Development and perception of surgery-specific goals of care discussions in the preoperative setting: A learning pilot Journal Article
| Authors: | Letica-Kriegel, A. S.; Rosen, R.; McNeil, N.; Thompson, E.; James, M.; Broach, V.; Long Roche, K.; Riportella, M.; Ng, S.; Bernal, C.; Vaynrub, M.; Downey, R.; Voigt, L.; Epstein, A. S.; Nelson, J.; Goldfrank, D.; Nash, G. M. |
| Article Title: | Development and perception of surgery-specific goals of care discussions in the preoperative setting: A learning pilot |
| Abstract: | Background: Goals of care discussions are infrequently documented in the preoperative period. Furthermore, documentation does not consistently address what matters most to patients, although patient values (PV) are central to person-centered care. Methods: A multidisciplinary working group was formed. An electronic note comprised of (1) topics of discussion, (2) PV, and (3) advance care planning (ACP), was created and embedded into existing note templates for Gynecologic Surgical Oncology. Surgeons and advanced practice providers (APPs) were educated to conduct and document these conversations in preoperative clinic for patients undergoing cancer surgery for a pilot period. Data were collected regarding usage of the template. Focus groups with surgeons, APPs, and patients were conducted. Qualitative analysis was performed on transcripts. Results: During the pilot, 7 surgeon/APP teams utilized the template on a total of 55 notes. Average number of notes completed per surgeon was 7.8 (SD 8.5). Forty-six notes (84%) included topics of discussion, 15 (27%) included PV, 4 (7%) included ACP. Qualitative analysis of focus group transcripts revealed that clinicians and patients perceived the initiative to be useful and important, although implementation barriers were identified. Conclusion: Creating a surgery-specific GOC template is feasible. Iterative revisions are needed to increase utility in clinic workflows. © 2024 Wiley Periodicals LLC. |
| Keywords: | controlled study; aged; cancer surgery; preoperative care; palliative therapy; psychology; motivation; information processing; genital neoplasms, female; preoperative period; pilot study; pilot projects; surgeon; surgery; gynecologic surgical procedures; gynecologic surgery; focus groups; patient care planning; female genital tract tumor; perception; qualitative analysis; learning; surgeons; procedures; clinician; advance care planning; workflow; humans; human; female; article; surgical palliative care; advanced practice provider; person-centered care; patient values; person centered care; surgical goals of care |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 129 |
| Issue: | 7 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2024-06-01 |
| Start Page: | 1384 |
| End Page: | 1389 |
| Language: | English |
| DOI: | 10.1002/jso.27632 |
| PUBMED: | 38549286 |
| PROVIDER: | scopus |
| PMCID: | PMC11566104 |
| DOI/URL: | |
| Notes: | Article -- MSK author Maksim Vaynrub's first name is listed as 'Max' on the original publication -- Source: Scopus |
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