Perioperative integration of palliative care and urology for patients with serious urologic illness: A qualitative need finding inquiry

Perioperative integration of palliative care and urology for patients with serious urologic illness: A qualitative need finding inquiry
Journal of Pain and Symptom Management; Bhagvat J Maheta, Nainwant K Singh, Jonathan Bergman, Cati G Brown-Johnson, Alekhya Gunturi, Nickolas Interrante, John T Leppert, Karl A Lorenz, Isabella G Raspi, Karleen F Giannitrapani; 3/25
Many urologic serious illnesses are treated with surgical procedures, which may put patients at a further risk of diminished quality of life. [We] purposefully sampled urologists, palliative care physicians, and clinical team members at fourteen geographically distributed Veteran Health Administration sites. We identified one general overall theme, to "change culture" so that PC [palliative care] is not a "last resort" ... Utilizing telehealth and team member role expansion when discussing the initial diagnosis, with surgery as a potential treatment option, allows for multiple conversations ... Creating a process to ensure goal of care conversations occur, since "urologic procedures can have complications that significantly impact quality of life" ... [and] during the pre-operative visits, interdisciplinary input and evaluation of the patient prior to surgery allows the patient to "have a sort of joint meeting with us and the urologist."