For example, a 2014 study conducted at the VA used a systematic frailty screening to identify at-risk surgical patients and refer them for a palliative care consultation. Palliative care can support prognostication for these patients, guide communication and decision-making, and put strategies in place to prevent post-operative delirium and other geriatric syndromes.
#Lyn may before surgery driver
One key driver of quality in surgery is careful patient selection and proactive risk management, an area in which palliative care specialists can be supportive by advocating for systematic pre-operative palliative care assessments for patients with complex risk profiles. Surgical chairs and division chiefs are motivated by concerns with quality and cost. Palliative care specialists who hope to work more closely with their colleagues in surgery can build more successful collaborations by considering the needs and perceptions of surgical departments, and framing palliative care as part of a solution to their challenges. And yet studies document that compared with medical patients, surgical patients with serious illness seldom receive specialist palliative care, although they have a higher likelihood of dying in the hospital and in the intensive care unit in the final year of life., The American College of Surgeons has called for surgeons to address the palliative care needs of seriously ill patients and families since at least 2005, emphasizing that palliative care can and should be delivered at any stage of disease and concurrently with curative or life-prolonging treatment. A systematic review of twenty-five palliative care interventions in surgical patients showed that preoperative decision-making interventions were associated with lower mortality, and other interventions were associated with improved symptoms, higher quality communication, reduced healthcare utilization and lower cost. The emerging literature on the outcomes of palliative care for surgical patients shows considerable promise.
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