TY - JOUR
T1 - Development and perception of surgery-specific goals of care discussions in the preoperative setting
T2 - A learning pilot
AU - Letica-Kriegel, Allison S.
AU - Rosen, Roni
AU - McNeil, Nita
AU - Thompson, Errika
AU - James, Monique
AU - Broach, Vance
AU - Roche, Kara Long
AU - Riportella, Michaela
AU - Ng, Susan
AU - Bernal, Camila
AU - Vaynrub, Max
AU - Downey, Robert
AU - Voigt, Louis
AU - Epstein, Andrew S.
AU - Nelson, Judith
AU - Goldfrank, Deborah
AU - Nash, Garrett M.
N1 - Publisher Copyright:
© 2024 Wiley Periodicals LLC.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - advance care planning
KW - patient values
KW - person-centered care
KW - surgical goals of care
KW - surgical palliative care
UR - http://www.scopus.com/inward/record.url?scp=85189503077&partnerID=8YFLogxK
U2 - 10.1002/jso.27632
DO - 10.1002/jso.27632
M3 - Article
C2 - 38549286
AN - SCOPUS:85189503077
SN - 0022-4790
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
ER -