Project Description
What Palliative Care can be 'Baked in' to a Preoperative Assessment? - Operationalizing Primary Palliative Care in Surgical Settings
Although surgery is safer than ever before, perioperative morbidity and mortality are not inconsequential and studies suggest that patients and their families suffer significant psychological and physical symptoms surrounding surgery and for weeks to months after surgery. Palliative care is patient- and family-centered care that symptomatically and psychosocially supports seriously ill patients and their families and optimizes quality of life, regardless of diagnosis, prognosis, or care goals. Multiple studies support that proactive palliative care improves outcomes meaningful to patients, families, and clinicians. Despite this evidence of benefit, nearly all of these studies were conducted in medical populations; there have been few studies translating proactive palliative care from a medical to a surgical population. Indeed, multiple studies even document surgeon and surgical culture resistance to palliative care involvement, particularly discussions that might concern goals of care and/or end-of-life care.
I hypothesize that perioperative palliative care for patients pursuing major surgery is likely beneficial to patients and family members. While my research group has grant proposals under review that explore the effectiveness of consultant palliative care in surgical populations, palliative care consultant work force shortages compel clinicians, researchers, advocates, and other stakeholders to also seek out ways to deliver primary palliative care to surgical patients. However, little is currently known about the feasibility and acceptability of integrating primary palliative care into standard perioperative routines. This TIA application proposes to (a) explore perioperative provider beliefs and attitudes about primary palliative care through qualitative in-depth interviews and (b) utilize this insight to develop and disseminate a cross-sectional survey to a national and diverse sample of perioperative providers.
Bio
Dr. Rebecca
A. Aslakson MD, PhD, FAAHPM, FCCM, is an Associate Professor and palliative care
doctor, critical care anesthesiologist, and researcher at The Johns Hopkins
University in Baltimore, MD. She completed anesthesia residency at
Massachusetts General Hospital in Boston and then surgical critical care
fellowship at The Johns Hopkins Hospital in Baltimore, where she has been faculty
since. Boarded in Hospice and Palliative Medicine in 2010, she has practiced
clinical palliative care at The Johns Hopkins Hospital (JHH) since inception of
the JHH palliative care unit in 2013. She obtained her PhD in Clinical
Investigations in 2013 from The Johns Hopkins Bloomberg School of Public Health
with her dissertation concerning integration of palliative care in intensive
care units. Triple boarded in anesthesia, surgical critical care, and
hospice and palliative medicine, Dr. Aslakson is an active researcher and her
research, academic, and clinical goal is to improve delivery of palliative
medicine, particularly to perioperative, critically ill, and minority populations.
She has published over 50 peer-reviewed papers, commentaries, and book chapters
and has received funding from organizations including the Patient-Centered
Outcomes Research Institute, AHRQ, the Foundation for Anesthesia Education and
Research, the National Palliative Care Research Center, and the Gordon and
Betty Moore Foundation. Dr. Aslakson has received multiple national awards for
her research work, including being named a 2015 AAHPM “40 under 40”
inspirational leader as well as having been given the 2015 AAHPM Early Career
Investigator Award. She was also named the 2014 American Society of
Anesthesiologists Presidential Scholar – an award given once a year by this
52,000 member society to the top anesthesia clinician researcher in the country;
this was the first time the award was given for palliative care-related
research work. Dr. Aslakson lives in Parkville, MD with her husband and two
young sons.
Email: raslaks1@jhmi.edu