Patient-reported goals of care in the preoperative clinic: Barriers to and facilitators of patient values elicitation and documentation Journal Article
| Authors: | Rosen, R. Y.; Bartsch, C.; Thompson, E.; Letica-Kriegel, A. S.; Kaur, Y.; Ng, S.; Vaynrub, M.; Rosa, W. E.; Broach, V.; Epstein, A. S.; Nelson, J. E.; Nash, G. M.; Goldfrank, D. |
| Article Title: | Patient-reported goals of care in the preoperative clinic: Barriers to and facilitators of patient values elicitation and documentation |
| Abstract: | Background and Objectives: Infrequent preoperative goals of care (GOC) documentation leads to challenges in medical decision-making when patients experience postoperative complications. We evaluated the feasibility of enhancing GOC documentation through a patient portal-based values questionnaire. Methods: A patient values questionnaire (PVQ) was distributed to patients before their Gynecologic Surgical Oncology clinic appointments via an electronic health record (EHR)-based portal from June to October 2023. Surgeons and advanced practice providers were encouraged to address PVQ responses during clinic appointments. Patient acceptability surveys were sent to PVQ respondents and clinicians were interviewed to assess feasibility and acceptability. Results: PVQ response rate was 225/383 (59%); 29% of all patients had an established cancer diagnosis. Clinicians deemed preoperative GOC documentation important and the PVQ valuable to prepare for unexpected postoperative complications. Accessing questionnaire responses through the EHR was a technical barrier. Clinicians agreed that GOC should be addressed after diagnosis and treatment discussions, but before surgery. Ninety percent of patients felt comfortable discussing GOC at their first clinic appointment. Conclusion: Patient portals facilitate preoperative GOC documentation, however, clarifying and integrating values into care require ongoing discussions between clinicians and patients. Optimal timing of GOC elicitation is posttreatment planning and before surgery when the patient is most informed. © 2024 Wiley Periodicals LLC. |
| Keywords: | adult; aged; middle aged; major clinical study; preoperative care; cancer diagnosis; postoperative complication; genital neoplasms, female; questionnaire; preoperative period; medical record; surgery; medical documentation; patient reported outcome measures; patient care planning; female genital tract tumor; documentation; electronic health records; patient-reported outcome; clinician; convenience sample; surgical oncology; medical informatics; humans; human; male; female; article; electronic health record; surveys and questionnaires; goals of care; patient portals; advanced practice provider; videoconferencing; advanced directives |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 131 |
| Issue: | 4 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2025-03-15 |
| Start Page: | 607 |
| End Page: | 613 |
| Language: | English |
| DOI: | 10.1002/jso.27974 |
| PUBMED: | 39523936 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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