Surgical and Perioperative Palliative Care: Updates from 2018 (TH307)

Abstract

•Cite recently published literature on evidence and best practices for palliative care interventions in surgical patients.•Discuss areas of active surgical palliative care investigation in the context of common treatment dilemmas faced while caring for seriously ill patients with surgical disease.•Describe the application of surgical palliative care research and its impact on patient, family, and caregiver outcomes using concrete examples. Recent years have seen rapid expansion of the evidence base supporting the implementation of palliative care programs across health systems, ranging from the community to the intensive care unit. Surgical patients face uniquely complex decisions, significant symptom burden, and prognostic uncertainty, and their needs warrant surgery-specific palliative care delivery. Different models have been developed to address these needs, including communication training for surgical providers, embedded inpatient and outpatient surgical palliative care programs, improved prognostication models, and advanced care planning interventions. The core principles of surgery and anesthesiology closely mirror those of palliative care, and the intersection between them is characterized by an increasing annual volume of emerging research. This session will summarize landmark peer-reviewed papers on surgical palliative care published in 2018. The authors will search PubMed and hand-review key journals in surgery, anesthesiology, critical care, and palliative medicine to identify and select articles for inclusion based on journal impact factor and broad interest to the AAHPM/HPNA audience. Using a case-based format to provide clinical context, the panel will present literature drawn from the following topic domains: communication around surgical decision-making, frailty and surgical risk assessment, perioperative advanced care planning, specialty palliative care triggers and delivery models for surgical patients, innovative caregiver and clinician education strategies, and novel symptom management approaches applicable to surgical patient populations. The presenters consist of an HPM fellowship-trained practicing general surgeon and HPM-focused anesthesiologist, an HPM social worker with a specialized practice in surgical oncology and critical care, and an HPM physician whose clinical and academic interests are focused on surgical patient populations. The cross-specialty representation of the panelists ensures a diversity of perspectives that will enrich the audience’s appreciation for the role of surgical palliative care research in improving the outcomes of patients and families facing surgical illness across an array of care settings.