Roni Y Rosen, Christan Bartsch, Errika Thompson, Allison Letika-Kreigel, Yashjot Kaur, Susan Ng, Maksim Vaynrub, William E Rosa, Vance Broach, Andrew S Epstein, Judith E Nelson, Garrett M Nash, Deborah Goldfrank
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引用次数: 0
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.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.