Table 2.
Perioperative Palliative Care Trial Recommendations for Postoperative Consultation of Palliative Care Specialists for Patients in the Enhanced Usual Care Study Arm, Based on National Comprehensive Cancer Network Guidelines62
| Consider consultation of palliative care specialists in the following circumstances: |
| Patient/family or provider dissatisfaction with the care plan |
| Need of clarification of goals of care |
| Poor postoperative pain management and/or high nonpain symptom burden (i.e., distress, nausea, etc.) |
| Need for a palliative surgical procedure, such as palliative stenting, a venting gastrostomy, or a palliative-intent hepato-jenjunostomy |
| Frequent postoperative emergency room visits or hospitalizations |
| Prolonged postoperative ICU-level care |
| Communication barriers (i.e., language, literacy, physical barriers, cognitive impairment) |
| Patient or family request for hastened death |
| Difficult caregiver/family social circumstances and/or high risk for complicated bereavement issues |
| Compassion fatigue, moral distress, burnout, or distress related to complex care coordination among the clinician team |