most extreme of cases.
3. Lifestyle changes: while the band may be the preferred procedure because of the cost or other it will
have the biggest possible change, into normal weight for the patient. However it also takes work on
behalf of the patient and will take many years to lose the weight necessary to get out of the range of
obesity.
D. Utilization Treatment Profiles:
1. Bypass: used on the extreme cases and when the patient wants to get results fast. When money is no
object this is where you go.
2. Band: cheaper way to get similar results
3. lifestyle changes: how to get results the old fashioned way. And look, it's free, yay.

NAME: Carter Baumgartner

References:
http://www.cdc.gov/obesity/data/adult.html
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a20.htm
http://www.cdc.gov/PDF/Frequently_Asked_Questions_About_Calculating_Obesity-Related_risk.pdf
http://www.cdc.gov/chronicdisease/overview/
http://jama.jamanetwork.com/article.aspx?articleid=1555137
http://www.pophealthmetrics.com/content/9/1/56
https://utsa.blackboard.com/bbcswebdav/pid-1760544-dt-content-rid-8140893_1/courses/BME-3013-01T33449-201530/Revisional%20Bariatric%20Surgery-%20How%20Bad%20Can%20It%20Be-.mp4
http://www.bariatric-surgery-source.com/cost-bariatric-surgery.html
http://www.bariatric-surgery-source.com/cost-of-lap-band-surgery.html