Surgical Health Scientists Aligning Research with Patient Priorities (SHARPP)
Research Projects
With a team that includes more than a dozen researchers and collaborators, the Geriatrics and Serious Illness in Surgery Program’s project portfolio continues to expand, covering a wide range of research topics and implementation of strategies dedicated to making surgical care more patient-centered and developing protections for vulnerable groups. Projects include: a pilot study on collecting patient-reported outcome measures for older Emergency General Surgery (EGS) patients; secondary data analysis to describe the 12-month healthcare trajectory and hospice utilization among older trauma and EGS patients; identifying best practice guidelines for older injured adults; developing Quality of Life and functional measures for older patients and incorporating them into the National Surgical Quality Improvement Program (NSQIP); and ensuring that shared decision making is routinely incorporated into the Perioperative Medicine Curriculum during anesthesia residents’ Weiner Center rotation at BWH.
Over one million older adults with serious illness have major surgery or severe trauma each year, and palliative care delivered alongside surgical care can help relieve patient suffering, improve post- operative outcomes, and reduce healthcare utilization. Although seriously ill surgical patients benefit from palliative care, they are less likely than other patients to receive it. This research project provides an innovative and layered examination of the role of palliative care in surgery in order to directly inform bedside clinical decisions and the implementation of targeted palliative care interventions to improve care for older seriously ill surgical patients.
NIH/NIA # 10297423
Emergency general surgery for conditions such as small bowel obstruction and cholecystitis are among the most common and morbid operations performed in older adults. As the population ages, increasing numbers of are expected to undergo these burdensome procedures, yet little is known about outcomes beyond 30-day mortality which are particularly relevant to older patients. The goal of this research project is to fully characterize the clinical trajectories, healthcare needs, illness experience and end-of-life care of older patients during the first year after emergency general surgery.
NIH/NIA # 5K76AG054859-05
Sponsor: National Palliative Care Research Center (NPCRC)
Emergency general surgery for conditions such as small bowel obstruction and cholecystitis are among the most common and morbid operations performed in older adults. As the population ages, increasing numbers of are expected to undergo these burdensome procedures, yet little is known about outcomes beyond 30-day mortality which are particularly relevant to older patients. The goal of this research project is to fully characterize the clinical trajectories, healthcare needs, illness experience and end-of-life care of older patients during the first year after emergency general surgery.
NIH/NIA # 9927967
This research project aims to accelerate the development of bold, nursing-driven interventions targeting the needs of groups and communities who have historically struggled against oppression, discrimination and indifference. The project will help ensure that nurse care coordinators and patients who are particularly vulnerable to COVID-19 have opportunities to conduct serious illness conversations and discuss the patient’s values and goals.
Sponsor: The Rita and Alex Hillman Foundation
Publications
Udelsman BV, Govea N, Cooper Z, Chang DC, Bader AM, Meyer MJ. Concordance in advance care preferences among high-risk surgical patients and surrogate health care decision makers in the perioperative setting. Surgery 2020;167:396-403.
Abbett SK, Urman RD, Bader AM. Shared decision making: creating pathways and models of care. Best Practice Res Clin Anaesth 2020;34(2):297-301.
Cooper Z, Hevelone N, Sarhan M, Quinn T, Bader AM. Identifying patient characteristics associated with deficits in surgical decision making. J Patient Safety 2020;16(4):284-288.
Sokas C, Yeh IM, Coogan K, Bernacki R, Mitchell S, Bader A, Ladin K, Palmer JA, Tulsky JA, Cooper Z. Older adult perspectives on medical decision making and emergency general surgery: “ It had to be done.” J Palliative Sympt Man; In press.
Udelsman BV, Govea N, Cooper Z, Chang DC, Bader AM, Meyer M. Variation in patient-reported advanced care preferences in the preoperative setting. Anesth Analg 2020;(Jan); PMID 31923000
Beutler S, McEvoy M, Ferrari L, Vetter TR, Bader AM. The future of anesthesia education: developing frameworks for perioperative medicine and population health. Anesth Analg 2020;130(4):1103-1108.
Susano MJ, Grasfield RH, Friese M, Rosner B, Crosby G, Bader A, Kang JD, Smith TR, Groff MW, Chi JH, Grodenstein F, Culley DJ. Brief preoperative screening for frailty and cognitive impairment predict delirium following spine surgery. Anesthesiology 2020;133:1184-91.
Nelsen BR, Chen YK, Lasic M, Bader AM, Arriaga AF. Advances in anesthesia education: increasing access and collaboration in medical education, from E-learning to telesimulation. Curr Opin Anaeesthesiol 2020 33(6)800-807.
Tankard KA, Park B, Brovnan EY, Bader AM, Urman RD. The impact of preoperative intravenous iron therapy on perioperative outcomes in cardiac surgery: A systematic review. J Hematol 2020;9(4):97-108.
Sokas C, Rowan JR, Dalton M, Coogan K, Bader AM, Bernacki RE, Orkaby A, Cooper Z. Association between patient reported frailty and non-home discharge among older adults having Surgery. J Amer Geriatrics Society 2020; October: 2909-2913.
Tanious M, Lindvall C, Cooper Z, Tukan N, Peters S, Streid J, Fields K, Bader AM. Prevalence, management and outcomes related to preoperative medical orders for life sustaining treatment (MOLST) in an adult surgical population. Annals of Surgery.
Cooper L, Abbett SK, Feng A, Bernacki RE, Cooper Z, Urman RD, Frain LN, Edwards AF, Blitz JD, Javedan H, Bader AM. Launching a geriatric surgery center: Recommendations from the society for perioperative assessment and quality improvement (SPAQI). Journal of the American Geriatrics Society 2020;68(9):1941-1946.
Arias F, Wiggins M, Urman RD, Armstrong R, Pfeifer K, Bader AM. Licon DJ, Chopra A, Price CC. Rapid in-person cognitive screening in the preoperative setting: Test considerations and recommendations from the Society for Perioperative Assessment and Quality Improvement. J Clin Anesth 2020;62(June): PMID 32018131.
Minami CA, Cooper Z. The Frailty Syndrome: A Critical Issue in Geriatric Oncology. 2. Crit Care Clin. 2021 Jan;37(1):151-174. doi: 10.1016/j.ccc.2020.08.007. Epub 2020 Oct 28.
McKenna L, Bader AM. Palliative care interventions for pediatric patients: a systematic review. Pediatric Anesthesia and Critical Care (PACCJ) 2020; 8(2):65-72.
Lee, Katherine C, Udelsman, Brooks V, Streid, Jocelyn, Chang, David C, Salim, Ali, Livingston, David H, Lindvall, Charlotta, and Cooper, Zara. Natural Language Processing Accurately Measures Adherence to Best Practice Guidelines for Palliative Care in Trauma. Journal of Pain and Symptom Management 59, no. 2 2020: 225-32.e2.
Sokas, Claire, Lee KC, Sturgeon D, Streid J, Lipsitz SR, Weissman, JS, Kim DH, Cooper Z. Preoperative Frailty Status and Intensity of End-of-Life Care Among Older Adults After Emergency General Surgery. Journal of Pain and Symptom Management. 2020 Nov 16. PMID: 33212144
Udelsman, Brooks V, Lee, Katherine C, Lilley, Elizabeth J, Chang, David C, Lindvall, Charlotta, & Cooper, Zara. Variation in Serious Illness Communication among Surgical Patients Receiving Palliative Care. Journal of Palliative Medicine. 2020. 23(3), 411-414.
