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A values-based conceptual framework for surgical appropriateness: an illustrative case report
Elizabeth J Lilley1, Angela M Bader2, Zara Cooper3
1The Center for Surgery and Public Health at Brigham and Women's Hospital, Boston, MA, USA; Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Annals of Palliative Medicine
|May 15, 2015
Summary
Surgical decisions must align with patient goals for appropriate care. Integrating palliative care can improve outcomes for older adults post-surgery, enhancing quality of life and functional status.
Area of Science:
- Geriatric Medicine
- Surgical Decision-Making
- Palliative Care
Background:
- Appropriate surgical decision-making requires aligning treatments with patients' goals and values.
- Informed surgical choices depend on patient understanding of recovery, quality of life, and functional outcomes.
Observation:
- An older patient experienced significant decline in health, function, and quality of life post-major surgery.
- The surgical intervention was not aligned with the patient's personal goals and priorities.
Findings:
- The case highlights unmet palliative care needs during postoperative recovery.
- There are opportunities for improved integration between palliative and postoperative care.
Implications:
- A conceptual framework is proposed for measuring surgical appropriateness based on patient goals, values, and preferences.
- This framework can guide clinical practice towards more patient-centered surgical care.
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