Utilization of palliative care consultation service by surgical services

Posted On 2015-12-21 15:57:50

Palliative medicine is specialized medical care for patients with serious and advanced illness. The primary aim of palliative care is to improve the quality of life of both patients and their families through the appropriate relief of symptoms and the stress that serious illness entails (1). Palliative care is commonly equated with end-of-life care; however, palliative care is appropriate for patients at any stage of serious illness and can be provided along with curative-intent treatment. Defined in this way, palliative care is appropriate for many patients with surgical disease.

Although the American College of Surgeons has worked to improve knowledge and integration of palliative care among surgeons since 1998 (2), there remain significant knowledge gaps and lack of referral to palliative care by surgeons (3,4). Bradley et al. sought to increase palliative care consultations in a surgical intensive care unit (ICU) through the use of triggers to prompt palliative care consultation (5). They found that palliative care consultations were rare, both before and after the institution of triggers for consultations. A recent study of trauma surgeons found that approximately half of those surveyed felt that palliative care was underutilized (4). It is unclear if this finding is true among the broader range of surgical services.

A preliminary review of our palliative care consultation database revealed that consultations from surgical services comprise only 15% of the total consultations received by our multidisciplinary palliative medicine team. The goal of the current study was to examine the characteristics of surgical patients who received palliative care consultations and compare them to medical patients who received palliative care consultations during the same period of time. Based upon the results of the current study, we hoped to identify potential barriers to consultation and opportunities to improve utilization of palliative care consultation services (PCCS) among surgical services.