Practicing Primary Palliative Care: A Comprehensive Guide

Edited by Dr. Pringl Miller, this issue of Surgical Clinics of North America delves into the importance of practicing primary palliative care in surgical settings. The collection of articles aims to provide insights into the benefits of a multidisciplinary team approach, the advantages of concurrent palliative care, and the significance of understanding patient outcomes that matter most.

Advantages of a Multidisciplinary Team Approach to Surgical Care

This article highlights the benefits of incorporating a multidisciplinary team approach in surgical care. It emphasizes how this strategy can lead to better patient outcomes, improved communication among healthcare providers, and enhanced patient satisfaction.

Concurrent Palliative Care: Clinical Outcome Benefits

This piece explores the clinical benefits of implementing concurrent palliative care in surgical settings. It discusses how this approach can improve symptom management, reduce hospital readmissions, and enhance the overall quality of life for patients.

Goals of Care Discussions: Understanding the Outcomes that Matter Most

This article focuses on the importance of engaging in goals of care discussions with patients. It underscores the need for healthcare providers to understand the outcomes that matter most to their patients, ensuring that care aligns with patient values and preferences.

Prognostic Tools and Shared Decision Making

This section examines the role of prognostic tools in shared decision making. It discusses how these tools can help healthcare providers and patients make informed decisions about treatment options, taking into account the patient’s prognosis and personal preferences.

Peri-Operative Advance Directives: DNR in the OR

This article addresses the importance of discussing and documenting advance directives, particularly do-not-resuscitate (DNR) orders, in the peri-operative period. It emphasizes the need for clear communication among healthcare providers, patients, and their families regarding end-of-life care preferences.

Optimizing Pain Control During the Opioid Epidemic

This piece delves into the challenges of managing pain in surgical patients amidst the ongoing opioid epidemic. It explores alternative pain management strategies and emphasizes the importance of a multidisciplinary approach to addressing pain while minimizing the risk of opioid misuse.

Wound and Stoma Care: Less is More

This article discusses the principles of wound and stoma care, highlighting the importance of a minimalist approach to promote healing and prevent complications. It emphasizes the role of the surgical team in providing comprehensive wound and stoma management.

Image-Guided Palliative Interventions

This section explores the use of image-guided interventions in palliative care. It discusses how these procedures can provide relief from symptoms such as pain, bleeding, and obstruction, improving the quality of life for patients with advanced illnesses.

Palliative Care and the Pregnant Surgical Patient

This article focuses on the unique challenges of providing palliative care to pregnant patients undergoing surgery. It emphasizes the need for a multidisciplinary approach, taking into account the patient’s preferences, the fetus’s well-being, and the potential risks and benefits of various treatment options.

Tracheostomies, PEGs, and Hemodialysis Vascular Access: When Are They Really Indicated?

This piece examines the indications for tracheostomies, percutaneous endoscopic gastrostomy (PEG) tubes, and hemodialysis vascular access in surgical patients. It discusses the potential benefits and risks of these interventions, highlighting the importance of careful consideration and shared decision making.

Post-Operative Recovery & Survivorship after Acute Hospitalization for Serious Life Limiting Illness

This article addresses the challenges of post-operative recovery and survivorship in patients who have undergone surgery for serious, life-limiting illnesses. It emphasizes the importance of comprehensive discharge planning, ongoing symptom management, and supportive care to promote optimal recovery and quality of life.

Spiritual Dimensions of Surgical Palliative Care

This section explores the spiritual aspects of palliative care in surgical settings. It discusses how addressing patients’ spiritual needs can enhance their overall well-being, improve coping mechanisms, and facilitate a more meaningful end-of-life experience.

Transitioning to Comfort-Focused Care at the End-of-Life

This article focuses on the process of transitioning patients from curative to comfort-focused care at the end of life. It emphasizes the importance of open communication, respect for patient autonomy, and provision of comprehensive supportive care to ensure a peaceful and dignified death.

Mitigating Burnout

This piece addresses the issue of burnout among healthcare providers involved in palliative care. It discusses strategies for mitigating burnout, including self-care, peer support, and organizational changes aimed at promoting a more sustainable work environment.

Surgical Palliative Care Education

This article highlights the importance of educating healthcare providers about the principles and practices of palliative care. It emphasizes the need for ongoing training and professional development to ensure that providers are equipped to deliver high-quality, patient-centered care.