Publications by authors named "Timothy Siegel"

Article Synopsis
  • The study explored how palliative care (PC) consultations affect surgical patients' treatment choices, particularly regarding high-risk surgeries.
  • Researchers analyzed cases from 2020 to 2021, finding that PC consultation was linked to a higher occurrence of elevated-risk surgeries, contrary to the belief that PC might discourage such operations.
  • Results indicated that early involvement of PC in the surgical decision-making process can enhance disease management without negatively impacting patients' chances for surgery or hospice discharge.
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Article Synopsis
  • The paper emphasizes the importance of integrating surgical palliative care into the preoperative process for cancer patients, focusing on frailty and its implications for decision-making.
  • It highlights how palliative care principles, like symptom management and communication, have historically influenced discussions around oncologic surgery for both palliative and curative purposes.
  • The authors suggest that understanding frailty and using specific measurement tools can improve risk assessment and enhance the overall quality of care and outcomes for patients undergoing cancer surgery.
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The need to integrate palliative care (PC) training into surgical education has been increasingly recognized. Our aim is to describe a set of PC educational strategies, with a range of requisite resources, time, and prior expertise, to provide options that surgical educators can tailor for different programs. Each of these strategies has been successfully employed individually or in some combination at our institutions, and components can be generalized to other training programs.

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We describe our institutional approach to incorporating surgical palliative care education into the Undergraduate Medical Education, Graduate Medical Education and Continuing Medical Education spaces as a model to help guide similarly interested educators. We had a well-established Ethics and Professionalism Curriculum, but an educational needs assessment revealed that both the residents and faculty felt that additional training in palliative care principles was crucial. We describe our full spectrum palliative care curriculum, which begins with the medical students on their surgical clerkship and continues with a 4 week surgical palliative care rotation for categorical general surgery PGY-1 residents, as well as a Mastering Tough Conversations course over several months at the end of the first year.

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Objective: National guidelines have suggested that quality surgical care should incorporate effective palliative care (PC). Numerous barriers to surgeon participation remain and the domains of optimal surgeon participation are unclear.

Design: Eight semi-structured and multi-professional focus groups with 34 total participants.

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Background: A shortage of palliative care (PC) sub-specialists highlights the need for quality PC provided by treating surgeons, although no established curriculum exists to teach surgical residents PC skills. To guide curriculum development, we sought to determine what modifiable factors contribute to surgical residents successfully providing PC.

Methods: Eight focus groups with 34 participants were conducted.

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Background: Primary palliative care (PPC) is provided by the primary team and is essential for high-quality surgical care. There is a recognized PPC clinical and research need but little work on the optimal way to teach PPC to general surgery residents. We sought to define important factors of PPC pedagogy (i.

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Background: Devastating injuries require both urgent assessment by a trauma service and early attention to patients' goals of care (GOC). American College of Surgeons Trauma Quality Improvement Program (TQIP) guidelines recommend an initial palliative assessment within 24 hours of admission and family meeting, if needed, within 72 hours. We hypothesize that a primary palliative care-based practice improves adherence to TQIP guidelines in trauma patients.

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To address the need for increased exposure to the essential components of Palliative Care in our residency, we created a 4 week rotation in Surgical Palliative Care for all of our categorical interns. The rotation includes time on an interdisciplinary inpatient consultative palliative care service as well as time in the outpatient clinic and in the operating room with the Surgical Palliative Care attending. Most patients who are seen and evaluated have surgical issues, allowing exposure to the fundamental aspects of palliative care as they pertain to surgical practice across the continuum of healthcare settings.

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Burnout is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. All physicians, and especially surgeons, are at risk for developing burnout. The best strategies for mitigating burnout mimic a modern approach to medicine: the development of preventive practices to protect, promote, and maintain health and well-being.

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Introduction: There is increasing recognition that Surgical Palliative Care is an essential component of the holistic care of surgical patients and involves more than end-of-life care in the intensive care unit. General surgery residents are clinically exposed to patients with palliative care needs during each year of training, but few have a dedicated surgical palliative care curriculum. We undertook this educational needs assessment as the first step towards a longitudinal curriculum.

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